Last Modified: 3/5/2024
Location: FL, PR, USVI
Business: Part A, Part B
In calendar year 2023, CMS began paying approximately $36 in addition to the standard administration amount to administer COVID-19 vaccines in the home for certain Medicare patients. For vaccines requiring multiple doses, this payment applies for each dose in the series, including any additional or booster doses.
Note: The payment rates are geographically adjusted. View the
2023 payment rates for COVID-19 vaccine and monoclonal administration.
HCPCS Level II code M0201 (COVID-19 vaccine administration inside a patient's home) is used to bill for the add-on payment.
HCPCS Level II code M0201 for the additional payment for administering the COVID-19 vaccine in the home is billed in addition to one of the COVID -19 vaccine administration CPT codes.
For dates of service between June 8, 2021, and August 24, 2021:
• Only report the HCPCS Level II code M0201 once per individual home or living unit.
For dates of service on or after August 24, 2021:
• If you administer the vaccine to fewer than 10 Medicare patients at the same group living location on that date, report the HCPCS Level II code M0201 for each Medicare patient vaccinated in an individual home that day, and up to a maximum of 5 times if you vaccinate multiple Medicare patients in the same home or communal space
Report the COVID-19 vaccine administration CPT code (90480) for each Medicare patient you vaccinated in the home that day.
• 04, 06, 09, 12, 13, 14, 16, 19, 22, 33, 54, 55, 56 and 60.
For Part A, the type of bill eligible for the add-on payment include:
• 13X, 34X, 72X, 75X, 81X, 82X, and 85X.
If you submit roster bills for administering the COVID-19 vaccine in the home, you must submit two roster bills:
• A roster bill containing the appropriate CPT code for the product and dose-specific COVID-19 vaccine administration
• A second roster bill containing the HCPCS Level II code M0201 for the additional in-home payment amount
You may submit a single set of roster bills (one containing M0201 and another containing the appropriate CPT code) for multiple Medicare patients who get the COVID-19 vaccine in their individual units of a multi-unit living arrangement.
Effective August 24, 2021, when fewer than ten Medicare patients are vaccinated on the same date at the same group living setting, you may submit a roster bill for M0201 for up to a maximum of five Medicare patients in the same home, including for multiple Medicare patients vaccinated in a communal space of the multi-unit living arrangement.
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