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NARHC-News
COVID 19 Vaccine Reimbursement
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11/2/2020 @ 9:19:00 AM
Post 1 of 13

Contributor: Cassie Beesley, Springfield Clinic - Hillsboro East

I was just reading the CMS Weekly Digest Bulletin for this week that talked about reimbursement for a COVID vaccine.  Of course it does not speak of how we will be paid in an RHC.  Has anyone seen any information on how RHCs will be reimbursed for this?  On Cost Report like flu and pneumonia?  Split off and bill part B?  It also says that for the Medicare Advantage plans that we will bill Medicare and not the MA directly. 
11/2/2020 @ 10:16:00 AM
Post 2 of 13

Contributor: Julie York, Marengo Family Medical Clinic

Following

Julie York
Clinic Billing Supervisor
Compass Memorial.org
Marengo, IA 52301
PH: 319-642-8155
FAX: 319-642-8142
jyork@CompassMemorial.org

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11/2/2020 @ 11:17:00 AM
Post 3 of 13

Contributor: Nathan Baugh, National Association of Rural Health Clinics

Dear Cassie and Julie,

You are absolutely correct in that the recently released rule does not explicitly address how RHCs are to bill for vaccine distribution. Nor does the rule address how much RHCs will be paid for vaccine distribution. We have asked CMS staff to provide those explicit billing, coding, and reimbursement details. What is extraordinarily clear is that cost sharing is to be waived for patients across all payer types.

I am loath to speculate but I presume that CMS will either allow RHCs to bill for COVID vaccine similarly to flu/pnuemo OR they will create an explicit G-code for RHCs/FQHCs that pays the amounts they have pegged for the vaccine which are:

For single does vaccines: $28.39
For two or more doses: $16.94 for inital dose(s), and $28.39 for final dose in series.


11/2/2020 @ 11:28:00 AM
Post 4 of 13

Contributor: Julie York, Marengo Family Medical Clinic

I appreciate you passing this information on. Thanks for your continuing work on all of this.

Julie York
Clinic Billing Supervisor
Compass Memorial.org

11/2/2020 @ 11:38:00 AM
Post 5 of 13

Contributor: Cassie Beesley, Springfield Clinic - Hillsboro East

Thanks Nathan. Thanks for all you continue to do for us.

[cid:image003.png@01D4EA20.04F19020] Cassie Beesley, CRHCP
Rural Health Clinic Manager
Springfield Clinic
Phone 217.528.7541 x44801



12/10/2020 @ 6:40:00 PM
Post 6 of 13

Contributor: Trina Gleese, Family Health Center Newport

Checking in to see if there have been any updates on how RHC's are to bill for the Covid19 vaccine? we are meeting on Tuesday and any information I can provide at our meeting would be helpful! I have searched the sites to day but unable to locate any specific guidelines for RHC. 

12/11/2020 @ 8:49:00 AM
Post 7 of 13

Contributor: Tammy Hicok, Vinton Family Medical Clinic

Here is a link from my CFO regarding billing administration of covid fees:
Medicare is allowing us to bill the administration fee. Advantage plans are also allowing it, but they must be billed to straight Medicare.

Reference: https://www.cms.gov/medicare/covid-19/medicare-billing-covid-19-vaccine-shot-administration#:~:text=You'll%20be%20able%20to,bill%20for%20the%20vaccine%20administration.


Tammy Hicok - RN, BSN
Director of Clinic Operations
Virginia Gay Hospital & Clinics
Phone: 319 - 472 - 6318

"Be the change that you wish to see in the world."
¯ Mahatma Gandhi


12/11/2020 @ 8:56:00 AM
Post 8 of 13

Contributor: Patty Harper, inQuiseek Consulting

It is expected that for RHCs the COVID 19 vaccine administration will be
reported on the cost report and on claims. So, the link below is for Part B
providers and not for RHCs.



Patty Harper, RHIA, CHTS-IM, CHTS-PW, CHC®

Healthcare Consultant/Principal

318-243-2687 (Cell)

866-855-0683 (Fax)



940 Ratcliff Street

Shreveport, LA 71104



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12/11/2020 @ 9:14:00 AM
Post 9 of 13

Contributor: Cassie Beesley, Springfield Clinic - Hillsboro East

It is my understanding that the administration costs for the COVID vaccines will be included on your cost report like flu and pneumonia. As we will most likely not be paying for the vaccine itself, the administration costs is all we will be able to recoup on the cost report. You will not be billing Medicare individuallay for the administration.

[cid:image003.png@01D4EA20.04F19020] Cassie Beesley, CRHCP
Rural Health Clinic Manager
Springfield Clinic
Phone 217.528.7541 x44801

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12/11/2020 @ 9:27:00 AM
Post 10 of 13

Contributor: Tammy Hicok, Vinton Family Medical Clinic

Thank you for this clarification Patty. I will relay this on to my CFO.

Tammy Hicok - RN, BSN
Director of Clinic Operations
Virginia Gay Hospital & Clinics
Phone: 319 - 472 - 6318

"Be the change that you wish to see in the world."
" Mahatma Gandhi



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