CMS has issued the final physician fee schedule for CY 2023, which updates vaccine payment information. The CY 2023 payment amount for influenza, pneumococcal, and HBV vaccine administration is $31.14. This amount will be geographically adjusted based upon the fee schedule area where the preventive vaccine is administered. With regard to COVID-19 vaccine administration, for CY 2023 the payment amount is $41.52. This differential will remain in place until the end of the calendar year in which the current Emergency Use Authorization declaration for drugs and biologicals with respect to COVID-19 ends. Thereafter, the payment amount for COVID-19 vaccine administration will be adjusted to align with the payment rate for the other Medicare Part B preventive vaccines.
CMS will also continue the in-home additional payment for the administration of COVID-19 vaccines. For CY 2023 the in-home additional payment amount for COVID-19 vaccine administration described by HCPCS code M0201 is $36.85, and payment for these services will be adjusted for geographic cost differences. NCPA will further analyze the physician fee schedule final rule and will be issuing that analysis shortly. For CMS’ fact sheet, click here. For CMS’ press release, click here. For the final rule, click here.
