CMS offers additional Medicare payments for at-home Covid-19 vaccinations

In an effort to further boost Covid-19 vaccinations, the Centers for Medicare & Medicaid Services is increasing payments for shots administered at smaller group homes, assisted living facilities and other group living situations.

Now, vaccine providers can receive $35 more per vaccination when administering shots to more than one Medicare beneficiary, and up to a total of five, in the same home or group living setting.

CMS currently pays about $40 for administering a single dose of the Covid-19 vaccine and an additional $35 when the vaccine is administered at home for certain beneficiaries. Previously, the agency only paid $40 for each shot plus a one-time payment of $35 for at-home administration, even when more than one Medicare patient in a group living situation was receiving the vaccine.

But, effective Aug. 24, if a provider administers a dose of the vaccine on the same date to two Medicare patients in the same home, Medicare will include an additional $35 for the at-home administration and pay approximately $150.

The increased payment only applies when fewer than 10 Medicare patients receive a shot.

So, for example, Medicare will pay approximately $535 for administering the shot on the same date to nine Medicare patients in the same home or communal living space.

On the other hand, if a vaccine dose is administered on the same date to 12 patients in the same communal space, Medicare would pay $515.

“We are doing everything we can to remove barriers to vaccinations, including ensuring appropriate payment levels for vaccine providers to connect with more people in their communities who are unable to receive the vaccine in a traditional setting,” said CMS Administrator Chiquita Brooks-LaSure in a news release.

As of Monday, 171.1 million people in the U.S. are fully vaccinated, a little over half (51.5%) of the total population, according to data from the Centers for Disease Control and Prevention.

Last month, new Covid-19 cases started rising again, especially in states where vaccination lagged. This was largely driven by the Delta variant of the coronavirus.

But, now that the vaccine co-developed by Pfizer and BioNTech has full FDA approval, federal officials are hopeful that vaccination rates will increase.

Photo: Pornpak Khunatorn, Getty Images