COVID-19 Vaccine Resource Center

Sept. 3, 2020 – HHS announced that pharmacists can independently order and administer COVID vaccines. Please see requirements in our “Requirement information” tab or in the HHS guidance directly.

• Therefore, a physician’s authorization is not required. HHS Guidance: https://www.hhs.gov/guidance/sites/default/files/hhs-guidance-documents/licensed-pharmacists-and-pharmacy-interns-regarding-covid-19-vaccines-immunity.pdf 

How does the pharmacy bill for the vaccine without an associated provider?

• Since there is no provider associated with the vaccine order, the pharmacist will use their individual Type 1 NPI (please see Reimbursement Information tab for application instructions). Please note that some state & commercial payers will require additional registration from the billing pharmacist. Please contact your state Medicare / Medicaid for more information. 

A physician protocol may still be required for legal or billing purposes in some states. 

Pharmacies must register with their state immunization information systems (IIS). Please check with your state registry for any additional COVID-19 vaccination registration requirements.

Pharmacies must register through the CDC’s free Vaccine Finder service (www.vaccinefinder.org).

• Vaccine Finder, maintained by HealthMap and the CDC, is a free, comprehensive service that connects vaccine-seeking patients to your practice when registered as a participating pharmacy. https://vaccinefinder.org/covid-provider-resources
• COVID-19 vaccination inventory must be reported to VaccineFinder daily. Please note that some immunization registries are able to report inventory on your behalf. https://www.cdc.gov/vaccines/covid-19/vaccination-provider-support.htm

Pharmacists must complete a practical training program of at least 20 hours approved by the Accreditation Council for Pharmacy Education (ACPE).

• Training to include hands-on injection technique, clinical evaluation of indications & contraindications of vaccines, and the recognition & treatment of emergency reactions to vaccines
• For states that allow pharmacists to order and administer vaccines with less training than the PREP Act 20-hour ACPE required education, pharmacists may be covered by the PREP act if in compliance with state regulations.

Pharmacists must complete a minimum of 2 hours of ACPE-approved, immunization-related continuing pharmacy education during each State licensing period.

Pharmacists must have a current certificate in basic cardiopulmonary resuscitation.

• Mandated basic CPR training can be met via an online program that has received accreditation from the American Nurses Credentialing Center, the ACPE, or the Accreditation Council for Continuing Medical Education.

For patients aged 18 years or younger, pharmacists must inform the patient, and the adult caregiver accompanying the patient, of the importance of a well-child visit with a pediatrician or other licensed primary-care provider, & refer patients as appropriate.

This is the number that is assigned to you through your state immunization system and can be obtained by contacting your state registry directly, followed by accessing COVID-19 vaccination portal

• Check with your state if you’re mandated to report electronically. If not, you may enter vaccination data into the IIS manually while going through the integration process with an electronic platform (such as PrescribeWellness) 

Through the PrescribeWellness Vaccination solution, you can:

• Ensure integration & connectivity with individual state IIS. Please note, if using PrescribeWellness for integration, enter “SMP PrescribeWellness” as the EHR/EMR. 
• Easily filter and identify patients to be considered for early vaccinations
  • The CDC is considering early vaccination groups if supply is limited. This may include people 65 years and older and those with chronic conditions. Learn more here.
• Communicate with physicians through integrated fax
• Leverage patient communications through voice and text
• Schedule vaccination appointments using a custom calendar to facilitate the crucial administration of the second dose

V-safe 

• COVID-19 vaccine safety monitoring will be top priority for the CDC. Therefore a mobile application v-safe was created for patients to easily report any adverse events experienced post-administration via surveys and text messaging. Any clinically significant side effects will result in provider follow up

• Vaccine recipients will receive health check-ins daily for the first week after receiving vaccination dose, then weekly until 6 weeks post-vaccination. Additional check-ins will be sent at 3, 6, and 12 months after vaccination dose. 

• As a COVID-19 vaccine provider, it is important for the pharmacist to encourage patients to use v-safe. Be sure to provide the v-safe info sheet to the patient post-administration (available on the CDC website). 

• Learn more about  v-safe on the CDC website: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety.html

VAERS

Pharmacists are required to report serious adverse events, and encouraged to report any clinically significant adverse events following a COVID-19 vaccine administration.

For a list of adverse events categorized as serious and additional questions, please visit the VAERS FAQs on the HHS website: https://vaers.hhs.gov/faq.html

Vaccinating pharmacists may consider obtaining individual NPIs for claim submission if they plan to bill for COVID-19 vaccines using themselves as the ordering providers in the dispensing system.

• If you plan on using the HHS guidance to provide COVID-19 vaccines independently without using an ordering provider (standing order, prescription, protocol / CPA), your dispensing system will require a provider (in this case, pharmacist) to provide an NPI for claim submission. Learn more and apply to get your NPI here. The application process is fast and free, and you can expect to receive your NPI electronically in less than a week.

COVID-19 Vaccinations will be covered under Medicare. In order to bill for these vaccines successfully, pharmacies need to ensure they are registered as Part B Mass Immunizers. Learn more here.

• PrescribeWellness VaccineComplete customers have access to the Vaccination Guidebook.

On May 3, 2021, HRSA announced a new program – the COVID-19 Coverage Assistance Fund (CAF) – to cover the cost of administering COVID-19 vaccines to patients with health insurance, but that insurance does not cover vaccination fees or covers them with cost-sharing. This program seeks to address the need for providers to be compensated for vaccinating underinsured patients and will reimburse providers at the increased national Medicare rate or patient costs for administration for those with some coverage. HHS views CAF as closing the final payment gap for the general public and removes any reimbursement issues for providers for administering vaccines approved by the FDA.

Providers will need to enroll in the CAF portal, which takes three to five days, prior to submitting claims. HRSA expects properly submitted claims to be paid within 15 days. For more information on how to process these claims and login and use the online system, please see the CAF portal guide.

NCPA COVID-19 Billing Guidlines PDF

Pharmacists can report COVID-19 billing issues to NCPA at the link here.