COVID Vaccine Admin Payments For Non-Insured?

Sharing with the forum an email I received an email that provides some info about how to get paid for COVID vaccine administration if the patient’s insurance is not covering the admin fees, etc:

Dear Valued Provider:

The US Department of Health and Human Services, through the Health Resources and Services Administration (HRSA), has launched the COVID-19 Coverage Assistance Fund (CAF). This new program is providing reimbursements on a rolling basis directly to eligible health care providers for claims associated with administering COVID-19 vaccines to beneficiaries whose health insurance does not cover vaccine administration fees, or does but typically with patient cost-sharing. Review and share the program fact sheet for a quick look at the program.

Providers can now begin submitting eligible claims for COVID-19 vaccine administration fees to the HRSA COVID-19 Coverage Assistance Fund Portal.

Provider Webcasts - Register Now
Two informational webcasts are being held to present an overview of the enrollment, claims submission, and payment processes. Register for one today.

Who is eligible for reimbursement?
Health care providers that have administered a COVID-19 vaccine authorized by the FDA to underinsured individuals on or after December 14, 2020 can request claims reimbursement through the program.

Reimbursement may be requested electronically and, subject to available funding, will be reimbursed at the national Medicare rate for the vaccine administration fee or for patient cost-sharing related to COVID-19 vaccination, including co-payments for vaccine administration, deductibles for vaccine administration, and co-insurance.

How are reimbursement rates determined?
Reimbursement pricing and policies for vaccine administration fees will be priced based on national Medicare rates and are outlined below:
For dates of service through March 14, 2021:

  • Administration of a single-dose COVID-19 vaccine - $28.39
  • Administration of the first dose of a COVID-19 vaccine requiring a series of two or more doses - $16.94
  • Administration of the final dose of a COVID-19 vaccine requiring a series of two or more doses - $28.39

For dates of service on or after March 15, 2021:

  • Administration (per dose) of a COVID-19 vaccine - $40.00

How will payments be distributed?
Reimbursements will be delivered by the SSI Group. Your organization’s payment will be sent via Automated Clearing House (ACH).

Contact the CAF Support Line at (833) 967-0770; for TTY (888) 970-2920. Hours of operation are 8 a.m. to 8 p.m. Monday - Friday ET.

Thanks you for all you are doing during this difficult time.

Diana Espinosa
Acting Administrator
Health Resources and Services Administration
U.S. Department of Health and Human Services