HRSA To Pay for Vaccine Administration for Underinsured Patients

May 5, 2021

Providers will be able to bill and be paid for vaccine administration provided to enrollees of health plans that either do not cover vaccine administration or apply patient cost-sharing. Most state regulated insurers are required to cover the service without cost-sharing but self-funded plans do not have the same requirement. HRSA set up a new portal for such services retroactive to December 14, 2020. The payment amount will be based on the Medicare allowable in effect for the date of service ($16.94 or $28.39 through March 14 and $40 for vaccines administered March 15 and later). More information is available here.

Payment for vaccine administration and other COVID-19 services provided to uninsured individuals is paid through a separate portal and fund. More information is available here. (Andrew Busz,


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