Posts Tagged ‘ambulance fee schedule’

Ambulance suppliers soon will be required to report mileage to the nearest tenth of a mile for all Medicare claims totaling up to, but not including, 100 covered miles.

Presently, ambulance suppliers round the mileage up to the nearest whole mile for trips totaling less than a whole number mile. This was necessary because the Medicare fee-for-service claims processing system was unable to accept fractional units of mileage on ambulance claims.

As the system is now able to process mileage HCPCS Level II codes to a tenth of a mile, suppliers should submit fractional mileage using a decimal in the appropriate place (e.g. 99.9) effective Jan. 1, 2010. For mileage totaling less than 1 mile, include a zero before the decimal point (e.g. 0.9). For trips totaling 100 or more covered miles, suppliers should continue to report mileage rounded to the nearest whole number.

This policy applies only to ambulance services billed on CMS-1500 paper claims or ANSI X12N 837P electronic claims. This policy does not apply to hospital-based ambulance services.

For further details, see the Centers for Medicare & Medicaid Services (CMS) Transmittal 1787, issued July 31.

The Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 amends the Social Security Act §1834(l)(13) and provides an increase in payment for ambulance ground transports.

Effective for claims with dates of service on or after July 1, 2008, and before Jan. 1, 2010, ambulance fee schedule amounts for covered ground ambulance transports which originate in a rural area increase by 3 percent, and covered ground ambulance transports which originate in a non-rural area increase by 2 percent.

For further details, read Transmittal 414, CR 6206 on CMS’s Web site.