CMS (Centers for Medicare and Medicaid Services) plans to start rewarding healthcare workers and organizations with higher payments for administering the COVID-19 vaccine. The amount is said to be increased to $40 per dose, which was $28 previously, making $45 in total for two shots.
The exact payment for the vaccine administration will depend on the entity furnishing the service. Moreover, the payment will also depend on the geographical location of the rendered service.
Why CMS Wants to Facilitate COVID Workers?
According to the statement issued by the CMS, the authority wants to reward the efforts that healthcare workers are investing in these tough times.
The supply of COVID-19 is increasing day by day, and healthcare organizations have to provide these shots with the same speed. To safely administer these shots, suppliers and medical billing services are constantly involved with the physicians. So, a lot of coordination is spent along with the effort put into the process.
The higher reimbursement will support their efforts in all aspects, be it for educating patients or assisting them with shots or others.
Who Can Benefit from this Payment?
It has been made clear by the CMS that there is no cost-sharing between any parties, whether it’s Medicare, Medicaid, or other private insurers.
Moreover, the vaccine is free for everyone, so there are no charges that patient has to pay for it.
Medicare beneficiaries do not have to pay any copayment or deductibles regarding the COVID vaccine shot. Their advantage plan is also immune to pay physicians for any shot.
It is stated that Medicare will reimburse physicians directly even if they are not receiving the free vaccine. The vaccination is completely funded by the government and is applied to eligible individuals as well.
For private healthcare plans, CMS has the same policy that they will facilitate all the in-network and out-of-network physicians during COVID emergency. The Medicare reimbursement rate is a guide in this regard. Companies must offer reasonable payment as per the market rates.
Physicians can also send claims for uninsured individuals via the Provider Relief Fund administered by the Health Resources and Services Administration.
There is a little uncertainty for the rates for the COVID variants along with the expenses for their testing and treatment. We don’t know where it would take the reimbursement game in 2022 if we stay under emergency for a long time. Let’s hope for the best.