How do RHCs bill for COVID-19 Vaccine Administration?
Rural Health Clinics (RHCs) will be reimbursed by Medicare for COVID-19 vaccine administration the same way we are reimbursed for flu and pneumococcal shots: a lump sum payment, based on vaccine administration costs as reported on the cost report. National Association of Rural Health Clinics (NARHC) has confirmed that reimbursement for vaccine administration to patients with Medicare Advantage will be treated the same way as traditional Medicare beneficiaries, meaning that RHCs will not bill for the vaccine administration for any Medicare patient but rather capture the costs of such vaccinations on their cost report.
In January, CMS provided some guidance on this issue HERE.
From CMS: COVID-19 Vaccines in RHCs and Federally Qualified Health Centers (FQHCs) – COVID-19 vaccines and their administration will be paid the same way influenza and pneumococcal vaccines and their administration are paid in RHCs and FQHCs. Influenza and pneumococcal vaccines and their administration are paid at 100 percent of reasonable cost through the cost report. The beneficiary coinsurance and deductible are waived. For additional information, please see https://www.cms.gov/covidvax.
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