Industry Insights

CMS Publishes Guidance on COVID-19 Vaccine Payment, Admin & Billing

Written by Admin | Jun 14, 2022 1:53:12 PM

March 4, 2021 — CMS Publishes Guidance on COVID-19 Vaccine Payment, Administration, and Billing Instructions: See MLN Connects Article and Related Links to CMS COVID-19 Website

The CMS MLN Connects Newsletter for March 4, 2021 provides the latest news in COVID-19 coverage, specifically issuing HCPCS/CPT codes and payment rates for the current and emerging vaccines, shot administration, and related billing instructions.  They have also updated their COVID-19 FAQ document and provide page references to relative questions and answers surrounding COVID-19 vaccine coverage, administration, and billing.

Link:  2021-03-04-MLNC | CMS

The categories featured and highlighted in the pdf are noted below and the correlating links to the CMS COVID-19 website sources:

  • Vaccine Codes:

Details the new vaccine codes and payment rates by manufacturer and dose.  Also details coding and payment for monoclonal antibody treatment.

COVID-19 Vaccines and Monoclonal Antibodies | CMS

  • Vaccine Administration:

Details the billing options, single claims versus roster billing. Provides guidance on billing when vaccine dose provided for free by government. Also instructs on how to bill for any Medicare Advantage Plans – must submit to Original Medicare.

Medicare Billing for COVID-19 Vaccine Shot Administration | CMS

  • CMS FAQs on Medicare FFS Billing to Administer Vaccines:

Updated FAQ document with page references for new information and topic categories.

COVID-19 Frequently Asked Questions (FAQs) on (cms.gov)

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