EMS Reimbursement Update January 2013

 2013 Ambulance Fee Schedule

Through recent “fiscal   cliff” legislation, Congress has voted to extend ambulance “add   on” payments until January 1, 2014.

The current “add on” payments   of 2% for urban providers, 3% for rural providers, and 22.6% for super rural   providers were set to expire on December 31, 2012. In addition to the   extension, the Ambulance Inflation Factor for 2013 is 0.8% .

Many Medicare Contractors have   published the 2013 Medicare Ambulance Fee Schedule; however, these extensions   were not taken into consideration.  Any rate adjustments should be   postponed until CMS publishes the official Ambulance Fee Schedule.    EMSMC will provide a client-specific charge comparison once the revised Fee   Schedule has been published.


Dialysis Transports

Effective October 1, 2013, Medicare reimbursement for non-emergency, BLS dialysis transports will be reduced by 10%.

These changes are a result of the recent GAO Study that identified a 59% increase in non-emergency dialysis transports and an increase in private, for-profit ambulance services into the industry.

OIG and CMS continue to warn ambulance providers of the high risk of fraud and abuse in repetitive, non-emergency transportation and the increase in Medicare audits in these areas.


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