August 13, 2021
People With Medicare Who Are Immunocompromised Would be Able to Receive an Additional COVID-19 Dose At No Cost
In response to the Food and Drug Administration’s (FDA) recent action that authorizes an additional dose of COVID-19 vaccine for immunocompromised individuals, CMS is assuring people with Medicare who qualify for an additional dose that they can receive it with no cost sharing. This is part of President Biden’s commitment that patients have access to the necessary vaccinations to protect themselves from COVID-19.
Medicare would pay for administering an additional dose of COVID-19 vaccines consistent with the modified FDA emergency use authorization (EUA) that was announced today. For COVID19 vaccines administered on or after March 15, 2021, the national average payment rate for physicians, hospitals, pharmacies and many other immunizers is $40 to administer each dose of a COVID-19 vaccine. The Medicare program would continue to pay providers $40 to administer this additional dose – the same amount as paid for other doses of the COVID-19 vaccine.
CMS will share more information and guidance in the coming days about billing and coding for the additional dose of the COVID-19 vaccine for immunocompromised patients.
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Source: SMP Program List, Administration for Community Living (ACL) https://acl.gov/