Clinical laboratories are eligible to administer COVID-19 vaccinations. In addition, the Health Resources and Services Administration COVID-19 Coverage Assistance Fund (CAF) provides reimbursement to entities administering COVID-19 vaccines to individuals lacking insurance coverage.
To become a vaccine administration site, a laboratory must first register with the Centers for Medicare & Medicaid Services as a mass immunizer. They must also set up appropriate billing codes for vaccine administration. Laboratories cannot be reimbursed for the vaccines themselves because they are provided free of charge; however, they can request reimbursement for administration services.
CAF “cover[s] 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. While patients cannot be billed directly for COVID-19 vaccine fees, costs to health care providers on the front lines for administering COVID-19 vaccines to underinsured patients will now be fully covered through CAF, subject to available funding. As vaccination efforts accelerate, patients will increasingly gain access to COVID-19 vaccines at locations near where they live with providers they trust.”
Immunizers may request reimbursement at the national Medicare rate, provided they have confirmed that no other payer is available to underwrite the cost of the bill. They must also agree to accept the stated reimbursement and are not permitted to bill the patient for any remaining balance.
For more information on registering as a mass immunizer, visit: https://www.cms.gov/medicare/covid-19/enrollment-administering-covid-19-vaccines
For more information on the COVID-19 Coverage Assistance Fund, visit: https://www.hrsa.gov/covid19-coverage-assistance
