Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) may request lump sum payments for administering COVID-19 vaccines in advance of cost report settlement. CMS will pay you for COVID-19 vaccines and administration at 100% reasonable cost like influenza and pneumonia vaccines. FQHCs will have the option to receive a lump sum adjustment based on the flu and pneumococcal vaccine costs from the most recent cost report or provide 60-90 days of actual COVID-19 vaccine and administration cost data. Contact your Medicare Administrative Contractor (MAC) for more information. Novitas is the MAC for Pennsylvania and their contact email address to request lump sum payments is NovitasReimbursement@novitas-solutions.com. Some Pennsylvania health centers still have National Government Service (NGS) as their MAC for some site locations. For more information from NGS on the lump sum process, visit their website.
