In an effort to increase access to COVID-19 vaccinations, the Centers for Medicare & Medicaid Services (CMS) is expanding opportunities for people to receive vaccinations at home. Healthcare providers can now receive additional payments for administering vaccines to multiple residents in one home setting or communal setting of a home to ensure that Medicare beneficiaries who find it difficult to leave their homes can receive their vaccination. 

This announcement aims to incentivize providers to improve the administration of vaccinations in smaller group homes, assisted living facilities, and other group living situations by allowing vaccine providers to receive the increased payment up to five times when fewer than ten Medicare beneficiaries get the vaccine on the same day in the same home or communal setting. This is to ensure that at-risk patients in smaller settings have the same opportunities as others to receive the vaccination.

Medicare had previously increased the at-home vaccination payment amount from approximately $40 to approximately $75 per vaccine dose, in certain circumstances. However, to offset some of the additional costs providers may face when delivering COVID-19 vaccinations to access-challenged and hard-to-reach individuals such as appropriate vaccine storage temperatures, handling, administration and other unique challenges, the additional payment amount also accounts for the clinical time needed to monitor a beneficiary after the vaccine is administered, as well as the upfront costs associated with administering the vaccine safely and appropriately in a beneficiary’s home. The standard and additional in-home payment amount for administering each COVID-19 vaccine dose is calculated using a geographical adjustment based on where the service is furnished.

Source: U.S. Centers for Medicare & Medicaid Services (CMS)

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