BriggsNetNews

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

CMS released this toolkit for providers, and a set of toolkits for states and insurers designed to:

• Help the health care system quickly administer vaccines as they’re available
• Increase the number of providers who can administer the vaccine
• Ensure adequate Medicare payment for administering the vaccine
• Ensure private insurers and Medicaid programs understand their responsibility to cover the vaccine at no cost to patients

We’re also taking action to increase payment for any new FDA-approved COVID-19 treatments.

Health care providers play an important role and we’re committed to ensuring you have the necessary tools to respond to the COVID-19 public health emergency (PHE). Because the federal government purchased the initial supply of COVID-19 vaccines, this toolkit primarily focuses on coverage for administering the vaccine. Americans can get vaccines purchased with U.S. taxpayer dollars at no cost. HHS issued a letter reminding the following:

• Health care providers about your signed agreements to administer COVID-19 vaccines to patients free-of-charge
• Group health plans and health insurers that you’re legally required to cover COVID-19 vaccines and diagnostic testing without patient cost sharing

This toolkit includes information to describe:

• How you can enroll in Medicare to bill for administering COVID-19 vaccines
• The COVID-19 vaccine Medicare coding structure
• Medicare payment rates for administering COVID-19 vaccines
• How to bill correctly for administering vaccines, including roster and centralized billing
• Monoclonal antibody infusion for treating COVID-19
• New COVID-19 Treatments Add-on Payment (NCTAP)