Biden admin to boost Medicare reimbursement for COVID-19 vaccinations

COVID-19 vaccine
The Biden administration will increase the Medicare reimbursement for COVID-19 vaccinations from $28 a shot to $40. (Getty/Meyer & Meyer)

The Biden administration is increasing the COVID-19 reimbursement for providers to $40 per shot, up from $28, for single-dose vaccines and $80 for two-dose vaccines.

The goal of the change is to better incentivize providers to perform outreach to communities in hard-to-reach areas and to help providers with extra funding.

“Medical professionals on the front lines of this vaccination effort need to be taken care of,” said Andy Slavitt, senior COVID-19 adviser to the White House, during a briefing Monday.

He added that the additional level of reimbursement could increase vaccination rates by providers to “make extra effort to meet people where they are.”

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Vaccinations will continue to be free for patients regardless of insurance status.

The exact payment rate for "administration of each dose of a COVID-19 vaccine will depend on the type of entity that furnishes the services and will be geographically adjusted based on where the service is furnished," the Centers for Medicare & Medicaid Services (CMS) said in a press release Monday.

CMS also said it is updating toolkits for providers, states and insurers to help swiftly administer their payment systems with the new rates. 

"These resources are designed to increase the number of providers that can administer the vaccine that can administer the vaccine, ensure adequate payment for administering the vaccine to Medicare beneficiaries, and make it clear that no beneficiary, whether covered by private insurance, Medicare or Medicaid, should pay cost-sharing for the administration of the COVID-19 vaccine," the agency added.

The $1.9 trillion relief package signed by President Joe Biden last week also enables the federal government to cover 100% of the cost for vaccinations for those on Medicaid and the Children’s Health Insurance Program to help ensure states do not shoulder any of the cost.

The package also includes $7.5 billion to the Centers for Disease Control and Prevention to distribute and purchase new doses of the vaccine.

The push to increase reimbursements also comes after reports of independent primary care practices being largely left out of the rollout of vaccinations in favor of larger sites and retail pharmacy chains.