EMS Reimbursement Update January 2013

Published by January 3, 2013 Category: Advocacy/Legislative Updates

 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.