Medicare COVID-19 Vaccine Analysis

Medicare COVID-19 Vaccine Analysis

In December of 2020, the first COVID-19 vaccine received emergency use authorization (EUA).  Following the EUA, CMS began to assess the feasibility of using Medicare claims data (i.e., fee-for-service claims) to track the administration of the COVID-19 vaccine among the Medicare population. 

CMS is releasing two resources with information on COVID-19 vaccine administration claims among Medicare beneficiaries.

  1. Assessing the Completeness of Medicare Claims Data for Measuring COVID-19 Vaccine Administration (PDF): This paper presents preliminary findings on the count of individuals ages 65 and older with at least one COVID-19 vaccine administration claim in the Medicare data compared to the count of people 65+ with at least one COVID-19 vaccine dose in the data reported by the Centers for Disease Control and Prevention (CDC). Using data as of June 4th, 2021, we estimate that CMS received a claim for COVID-19 vaccine administration for roughly half of Medicare beneficiaries who have received at least one COVID-19 vaccine dose as compared to the estimated counts based on adjusted CDC figures (17.5 million out of 36.6 million). As a result, we recommend that the public apply significant caution when analyzing COVID-19 vaccine administration trends using Medicare claims data. 
     
  2. Medicare COVID-19 Vaccine Public Use File (PUF) (ZIP): This PUF presents a high-level and preliminary overview of Medicare utilization and spending information from Medicare Fee-for-Service (FFS) claims for the administration of the COVID-19 vaccine. We anticipate that the PUF will be updated quarterly for the remainder of the COVID-19 Public Health Emergency.

[Note: For dates of service prior to 2022, all claims for the administration of the COVID-19 vaccine were paid through Original Medicare for both FFS and MA beneficiaries. Beginning on January 1, 2022, COVID-19 vaccine administration encounters for MA beneficiaries are billed through the beneficiary’s MA plan and are not included in this PUF.]

Inquiries regarding the Medicare COVID-19 Vaccine Analysis can be sent to PDAG_Data_Products@cms.hhs.gov.

Page Last Modified:
12/01/2022 11:21 AM