Ambulance Billing/Medicare

CMS Issues Notice About Prior Authorization Model in PA, NJ and SC

Requests Can Start on December 1, 2014

On November 13, 2014, CMS issued a Notice in the Federal Register officially announcing a 3-year Medicare Prior Authorization model for repetitive scheduled non-emergent ambulance transports in the states of New Jersey, Pennsylvania, and South Carolina.  The new model means that certain ambulance services in these three states must soon obtain prior authorization for repetitive, scheduled non-emergent transports by submitting a host of documentation to their Medicare Administrative...

PWW Summary of Final 2015 Ambulance Fee Schedule Rule

Many ZIP Codes Going From Rural to Urban

On November 13, 2014, the Centers for Medicare and Medicaid Services (CMS) issued a Final Rule that updates regulations to account for the ambulance bonuses and changes many ZIP code designations for purposes of Medicare reimbursement.  The Rule, Medicare Program; Revisions to Payment...

2015 Ambulance Inflation Factor Updated

AIF Will be 1.5% in 2015

Medicare reimbursement rates for ambulance services will increase by 1.5% in calendar year 2015.  On October 7, 2014, CMS issued Transmittal 3090, revising the Ambulance Inflation Factor for calendar year 2015.  CMS previously said the Inflation Factor would be 1.4%.   

Each year, CMS updates the Medicare ambulance reimbursement rates to reflect increases in inflation.  CMS calls this...


PWW Summary of Proposed 2015 Ambulance Fee Schedule Rule Changes

On July 11, 2014, Centers for Medicare and Medicaid Services (CMS) issued a Proposed Rule entitled: “Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule, Clinical Laboratory Fee Schedule, Access to Identifiable Data for the Center for Medicare and Medicaid Innovation Models & Other Revisions to Part B for CY 2015.” The lengthy Proposed Rule revises payment polices for several types of Part B Medicare providers, including ambulance services,...