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CMS Publishes New Rules for Ambulances

PWW’s Summary

11/16/2015

On November 16, 2015, the Centers for Medicare & Medicaid Services (CMS) published the Final 2016 Physician Fee Schedule Rule in the Federal Register.  The Final Rule contains several notable ambulance-specific provisions, which PWW excerpted HERE. 

The Final Rule Does Three Main Things:
 

1. Updates Medicare Regulations to Account for Bonus Payment Extensions

Starting way back in July of 2008, Congress increased the Medicare ambulance fee schedule amounts for ground ambulance services.  These...

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

Requests Can Start on December 1, 2014

11/13/2014

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 Contractors...

PWW Summary of Final 2015 Ambulance Fee Schedule Rule

Many ZIP Codes Going From Rural to Urban

11/06/2014

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 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,” is a...

2015 Ambulance Inflation Factor Updated

AIF Will be 1.5% in 2015

09/12/2014

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 the "Ambulance Inflation Factor" (or "AIF").  The AIF is tied to the annual consumer price index for all urban...

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CMS

PWW Summary of Proposed 2015 Ambulance Fee Schedule Rule Changes

07/11/2014

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, and comprises the “...

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CMS