Enrollment for Administering COVID-19 Vaccines

This page is for health care providers.

If you're a person with Medicare, learn more about your Medicare coverage for COVID-19 vaccines, and find a COVID-19 vaccine near you

Get information about provider enrollment in Medicaid and the Children’s Health Insurance Program (CHIP)

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

View our video for an overview of the COVID-19 vaccine enrollment process and requirements.

 

Enrollment Information for Medicare

I'm Already Enrolled in Medicare

If you’re enrolled in Medicare under the institutional or non-institutional provider types listed below, you don’t need to take any action to administer and bill the COVID-19 vaccine. You can submit individual claims or roster bill, without enrolling as a mass immunizer.

Institutional Non-Institutional
  • Hospital
  • Hospital Outpatient Department
  • Skilled Nursing Facility (SNF) (includes Parts A and B)1
  • Critical Access Hospital
  • Independent Renal Dialysis Facility
  • Hospital-Based Renal Dialysis Facility2, 4
  • Home Health Agency
  • Hospice
  • Comprehensive Outpatient Rehabilitation Facility
  • Federally Qualified Health Center2,3
  • Rural Health Clinic2
  • Indian Health Services Facility
  • Physician
    • Doctor of Medicine or Doctor of Osteopathy 
    • Doctor of Dental Surgery or Dental Medicine
    • Doctor of Podiatric Medicine
    • Doctor of Optometry
    • Doctor of Chiropractic
  • 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 in a covered Part A stay or under arrangement pursuant to which the SNF pays an outside immunizer to administer the vaccine. In both situations the SNF must bill Medicare. But, during the public health emergency (PHE), we’ll allow Medicare-enrolled immunizers who aren't under arrangement with the SNF to vaccinate Medicare SNF residents and bill directly for Medicare payment. See the recent enforcement discretion notice (PDF) for more information. For a resident in a noncovered stay, the SNF or the immunizer not under arrangement may bill for the vaccine.

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

Report vaccine and administration on claim informationally.

4 Claims should be billed as usual and reconciled through the cost report process.

Review how to bill your claims (PDF)

I'm Enrolled in Medicare, but My Provider Type Doesn’t Allow Me to Bill for Administering Vaccines

If you’re enrolled in Medicare under the provider types listed below and you want to bill for administering COVID-19 vaccines, you must also separately enroll as an institutional or non-institutional provider type, like a mass immunizer, that can bill for the COVID-19 vaccine.

Enrolling over the phone is easy and quick — call your Medicare Administrative Contractor (MAC)-specific enrollment hotline (PDF) and give them your:

  • Valid Legal Business Name (LBN)
  • National Provider Identifier (NPI)
  • Tax Identification Number (TIN)
  • Practice location
  • State license, if applicable
Note:

Medicare grants billing privileges through the Medicare Provider Enrollment Hotline on a provisional basis because of the public health emergency (PHE). These billing privileges are temporary. When the COVID-19 PHE ends, MACs will contact providers and suppliers to request a complete CMS-855 enrollment application to establish full Medicare billing privileges. If you don't respond within 30 days of the MAC’s request, the MAC will deactivate your temporary billing privileges.  If you provide services while you have deactivated billing privileges, Medicare can’t pay you.

 

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 (DME) Supplier
  • Pharmacy (enrolled as DME supplier)

Review our quick reference process on enrollment (PDF)

I'm Not Currently 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. Enrolling over the phone is easy and quick — call your Medicare Administrative Contractor (MAC)-specific enrollment hotline (PDF) and give them your:

  • Valid Legal Business Name (LBN)
  • National Provider Identifier (NPI)
  • Tax Identification Number (TIN)
  • Practice location
  • State license, if applicable
Note:

Medicare grants billing privileges through the Medicare Provider Enrollment Hotline on a provisional basis because of the public health emergency (PHE). These billing privileges are temporary. When the COVID-19 PHE ends, MACs will contact providers and suppliers to request a complete CMS-855 enrollment application to establish full Medicare billing privileges. If you don't respond within 30 days of the MAC’s request, the MAC will deactivate your temporary billing privileges.  If you provide services while you have deactivated billing privileges, Medicare can’t pay you.

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

Review our quick reference process on enrollment (PDF)

 

How Can I Enroll as a Centralized Biller?

If you’re a mass immunizer, you can use centralized billing to send all of your COVID-19 vaccine roster bill claims, to a single MAC, Novitas. Medicare pays based on where you administer the vaccine. You can enroll in and use centralized billing regardless of where you administer the vaccines.

You must operate in at least 3 MAC jurisdictions and get prior approval from Novitas to use centralized billing.

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 vaccine
  • Approximate dates of vaccines
  • 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)
  • Whether you employ nurses who will administer the COVID-19 vaccine or if you hired them specifically to give these vaccines
  • Names and addresses of all entities operating under your application
  • Contact information for your centralized billing program
Page Last Modified:
05/27/2021 11:25 AM