Page, Wolfberg & Wirth provides these forms for use in your organization.
Click HERE to download our tool for the 2023 Medicare Ambulance Fee Schedule Allowed Amounts by Zip Code. The spreadsheet will open in Protected View. Please click the Enable Editing Button. Enter the zip code of the pickup location for the patient in yellow box and press enter. All fee schedule amounts will populate. Other important information such as the Carrier ID, locality and urban, rural, or super rural will also appear.
Our Medicare and Billing Forms have been used by organizations all throughout the USA. Take a look for yourself!
Sample policy for the refusal of care, transporation or recommended destination