CMS Publishes 2019 Proposed Fee Schedule Rule

On July 27, 2018, the Centers for Medicare & Medicaid Services (CMS) published the 2019 Proposed Physician Fee Schedule (PFS). This Rule simply updates the ambulance regulations concerning the add-on payments and dialysis reductions that were passed by Congress earlier this year.  Here’s a quick breakdown…

Add-Ons Extended For 5 Years
First, CMS is updating the regulations to reflect the ambulance add-on extensions through December 31, 2022.  Congress extended the 2% urban, 3% rural, and 22.6% super-rural bonuses on February 9 of this year, and made them retroactive to January 1, 2018.
More Decreases for Dialysis Transports
The Proposed Rule also implements the new 13% reduction for dialysis transports beginning on October 1, 2018.  This reduction is in addition to the existing 10% reduction for dialysis transports that has been in effect since October 1, 2013.  Beginning October 1, 2018, the total reduction in Medicare payments for non-emergency dialysis transports will be 23%.    

But Wait, There’s More…
By December 31, 2019, CMS is required to develop a “data collection system” for ground ambulance services that will collect data about ambulance costs, revenue and utilization rates.  If your agency is selected, you must report data on time, or potentially face a 10% Medicare payment reduction.  While CMS didn’t request any information about the data collection system in the Rule, CMS has been taking steps to prepare for the initiative.

Discover more about the data reporting requirement, and what all of this means for ambulance reimbursement in the next 5 years by attending abc360.  Registration is now open for all four 2018 - 2019 locations.