CMS Expands Payments for In-Home COVID-19 Vaccine Administration

The Centers for Medicare & Medicaid Services (CMS) took additional steps this week to make COVID-19 vaccines available to Medicare beneficiaries who have difficulty leaving their homes or are otherwise hard-to-reach.

Under the new policy, Medicare will pay an additional $35 per dose for in-home vaccine administration, increasing the total payment amount to nearly $75 per dose. For a two-dose vaccine, this results in a total payment that is approximately $70 more than the current rate.

While people with Medicare can get vaccinated at a retail pharmacy, their physician’s office, or a mass vaccination site, some beneficiaries who live in the community—including approximately 1.6 million older adults—may not be able to access these locations on their own or without considerable effort.

The new payment rate is intended to better serve this cohort, by incentivizing providers to meet them where they are. According to the announcement, the update is part of the administration’s overall strategy to “make it as easy as possible for all Americans to get vaccinated.”

To help providers navigate this shift, the Centers for Disease Control and Prevention (CDC) issued guidance on safe and effective in-home vaccination management.

Like all COVID-19 vaccines, those provided in-home to people with Medicare will be free of charge. Regardless of where they receive the vaccine, Medicare beneficiaries pay nothing out-of-pocket; there is no applicable copayment, coinsurance, or deductible.

Looking for a vaccine? Unvaccinated individuals and those assisting friends and family can:

1. Visit vaccines.gov (English) or vacunas.gov (Spanish) to search for vaccines nearby.
2. Text GETVAX (438829) for English or VACUNA (822862) for Spanish for near-instant access to details on three vaccine sites in the local area.
3. Call the National COVID-19 Vaccination Assistance Hotline at 1-800-232-0233 (TTY: 1-888-720-7489) for assistance in English and Spanish.

Read more from Medicare Interactive about Medicare coverage and COVID-19.

Read more from CMS about the payment change.