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The Centers for Medicare & Medicaid Services (CMS) recently increased the Medicare payment rate for administering COVID-19 vaccines to approximately $40 per shot.
The rate will be adjusted based on where in the country the vaccine is administered.
Previously, Medicare paid $28.93 for a single-dose vaccine or for the second dose in a series of 2, and $16.94 for the first dose in a series of 2.
Two authorized vaccines in the US, manufactured by Pfizer-BioNTech and Moderna, require 2 injections 3 and 4 weeks apart, respectively. The third authorized vaccine in the US is manufactured by Janssen/Johnson & Johnson and requires only 1 shot.
The increased payments reflect updated information about the vaccine administration costs for different types of providers and suppliers and the additional resources needed to ensure safe and appropriate administration, according to CMS.
Usually, CMS changes Medicare payments for specific services through notice and comment rulemaking, but to save time during the COVID-19 pandemic, the agency bypassed that route before increasing payments for administering the vaccines. However, CMS said it continues to seek information from the public for reviewing and establishing payment rates for vaccine administration, both during the pandemic and on a longer-term basis.
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Rubin R. Medicare Raises Payment for Administering COVID-19 Vaccines. JAMA. 2021;325(16):1601. doi:10.1001/jama.2021.5882
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