M0201

Covid-19 vaccine administration inside a patient's home; reported only once per individual home per date of service when only covid-19 vaccine administration is performed at the patient's home

Medicare pricing data for 852 providers across 44 states

🤖AI Overview

Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Covid-19 vaccine administration inside a patient's home; reported only once per individual home per date of service when only covid-19 vaccine administration is performed at the patient's home (HCPCS code M0201) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $36.22, but hospitals typically charge $62.19 — a 1.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.24

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $36.22, your out-of-pocket cost would be approximately $7.24. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$36.22
Average Hospital Charge
$62.19
Markup Ratio
1.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$62.19
Medicare Allowed$36.22
Medicare Payment$36.22

Hospitals charge 1.7x more than what Medicare allows for this procedure. Medicare actually pays $36.22 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$41$592528+14.5%
Massachusetts$39$84273,051+8.9%
Maryland$39$69441,855+7.2%
California$39$83733,338+7.2%
New York$38$67661,798+6.0%
Illinois$38$42192,279+5.1%
Hawaii$38$102122+4.9%
Connecticut$38$6511161+4.4%
New Jersey$38$79411,121+3.6%
Virginia$37$4015456+1.6%
Delaware$36$5914118+0.1%
Oregon$36$5710775-0.1%
Colorado$36$9415364-0.2%
Washington$36$41112,701-0.4%
Pennsylvania$36$67662,499-1.2%
Minnesota$35$74141,240-2.8%
North Dakota$35$40579-2.9%
Montana$35$38111,213-3.4%
Texas$35$5339809-3.5%
Missouri$35$1741040-3.7%
New Mexico$35$45158-4.1%
Michigan$35$53551,053-4.3%
Florida$35$58351,370-4.6%
North Carolina$35$46231,077-4.7%
Ohio$35$7524677-4.7%
Arizona$34$9414533-4.9%
Wyoming$34$35223-5.2%
Louisiana$34$687123-5.3%
Wisconsin$34$8426606-5.7%
South Carolina$34$40134,677-5.8%
Oklahoma$34$6313626-6.3%
West Virginia$34$32310207-6.7%
Iowa$34$5613441-6.8%
Kansas$34$516236-6.9%
Tennessee$34$4920739-7.1%
Georgia$34$7516594-7.3%
Kentucky$34$6811131-7.3%
Nebraska$34$595319-7.3%
Utah$34$637104-7.4%
Idaho$34$558124-7.5%
Mississippi$33$417177-8.8%
Arkansas$33$4513252-9.1%
Indiana$33$901049-9.8%
Alabama$33$4413262-9.8%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber