Reimbursement and Payment Methodologies

CMS announced an increase in Medicare payment for at-home administration of COVID-19 vaccines. Medicare will now pay $75 per at-home dose, nearly double its previous $40 adminitration rate.

CMS boosted Medicare payment for COVID-19 vaccines administered in the patient’s home to $75 per dose, the agency announced June 9. Prior to June 9, Medicare paid $40 per dose for COVID-19 vaccines administered in the patient’s home.

CMS is considering alternatives to established practice for setting payment rates in the fiscal year (FY) 2022 Inpatient Prospective Payment System (IPPS) proposed rule. The agency cites the need to address changes in hospital utilization due to the COVID-19 pandemic, but its proposal raises questions about future rate-setting and how to account for the ongoing impact of COVID-19.

The following is an excerpt from the May 20 episode of The Revenue Integrity Show: A NAHRI Podcast in which we covered the 2022 IPPS proposed rule with guest Jugna Shah, MPH, CHRI, President, Nimitt Consulting Inc., in Spicer, Minnesota.

The fiscal year 2022 Inpatient Prospective Payment System proposed rule makes broad efforts to cushion the ongoing impact of the COVID-19 pandemic on hospital revenue and resources. The proposed rule, released April 27, also eliminates sweeping changes to MS-DRG rate-setting finalized in the 2021 IPPS final rule.

The fiscal year (FY) 2022 Inpatient Prospective Payment System (IPPS) proposed rule makes broad efforts to cushion the ongoing impact of the COVID-19 pandemic on hospital revenue and resources. The proposed rule, released April 27, also eliminates sweeping changes to MS-DRG rate-setting finalized in the 2021 IPPS final rule.