The Centers for Medicare & Medicaid Services (CMS) recently increased Medicare’s reimbursement rates for hospitals, pharmacies, physicians, and others for administering COVID-19 vaccines. These changes by CMS are in support of the administration’s efforts to ensure that all Americans can be vaccinated against COVID-19 as soon as possible.
The pandemic has certainly resulted in rapid changes to the regulatory environment, but Coronis Health has kept abreast of all CMS compliance topics and the best practices available to increase client cash flow and maximize revenue. With offices nationwide, Coronis is a leader in billing for COVID-19 tests and vaccines. We are up to date with the latest vaccine codes and remain constantly vigilant of new compliance requirements so we can share timely, relevant, and accurate information about medical billing. We don’t just help you get money. We help you financially grow.
COVID Vaccination Opportunities
As of March 24, 2021, the US has administered a total of 128 million vaccines, and 45,533,962 of the recipients have already been fully vaccinated, according to the CDC.
The higher payment rates for COVID-19 vaccinations not only give your facility the ability to bill a higher amount for vaccine administration, but it also means you have a greater capacity to increase the number of vaccine administrations each day, establish more vaccination sites, conduct wider patient outreach, or even hire additional staff.
Increased Reimbursements for Administered Vaccines
Effective March 15, the national average payment for the administration of COVID-19 vaccines is $40 for each dose. Meaning, the average payment rose from $28 to $40 for the administration of single-dose vaccines and $45 to $80 for the administration of two-dose vaccines.
“The exact payment rate for the 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 says.
CMS representatives also expect commercial carriers to maintain reasonable rates compared to the existing market rates.
There is still a large percent of the country that has yet to receive vaccinations, indicating a long road ahead for the vaccine rollout. The implementation of the new reimbursement rates aims to benefit providers and communities. Andy Slavitt, White House senior advisor for COVID response, says that the increase in reimbursement “will make it easier for more healthcare providers to get out into communities and give more COVID shots to people in need.”
Furthermore, the American Medical Association (AMA) had previously advocated for an increase in the payments for COVID-19 vaccine administration. Dr. Susan R. Bailey, AMA’s president says, “The updated rate reflects new information about the costs involved in administering the vaccine for different types of providers and suppliers and the additional resources necessary to ensure the vaccine is administered safely and appropriately.”
CMS is also prepared to update a set of toolkits for states, providers, and insurers to further aid in the swift and more efficient administration of the vaccines with the new payment rates.
“These resources are designed to increase the number of providers 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,” CMS shared.
New Vaccine Codes
Your facility should update your COVID-19 vaccine administration codes in your billing system to ensure you receive the increased payment rates. Read our COVID-19 Vaccine Codes blog to learn more about new vaccination codes and frequently asked questions.
SARSCOV2 VAC 30MCG/0.3ML IM – Phizer – Pfizer-Biontech Covid-19 Vaccine
ADM SARSCOV2 30MCG/0.3ML 1st – Pfizer – Pfizer-Biontech Covid-19 Vaccine Administration – First Dose
ADM SARSCOV2 30MCG/0.3ML 2nd – Pfizer – Pfizer-Biontech Covid-19 Vaccine Administration – Second Dose
SARSCOV2 VAC 100MCG/0.5ML IM – Moderna – Moderna Covid-19 Vaccine
ADM SARSCOV2 100MCG/0.5ML1ST – Moderna – Moderna Covid-19 Vaccine Administration – First Dose
ADM SARSCOV2 100MCG/0.5ML2ND – Moderna – Moderna Covid-19 Vaccine Administration – Second Dose
SARSCOV2 VAC 5X10^10VP/.5MLIM – AstraZeneca – AstraZeneca Covid-19 Vaccine
ADM SARSCOV2 5X10^10VP/.5ML 1 – AstraZeneca – AstraZeneca Covid-19 Vaccine Administration – First Dose
ADM SARSCOV2 5X10^10VP/.5ML 2 – AstraZeneca – AstraZeneca Covid-19 Vaccine Administration – Second Dose
SARSCOV2 VAC AD26 .5ML IM – Janssen – Janssen Covid-19 Vaccine***
ADM SARSCOV2 VAC AD26 .5ML – Janssen – Janssen Covid-19 Vaccine Administration***
***Johnson & Johnson COVID-19 vaccine
View the complete list here.
How Coronis is Leading the Way
Because of our industry-leading technology, global solutions, and highly experienced manpower, Coronis Health has quickly become the trusted partner in COVID-19 testing and billing throughout the pandemic.
The battle against COVID-19 is far from over. We understand that facilities can become buried in claims processing with the continuous rise of COVID-19 testing and vaccinations. This does not deter us. We are equipped to help you clear your billing backlog, recover critical payments, and create new revenue streams in the process. In fact, we were able to help a client clear a 20,000 test backlog in just two weeks. We successfully accomplished this through our entrepreneurial mindset, high-touch relationship building, and our commitment to helping clients stay financially independent.
Partner With Coronis Health for Your COVID-19 Billing Needs
COVID-19 presents unique challenges for the healthcare industry, and the medical billing process should not add to your burdens when you should be focusing on patient care. Allow us to help you during this stressful time. We are a full-service billing and management company with over 30 years of experience in helping facilities with billing, practice management, and revenue cycle optimization. While helping you stay compliant with the ever-changing regulations, we can also navigate you into new revenue streams. To learn more, contact Coronis Health today.