COVID-19 Vaccine Coverage Assistance Fund
The Biden-Harris Administration is providing free access to COVID-19 vaccines for every adult living in the United States. Accordingly, the Health Resources and Services Administration’s (HRSA) COVID-19 Coverage Assistance Fund (CAF) will cover the costs of administering COVID-19 vaccines to patients whose health insurance doesn’t cover vaccine administration fees or does but typically has patient cost-sharing.
About the Program
HRSA will provide claims reimbursement to eligible health care providers at the national Medicare rate for administering Food and Drug Administration (FDA) authorized COVID-19 vaccines under an Emergency Use Authorization (EUA) or FDA-licensed COVID-19 vaccines under a Biologics License Application (BLA) to underinsured individuals.
NOTE: For Uninsured patients please use the HRSA Uninsured Patient Program
How it Works
Health care providers can request claims reimbursement, through the COVID-19 Coverage Assistance Fund electronically and will be reimbursed at the national Medicare rate for vaccine administration, and for patient charges related to COVID-19 vaccination, including co-payments for vaccine administration, deductibles for vaccine administration, and co-insurance, subject to available funding.
There is no cost to health care providers for COVID-19 vaccines received from the federal government, therefore, providers are expected to submit a claim for only vaccine administration to the individual’s health plan for payment. Only those claims denied or for which a patient’s health plan assesses charges to the patient related to COVID-19 vaccine administration are eligible for reimbursement and may be submitted to the Coverage Assistance Fund. Those claims include co-payments for vaccine administration, deductibles for vaccine administration, and co-insurance.
Create an account: https://covid19coverageassistance.ssigroup.com/
Once enrolled, eligible providers and pharmacies can submit claims through their current clearinghouse or submit a claim electronically or manually through the Portal.
Claims Reimbursement Rate
Claims for reimbursement will be priced as described below for eligible services:
Vaccine administration fees will be priced based on national Medicare rates for administering the COVID-19 vaccine (not geographically adjusted) 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.
Link to the complete article: https://www.hrsa.gov/covid19-coverage-assistance
For 25 years, MedicareCoding.com has helped over 20,000 Florida Practitioners and their staff navigates the complex Medicare system. We provide a full suite of Preventive, Diagnostic, and Treatment Services to ensure optimal health of their Medicare revenue cycle and maximize the Medicare coverage for your patients.
Learn more about our webinars, conferences, meetings & newsletters covering the most recent updates about Florida Medicare as well as best practices on coding, billing, and more.
Queen Bee of Medicare