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COVID-19: Rural Health Clinics Lump Sum Payments

Rural Health Clinics (RHCs) will be reimbursed by Medicare for COVID-19 vaccine administration the same way they 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, the Centers for Medicare and Medicaid Services provided some guidance on this issue.

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, click here or contact your Medicare Administrative Contractor for more information.

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