How It Works

Program Overview
How It works
Resources

Eligible providers can request claims reimbursement through the HRSA COVID-19 Coverage Assistance Fund electronically and will be reimbursed at national Medicare rates for the vaccine administration fees, and for patient charges related to vaccination, including:

  • co-pays
  • deductibles, and
  • co-insurance

Eligible providers interested in receiving funding should take the following actions:

  1. Submit a claim for vaccine administration to the individual’s health plan carrier for payment and have the claim denied or only partially paid
  2. Verify no other third party payer will reimburse them for vaccine administration fees for that patient encounter

Next, eligible providers should:

  1. Enroll at the HRSA COVID-19 Coverage Assistance Fund Portal
  2. Agree to program Terms and Conditions, including
    1. Accept defined program reimbursement as payment in full
    2. Agree not to balance bill the patient
  3. Submit claims (via current clearinghouse or submit a claim electronically or manually through the portal)

Vaccine administration fees will be priced based on Medicare rates and are outlined below:
For dates of service through March 14, 2021:

  • Administration of a single-dose COVID-19 vaccine - $28.39
  • Administration of the first dose of a COVID-19 vaccine requiring a series of two or more doses - $16.94
  • Administration of the final dose of a COVID-19 vaccine requiring a series of two or more doses - $28.39

For dates of service on or after March 15, 2021:

  • Administration (per dose) of a COVID-19 vaccine - $40.00
    • Effective August 12, 2021, this includes an additional (third) dose of a COVID-19 vaccine for certain immunocompromised individuals (refer to the CDC website for more information).

For COVID-19 vaccinations administered in-home with dates of service on or after June 8, 2021:

  • Administration (per dose) of a COVID-19 vaccine - $75.00
    • Effective August 12, 2021, this includes an additional (third) dose of a COVID-19 vaccine for certain immunocompromised individuals (refer to the CDC website for more information).
  • *Note: In-home vaccine administration claims must be submitted with two codes to be eligible for reimbursement:
    • The first code must be one of the following:
      • Pfizer: 0001A, 0002A, 0003A, D1701, D1702
      • Moderna: 0011A, 0012A, 0013A, D1703, D1704
      • Janssen: 0031A, D1707
    • The second code must be M0201 (COVID-19 vaccine home administration)
    • For a definition of what constitutes in-home administration, see this Centers for Medicare & Medicaid Services fact sheet.