Medicare to Double Payment to Administer Vaccines

COVID-19_Vaccine_Distribution_Meeting

Medicare will pay physicians and practices that administer COVID-19 vaccines $40 per dose – nearly double the current payment, the Centers for Medicare & Medicaid Services has announced. 

Practices and physicians are required to administer vaccines to eligible recipients free of charge. 

Medicare will pay the associated costs for administering COVID-19 vaccines using three separate current procedural codes (CPT) for doses administered after March 15, 2021:

  • 91300 for Pfizer/BioNTech
  • 91301 for Moderna
  • 91303 for Janssen

Find more vaccine coding details in a guide published by the American Medical Association.

“The exact payment rate for administration of each dose of a COVID-19 vaccine will depend on the type of entity that furnishes the service and will be geographically adjusted based on where the service is furnished,” CMS said.   

More than 5 million people in Texas have received at least one dose of a COVID-19 vaccine, and more than 2.7 million are fully vaccinated, according to the Texas Department of State Health Services.

There are numerous requirements and steps physicians and health care facilities must adhere to in order to administer vaccines.

If you are enrolled in Medicare or plan to enroll to administer vaccines, keep up to date on coding, billing, and payment requirements on the CMS website

Find more tools, resources, and information on TMA’s COVID-19 Resource Center, which is continually updated. 

Correction: This story has been edited to provide the correct CPT codes for each COVID-19 vaccine.

CPT copyright American Medical Association. All rights reserved.

 

Last Updated On

April 01, 2021

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