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Medicare to increase ambulance service
claims by 4.3% for 2007
By Jim Duke
KAPA Secretary
LOUISVILLE —
As everyone starts to receive their
2007 Medicare EOBs, you may notice that the increase does not
match up with the 4.3% increase publicized by CMS. When inquiring
about this issue, below was the response from Lindy Lady at
National Government Services (Formerly AdminaStar Federal).
“Although the ambulance inflation factor is 4.3% for 2007, you
must also consider the following:
For services furnished during the period July 1, 2004 through
December 31, 2009, the base rate portion of the payment under the
Ambulance Fee Schedule (FS) for ground ambulance transports is
subject to a minimum amount. This minimum amount depends upon the
area of the country in which the service is furnished. The country
is divided into 9 census divisions and each of the census
divisions has a regional FS that is constructed using the same
methodology as the national FS. Where the regional FS is greater
than the national FS, the base rates for ground ambulance
transports are determined by a blend of the national rate and the
regional rate in accordance with the following schedule.
For FY 2007
- 2009 the blending is 80% of the national FS and 20% of the
regional FS.
In cases
where the regional FS is not greater than the national FS, there
is no blending and only the national FS applies. This floor amount
is calculated by CMS Central Office and is incorporated into the
FS amount that appears in the FS file maintained by CMS and
downloaded by CMS contractors.
The Ambulance Fee Schedule is maintained by the Centers for
Medicare/Medicaid Services, and National Government Services could
not make any changes to the Fee Schedules.”
Jim Duke, Ohio County EMS
Secretary, KAPA |
