The Centers for Medicare & Medicaid Services more than doubled the reimbursement for COVID vaccines as of March 15, 2021; the payment rate is now approximately $40 per dose. For up-to-date information on payment rates for Medicare, see COVID-19 Vaccines and Monoclonal Antibodies | CMS . If your practice is offering COVID vaccines, you can bill for the shot administration. The process is seamless, but let’s review some tips to ensure that you are getting paid for your hard work:
Submit a single claim per patient – or a roster bill to Medicare for five or more patients. For more information about roster billing for the vaccine, see https://www.cms.gov/medicare/covid-19/medicare-billing-covid-19-vaccine-shot-administration. For more information about billing for the vaccine for non-Medicare patients, query the payer’s website.
If the vaccine was free to you, charge only the administration.
For Medicare Advantage patients, submit your claims to your Medicare contractor as Original Medicare under Part B coverage using the patient’s Medicare Beneficiary Identifier (MBI). If the patient doesn’t have the MBI, gather the patient’s name, birthdate, and social security number; use this handy guide to query for the MBI. https://www.cms.gov/Medicare/New-Medicare-Card/Providers/MACs-Provider-Portals-by-State.pdf
To get paid for uninsured patients at the Medicare rate; submit the claim for the vaccine administration to: https://www.hrsa.gov/CovidUninsuredClaim.
If you’re having issues with scheduling in your practice management system, download free vaccine scheduling software here: https://www.blockitnow.com/covid.
