2005 Ambulance Fee Schedule Amounts
The amounts accessible from the link provided below are the Ambulance Fee Schedule amounts for services performed in 2005 in each of the WPS states.
In accordance with the Final Rule, the new fee schedule is being phased in over five years, starting April 1, 2002, blending current reasonable charge payment levels with the new fee schedule rates listed below during the transition. In 2005, the blend is 80 percent of the Ambulance Fee Schedule (below), and 20 percent of the current Reasonable Charge rates.
**The rural Ambulance Fee Schedule rate for ground mileage (A0425) is 50% higher for the first 17 loaded miles (rural rate X 1.5 = rural rate). Rural ground miles 17-50 are equal to the rural mileage rate. For all ground miles (both rural and urban) over 50, the ambulance fee schedule rate for A0425 is 25% higher than the appropriate rate (urban rate x 1.25 or rural rate x 1.25). These amounts are then blended using 20% of the Reasonable Charge rate and 80% of the Ambulance Fee Schedule.
# Effective for dates of service 7/1/04 - 12/31/09, the base rate of the payment under the Ambulance Fee Schedule for ground ambulance transports furnished in certain rural areas is increased by 22.6% as determined by the Centers for Medicare & Medicaid Services (CMS). This increase applies where the point of pick-up (POP) is in a rural county (or Goldsmith Area) that is comprised by the lowest quartile by population of all such rural areas arrayed by population density. (The codes that are eligible for this bonus are indicated in the Fee Schedule chart with a '#' indicator.)
NOTES:
Method 3 and Method 4 ambulance suppliers can continue to bill for supplies during the transition period, using the existing old supply codes. There are no corresponding 'new' supply codes. Supplies are included in the Ambulance Fee Schedule base rates; therefore, the allowed amounts for these codes for dates of service in 2005 will be based on 20% of the 2005 Reasonable Charge rate.
For dates of service 4/1/02 and after, Method 1 and Method 3 suppliers may bill mileage code A0425. Their allowed amount for A0425 is based on the AFS percentage only. The Reasonable Charge portion of the calculation does not apply to those suppliers for A0425. (Their Reasonable Charge portion for mileage is included in their base rate allowance.) For 2005, code A0425 is allowed at 80% of the AFS.
To view the 2005 Ambulance Fee Schedule Amounts for Wisconsin, Illinois, Michigan, and Minnesota, please click here 
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Page Last Updated: Tuesday, 04-Dec-2007 13:19:04 CST
