Enrollment for Administering COVID-19 Vaccine Shots

This page is for health care providers.

If you're a person with Medicare, learn more about your Medicare coverage for COVID-19 vaccines.

State governments will handle the distribution of COVID-19 vaccines. Look for updates from your state or governor as more doses of the vaccine become available for additional priority groups. Learn more about COVID-19 vaccine progress.

Review provider enrollment in Medicaid and CHIP information in the State Medicaid Plans toolkit

Review enrollment information for health insurance issuers and Medicare Advantage plans (PDF)

*New* View the Enroll in Medicare to Administer COVID-19 Vaccine Shots: Information for Health Care Providers video for an overview of the enrollment process and requirements.

 

Are you already enrolled in Medicare?

If you’re enrolled in Medicare under these institutional or non-institutional provider types, you don’t need to take any action to administer and bill the COVID-19 shot, either through individual claims or roster bill, without enrolling as a mass immunizer.

Institutional Non-Institutional
  • Hospital
  • Hospital Outpatient Department
  • Skilled Nursing Facility (includes Parts A and B)*
  • Critical Access Hospital
  • End-Stage Renal Disease Facility
  • Home Health Agency
  • Hospice
  • Comprehensive Outpatient Rehabilitation Facility
  • Federally Qualified Health Center**
  • Rural Health Clinic***
  • Indian Health Services Facility
  • Physician
  • Non-Physician
  • Clinic/Group Practice
  • Pharmacy (enrolled as Part B)
  • Mass Immunizer (roster bill only)

*A SNF may either administer the vaccine directly to a resident who’s in a covered Part A stay or under arrangement pursuant to which the SNF pays an outside immunizer to administer the vaccine. In both these situations the SNF must bill Medicare.  However, during the public health emergency, we’ll allow Medicare enrolled immunizers who are not under arrangement with the SNF to vaccinate Medicare SNF residents and bill directly to get reimbursed from Medicare. See the recent enforcement discretion notice (PDF) for more information. For a resident in a noncovered stay, either the SNF or the immunizer not under arrangement may bill for the shot.

**Report vaccine and administration on claim informationally; we pay vaccine and administration based on reasonable cost through the cost report process.

*** We pay vaccine and administration based on reasonable cost through the cost report process.

 

Review how to bill your claims (PDF)

 

Are you enrolled in Medicare, but your provider type doesn’t allow you to bill for administering vaccines?

If you’re enrolled in Medicare under these provider types and you want to bill for administering COVID-19 shots, you must also separately enroll as an institutional or non-institutional provider type, such as a mass immunizer, that can bill for the COVID-19 shot. Enrolling over the phone is easy and quick — call your MAC-specific enrollment hotline (PDF) and give your valid Legal Business Name (LBN), National Provider Identifier (NPI), Tax Identification Number (TIN), practice location and state license, if applicable.

Note: Medicare billing privileges established via the Medicare Provider Enrollment Hotline are being granted on a provisional basis as a result of the public health emergency declaration and are temporary. Upon the lifting of the COVID-19 PHE declaration, providers and suppliers, will be asked to submit a complete CMS-855 enrollment application in order to establish full Medicare billing privileges. Failure to respond to the MAC’s request within 30 days of the notification, will result in the deactivation of your temporary billing privileges. No payments can be made for services provided while your temporary billing privileges are deactivated.

Institutional Non-Institutional Durable Medical Equipment (DME)
  • Outpatient Physical Therapy
  • Occupational Therapy
  • Speech Pathology Services
  • Histocompatibility Laboratory
  • Religious Non-Medical Health Care Institution
  • Independent Clinical Laboratory
  • Ambulance Service Supplier
  • Independent Diagnostic Testing Facility
  • Intensive Cardiac Rehabilitation Supplier
  • Mammography Center
  • Medicare Diabetes Prevention Program Suppliers
  • Portable X-ray Supplier
  • Radiation Therapy Center
  • Opioid Treatment Program
  • Organ Procurement Organization
  • Home Infusion Therapy Supplier
  • Durable Medical Equipment Supplier
  • Pharmacy (enrolled as DME supplier

 

Review our quick reference process on enrollment (PDF)

 

Are you currently not enrolled as a Medicare provider?

If you’re not a Medicare provider, you must qualify and enroll as a mass immunizer or other Medicare provider type that allows billing for administering vaccines, so you can bill for administering COVID-19 shots. Enrolling over the phone is easy and quick — call your MAC-specific enrollment hotline (PDF) and give your valid Legal Business Name (LBN), National Provider Identifier (NPI), Tax Identification Number (TIN), practice location and state license, if applicable.

Note: Medicare billing privileges established via the Medicare Provider Enrollment Hotline are being granted on a provisional basis as a result of the public health emergency declaration and are temporary. Upon the lifting of the COVID-19 PHE declaration, providers and suppliers, will be asked to submit a complete CMS-855 enrollment application in order to establish full Medicare billing privileges. Failure to respond to the MAC’s request within 30 days of the notification, will result in the deactivation of your temporary billing privileges. No payments can be made for services provided while your temporary billing privileges are deactivated.

If you want to enroll in your state Medicaid program as well, reach out to your representative from the State Medicaid Agency Provider Enrollment Contact List (PDF).

 

Review our quick reference process on enrollment (PDF)

 

Centralized Billing Enrollment

Centralized billing allows mass immunizers to send all roster bill claims for flu, pneumococcal, and soon COVID-19 vaccinations to a single Medicare Administrative Contractor (MAC), Novitas, for payment, regardless of where you administer the shots. Medicare makes geographic payment adjustments based on the locality where you administer the shot. You must submit all centralized biller claims as professional claims on a roster bill.

Mass immunizers can enroll as centralized billers and send claims to Novitas, regardless of mass immunizer location, because Medicare pays based on where you deliver the service.

You must operate in at least 3 MAC jurisdictions and get prior approval from Novitas to centralize bill.

To become a centralized biller, call Novitas at 1-855-247-8428 with this information:

  • Estimate of how many patients to whom you expect to administer the COVID-19 shot
  • Approximate dates of shots
  • List of states for COVID-19 vaccination clinics
  • Type of services you generally deliver other than preventive vaccinations, if any (for example, ambulance, home health, visiting nurse)
  • If you employ nurses who will administer the COVID-19 shot or if you hired them specifically to give these shots
  • Names and addresses of all entities operating under provider application
  • Contact information for the centralized billing program designated contact
Page Last Modified:
01/12/2021 02:37 PM