The COVID-19 vaccine is available at NO charge. The vaccine itself has been paid for through funding authorized by the CARES Act. Providers who receive the COVID-19 vaccine free from the federal government are prohibited from seeking reimbursement from members for vaccine administration costs—including through cost sharing or balance billing. Providers should bill any cost to administer the vaccination as follows:
IHN-CCO ProvidersAdministration costs should be billed to IHN-CCO for reimbursement. Vaccine doses may be billed to IHN-CCO at $.01 for reporting purposes (reimbursement will not be considered).
Samaritan Advantage Health Plans ProvidersPayment for the administration costs will be reimbursed by Original Medicare. Claims should be submitted through the Medicare Administrative Contractor and not include charges for the vaccine dose itself. Claims submitted to Samaritan Advantage Health Plans will be denied.
Samaritan Employer Group Plans & Samaritan Choice PlansAdministration costs should be billed to the member’s plan. Vaccine doses may be billed at $.01 for reporting purposes (reimbursement will not be considered).
Modifiers are not required when submitting claims for the COVID-19 vaccine or administration costs. All places of service (POS) on the CMS POS list for vaccine codes are acceptable.
Please go to the CMS Medicare Part B web page for COVID-19 vaccine information on coding and reimbursement rates.