CMS Increases Payment Amounts for Medicare Beneficiaries' At-Home COVID-19 Vaccinations

Approximately 1.6 million adults age 65 or older may have trouble accessing COVID-19 vaccinations because they have difficulty leaving their home. As part of the Biden administration's commitment to increasing access to vaccinations, the Centers for Medicare & Medicaid Services (CMS) announced an additional payment amount for administering in-home COVID-19 vaccinations to reach this specific group of Medicare beneficiaries.  

To better serve this group, Medicare will pay an additional $35 per dose for COVID-19 vaccine administration in a beneficiary's home, increasing the total amount to $75 per vaccine dose from $40. For a two-dose vaccine, the total increases to approximately $150 for the administration of both doses (or $70 more than the current rate).

Delivering COVID-19 vaccination to access-challenged and hard-to-reach individuals poses some unique challenges, such as ensuring appropriate vaccine storage temperatures, handling, and administration. To assist vaccine providers in overcoming these challenges, the CDC has created guidance. This announcement now helps to address the financial burden associated with accommodating these complications.

The additional payment amount also accounts for the time needed to monitor a beneficiary after vaccine administration, as well as the upfront costs associated with administering the vaccine safely and appropriately in a beneficiary’s home. The payment rate for administering each dose of a COVID-19 vaccine, as well as the additional in-home payment amount, will be geographically adjusted based on where the service is completed.

Unvaccinated individuals and those looking to assist 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.