Eric Larson, owner of Prescriptions Unlimited in St. Cloud, Fla. and an APCI Board of Directors member, provides a COVID-19 vaccination to a homebound resident earlier this year. (Screen capture from Spectrum News 13)

CMS has announced, effective June 8, 2021, an additional $35 payment for pharmacists and pharmacy technicians administering the COVID-19 vaccine (per dose) in the home of Medicare patients that have difficulty leaving their homes or are hard to reach. This is in addition to the standard administration amount (approximately $40 per dose), for a total payment of approximately $75 for a single-dose vaccine or $150 for both doses of a two-dose vaccine when administered in a Medicare patient’s home.

CMS will geographically adjust the additional amount and administration rate based on where the vaccine is administered. This is a key announcement for independent pharmacies because it’s mostly independents who are visiting homes. Many types of locations can qualify as a Medicare patient’s home for the additional in-home payment amount, including a unit in an assisted living facility (ALF) or group home. However, communal spaces of a multi-unit living arrangement do not qualify as a home for the additional payment amount, nor do Medicare skilled nursing facilities (SNFs) or ALFs participating in the CDC’s Pharmacy Partnership for Long-Term Care Program when their residents are vaccinated through this program.

Additional information regarding eligibility and restrictions can be found here.