Home Health Care CMS ups Medicare payment for at-home vaccinations to about $75 per dose

CMS ups Medicare payment for at-home vaccinations to about $75 per dose


The Centers for Medicare & Medicaid Services is increasing the payment provided for administering Covid-19 vaccinations to Medicare beneficiaries at home.

The agency will now pay an additional $35 per dose for Covid-19 vaccine administration in a Medicare beneficiary’s home, increasing the total payment amount from approximately $40 to around $75 per dose. For a two-dose vaccine administered at home, this results in a total payment of about $150, up $70 from the current rate. The payment rates will be geographically adjusted based on where the service is provided.

The additional reimbursement accounts for the clinical time needed to monitor a beneficiary after the vaccine is administered, as well as the upfront costs associated with administering it at home.

Through this payment increase, the agency aims to encourage at-home immunizations for those who may have difficulty accessing a vaccine site and thereby boost vaccination rates.

“CMS is committed to meeting the unique needs of Medicare consumers and their communities — particularly those who are homebound or who have trouble getting to a vaccination site,” said CMS Administrator Chiquita Brooks-Lasure in a news release. “That’s why we’re acting today to expand the availability of the Covid-19 vaccine to people with Medicare at home.”

There are approximately 1.6 million adults, 65 years and older, who may have trouble accessing Covid-19 vaccinations because they have difficulty leaving home, CMS estimates.

Further, CMS released guidance for vaccine administrators, which provides recommendations on safely storing, handling and administering doses to homebound individuals, especially those living in hard-to-reach areas.

The hike in payment for vaccine administration at home comes amid the Biden administration’s push to increase vaccination rates nationwide. The administration recently dubbed June as the National Month of Action with the aim of getting at least one shot in the arms of 70% of U.S. adults by July 4th.

Overall, vaccination rates among adults aged 65 and older are high, with 71.9% having been fully vaccinated as of May 12, according to a data brief by the Kaiser Family Foundation. But rates vary widely across states — from 57.6% in Utah to 87% in Vermont — and across counties. Counties in the south and those with a higher share of seniors living in poverty had lower immunization rates than the average county Covid-19 vaccination rate of 68.9% among seniors.

Photo: PixelsEffect, Getty Images












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