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March 31, 2021

COVID-19: RHC and FQHC Lump Sum Payments

Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) may request lump sum payments for administering COVID-19 vaccines in advance of cost report settlement. CMS will pay you for COVID-19 vaccines and administration at 100% reasonable cost like influenza and pneumonia vaccines.

CMS direction to CGS is to, upon request from the provider, calculate a lump sum based on either:

  1. Data from the RHC’s or FQHC’s most recently submitted cost report, specifically, flu and pneumococcal vaccine costs, or
  2. 60-90 days of actual COVID-19 vaccine and administration data, which would include, but not necessarily limited to: invoices for vaccines, payroll data for the staff providing the administration of the vaccines, and billing rosters that include all vaccines given and the payor for each vaccine given

The request for the lump sum can be submitted to: The request should indicate the basis requested, as noted above, and documentation, if requesting actual COVID-19 vaccine and administration cost reimbursement.


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