The COVID-19 vaccine distribution process leverages existing networks, processes and partnerships to make vaccines available across America as quickly and safely as possible. Each week, as doses are released by companies for distribution, planes and trucks transport the vaccine to states and jurisdictions across the country.

Medicare payment rates for COVID-19 vaccine administration will be $28.39 to administer single-dose vaccines. For a COVID-19 vaccine requiring a series of 2 or more doses, the initial dose(s) administration payment rate will be $16.94, and $28.39 for the administration of the final dose in the series. These rates recognize the costs involved in administering the vaccine, including the additional resources involved with required public health reporting, conducting important outreach and patient education, and spending additional time with patients answering any questions they may have about the vaccine. These rates will also be geographically adjusted.

Note: these rates don’t apply for entities that are reimbursed for vaccines at reasonable cost.

People with Medicare pay nothing for COVID-19 shots:

• No copayment/coinsurance

• No deductible

How to Bill for COVID-19 Shot Administration – Medicare Only

• You’ll be able to bill on single claims for COVID-19 shot administration, or submit claims on a roster bill for multiple patients at one time.

• When COVID-19 vaccine doses are provided by the government without charge, only bill for the vaccine administration. Don’t include the vaccine codes on the claim when the vaccines are free.

• If you participate in a Medicare Advantage Plan, submit your COVID-19 claims to Original Medicare for all patients enrolled in Medicare Advantage in 2020 and 2021.

Payment Allowances and Effective Dates for COVID-19 Vaccines and their Administration during the Public Health Emergency:

* Since we anticipate that providers, initially, will not incur a cost for the product, CMS will update the payment allowance at a later date.  Providers should not bill for the product if they received it for free.

Schedule your 1:1 consultation today for the most up to date list of billing codes, payment allowances and effective dates with the Dagger HealthCare Team! Please do not hesitate to reach out for any specific questions that we may be able to help you navigate the ever changing dynamics to COVID-19 Vaccine distribution, documentation, and billing guidelines.