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The Centers for Medicare and Medicaid Services (CMS) reimbursement rate for COVID-19 vaccinations has been $16.94 for the first dose and $28.39 for the second dose, with some geographic variation. On March 11, 2021 the American Rescue Plan Act was enacted, which increases reimbursement rates for COVID-19 vaccination. The new plan calls for higher reimbursement to ensure safe and appropriate administration of COVID-19 vaccines. It also states that there will be no charge to recipients during the public health emergency and for up to 1 year afterwards. For vaccinations received after March 15, 2021 the reimbursement rate is $40 for each dose. With vaccine supplies growing, the increased reimbursement rate comes at an essential time. It is expected to increase vaccinations and encourage vaccine outreach.

CMS is currently updating their COVID-19 Vaccine Toolkits to help vaccine providers with the new payment system. Medicare reimbursement rates have been a benchmark for private insurance plans; CMS, along with the Departments of Labor and Treasury, is requiring that most private health plans and issuers cover administration of the COVID-19 vaccine – using Medicare reimbursement rates as a potential guideline.

Medicare COVID-19 Vaccine Shot Payment

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