New CMS guidance released Oct. 28 on a future COVID-19 vaccine offered new details for providers on distribution, billing and payment.
An interim final rule establishes that any vaccine that receives Food and Drug Administration (FDA) authorization will be covered under Medicare as a preventive vaccine at no cost to beneficiaries.
The rule also relaxes some regulations to expedite the application process for health care providers not currently enrolled in Medicare so they can administer vaccines to Medicare patients.
New providers are now able to enroll as a “Medicare mass immunizers” through an expedited 24-hour process, according to a CMS release. These mass immunizers are expected to include pharmacies, schools and other entities that may be non-traditional providers or otherwise not eligible for Medicare enrollment.
After the FDA either approves or authorizes a vaccine for COVID-19, CMS will identify the specific vaccine codes, by dose if necessary, and specific vaccine administration codes for each dose for Medicare payment, the release noted.
CMS also released new Medicare payment rates for COVID-19 vaccine administration. The Medicare payment rates will be $28.39 to administer single-dose vaccines. For a COVID-19 vaccine requiring a series of two or more doses, the initial dose(s) administration payment rate will be $16.94, and $28.39 for the administration of the final dose in the series.