older woman about to get a shot from a healthcare worker

The Centers for Medicare and Medicaid Services (CMS) announced Wednesday an additional payment for administering in-home COVID-19 vaccinations to Medicare beneficiaries having difficulty leaving their homes or in hard-to-reach locations.

To help this cohort, CMS is incentivizing providers and has agreed to pay an additional $35 per dose for vaccines administered in a beneficiary’s home, increasing the total payment for an in-home vaccination from roughly $40 to about $75. For a two-dose vaccination, the total payment will be $150 for both shots. That’s about $70 more than the current rate. CMS estimates 1.6 million adults age 65 and older may be having difficulty accessing the vaccine. 

“CMS is committed to meeting the unique needs of Medicare consumers and their communities — particularly those who are homebound or who have trouble getting to a vaccination site,” CMS Administrator Chiquita Brooks-Lasure said. “That’s why we’re acting today to expand the availability of the COVID-19 vaccine to people with Medicare  at home. We’re committed to taking action wherever barriers exist and bringing the fight against the COVID-19 pandemic to the door of older adults and other individuals covered by Medicare who still need protection.”

The additional payment includes the clinical time needed to monitor beneficiaries after the vaccinations have been administered, as well as the u-pfront costs associated with administering the shots safely in the beneficiaries’ homes.

The announcement comes as the pace of vaccinations has been slowing in some states. President Joseph Biden has set a goal of getting 70% of Americans partially vaccinated by the July 4 holiday, but so far only about 51% of Americans have received at least one shot.