On August 24, 2021, CMS announced that it is again increasing the Medicare reimbursement rate for providers who administer at-home COVID-19 vaccines. This rate increase aims to boost the rate of COVID-19 vaccination, including second and third doses, particularly among vulnerable patients who have difficulties leaving their homes. The additional payment provides relief to providers administering vaccines to multiple residents in one home or communal setting.

Medicare will pay an additional $35 per dose for vaccine administration services per home unit, group home, assisted living facility or other group living situations, as long as it is in a single group living location. The increase is available up to five times when fewer than 10 Medicare beneficiaries are vaccinated on the same day in the same home unit or communal setting.

In its announcement regarding reimbursement, CMS acknowledged some Medicare beneficiaries’ difficulties leaving their homes. These individuals tend to be at-risk patients who could require hospitalization if they contracted COVID-19.

The reimbursement increases recognize the additional clinical time needed to monitor beneficiaries after the vaccine is administered, and upfront costs associated with administering the vaccine safely in a beneficiary’s home. Delivering vaccines to hard-to-reach patients also poses unique challenges, such as ensuring appropriate vaccine storage and handling.

To address difficulties for at-risk patients to leave their homes to receive vaccinations, Medicare had previously increased the total payment amount for at-home vaccinations from about $40 to $75 per dose, or $150 per two-dose vaccine, in certain situations. Like the prior rate bump, the payment increase for administering each dose of vaccine will depend on the geographic location where the service is furnished.

CMS’s press release can be found on its website here.