Primary Care COVID-19 Vaccination: We Need You to Vaccinate!

August 20, 2021

WNC falls behind on vaccinations: as of July 28, 2021, WNC has partially vaccinated 42% of the total population against COVID-19 compared to the state (50%) and the nation (57%).  


August 2021

Physicians are key to increasing COVID-19 vaccination rates and easing their patients’ concerns about the vaccine. Vaccines are a critical tool for preventing the spread of the virus, but many people do not want to get them a mass vaccine clinic, public health department, or their local drug store. 

Many want to hear from their most trusted source of medical information – their primary care physician.

Others want the privacy of their doctor’s office so their decision can remain confidential. Some may want their physician to answer their questions about the safety and efficacy of the vaccine. A few more may be looking for their physician to review their medical information and encourage them to get the vaccine.   According to a survey by the Kaiser Family Foundation, 75% of those surveyed said they would be most likely to get a shot at their doctor’s office.

It is crucial for primary care practices to offer vaccinations as part of the routine care they deliver, while also serving as trusted messengers for patients with concerns.

We Need YOU to Offer Vaccines in your Office!

  • For the health of your patient
  • To decrease community spread
  • To answer your patients’ questions
  • It is best practice
  • It will provide a new revenue stream
  • It will help you prepare for the future

 

Reimbursement for Vaccine Administration

The new Medicare payment rate for administering a COVID-19 vaccine will be approximately $40 to administer each dose of a COVID-19 vaccine (effective for services provided on or after March 15, 2021). You can submit for vaccinating uninsured and underinsured patients through HRSA.Private insurance also covers.The vaccine is free to practices and patients.

Reimbursement for counseling

Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual, up to 15 minutes, has been added for Medicaid beneficiaries receiving the COVID-19 vaccine (CPT 99401) as PPS rate. This is set to expire 9/22/2021. You can find additional COVID-19 Counseling Code Reimbursement information in the Medicaid  #170 Special Bulletin at https://medicaid.ncdhhs.gov/blog/2021/07/09/special-bulletin-covid-19-170-update-vaccination-counseling-code-reimbursement.

Case Example: If there are 30 unvaccinated Medicaid patients the PCP can provide and bill for counseling and get paid around $1,000If 10 of these are vaccinated, then an additional $40 can be billed for each vaccination given. While financial projections are tricky due to so many variables, there is potential to bring in an additional revenue to cover some of your cost.

More Resources

COVID-19 Provider Guidance Summary Sheet  at https://covid19.ncdhhs.gov/media/1239/download