NARHC Forum

Contributor: Nathan Baugh, National Association of Rural Health Clinics

The Centers for Medicare and Medicaid Services (CMS) confirmed to NARHC today that they are “in the process of modifying the Worksheet B-1, to add an additional column for the COVID vaccines and administration and we are also including a subscripted line to report MA patients in addition to traditional Medicare [we] hope to have a revised cost report out within the next 30 days.”

This modification will allow RHCs to separate out COVID vaccine costs from the influenza and pneumococcal costs and it will ensure that RHCs are paid their full Medicare costs for all three vaccines. 

Because reimbursement for the administration of the COVID vaccination is to be made through the cost report for both Medicare Advantage patients as well as traditional Medicare patients, it was imperative for CMS to break out COVID vaccine administration costs from the influenza and pneumococcal columns. 

As a reminder, RHCs will be reimbursed a lump sum amount for COVID-19 vaccine administration based on costs as reported on the cost report. Here is the policy as articulated on the CMS website:

COVID-19 vaccines and their administration will be paid the same way influenza and pneumococcal vaccines and their administration are paid in RHCs and FQHCs.  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.  RHCs and FQHCs should include COVID-19 vaccines and their administration costs for patients enrolled in Medicare Advantage on the cost report as well. For additional information, please see https://www.cms.gov/covidvax. 

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Contributor: John Duke, Complete Care Rural Health Clinic

Hi Nathan,

 Thank you for the clarification here.  What about patients who have Medicaid or a private insurance?

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