New MA Bulletin Updates Vaccine Administration Fees

The Pennsylvania Department of Human Services (DHS), Office of Medical Assistance Programs has issued a new bulletin. The purpose of this bulletin is to inform Medical Assistance (MA) providers about updates related to billing and payment for the administration of the novel coronavirus (SARSCoV-2) vaccines, effective Dec. 1, 2020. MAB 01-20-59 advised providers that the administration fee for first and second doses was $10.00. The new administration fee, going back to Dec. 1, 2020, is now $16.94 for the first dose and $28.39 for the second dose. The new fees are based on what Medicare is paying for first and second dose administration and publication of the bulletin indicates DHS received approval from the Centers for Medicare and Medicaid Services (CMS) to pay at Medicare rates. DHS will also pay FQHCs/RHCs for COVID-19 vaccination not affiliated with an FQHC/RHC encounter at Medicare rates, but has not yet published the MA Bulletin affirming this.