Summary of Changes NOT Delayed 

1. HCFA is requiring implementation of the New HCPCS codes, except for mileage. 
2. HCFA is requiring the placement of the zip code of the point of pick-up on all claims.

Changes Delayed: 

1. Use of the transition formulas - payment based on current methodology. 
2. Mandatory assignment is delayed. 
3. Use of new mileage code. - Use current mileage codes. 
4. Payment of "ALS No ALS provided" at BLS rates - Use ALS1 rates during interim.

Other Changes: 

1. An ambulance company will be required to bill using a single billing method (1, 2, 3 or 4) for all claims starting January 
2. Carriers are instructed to ask suppliers to use a SINGLE carrier-wide billing method - the same method for ALL suppliers in the locality.

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MECHANICSBURG, Pennsylvania — As was expected, the Health Care Financing Administration (HCFA) officially announced a delay in the implementation of certain aspects of the Medicare Ambulance Fee Schedule. 

To briefly summarize, the important points in HCFA's announcement are as follows:

Payment under the fee schedule is being delayed and will not begin on January 1, 2001. Although it is believed that HCFA is still working toward an April 1, 2001 implementation date, the Program Memorandum postpones the Fee Schedule indefinitely. As a result, ambulance providers and suppliers will continue to be paid based on 100% of the allowance under current payment rules even after January 1st.

Also being delayed indefinitely is the instruction to carriers to implement system changes on the mandatory assignment rule, though carriers are instructed to enforce mandatory assignment "through administrative actions" when necessary.

Carriers are also instructed to delay implementation of the "ALS vehicle used, but no ALS service furnished" rule. Thus, even after January 1, providers who use an ALS vehicle but furnish no ALS services can bill at the ALS level under the new ALS1 and ALS1 emergency HCPCS codes.

Carriers have also been instructed to delay implementation of the new mileage HCPCS code (A0425). The old ALS and BLS mileage codes will continue. Providers SHOULD NOT bill under the new mileage HCPCS code until further notice.

Finally, HCFA is delaying the policy regarding payment based on the condition of the beneficiary and services rendered by the crew.

There are, however, some significant changes that will still be implemented on January 1, 2001, including:

• All new HCPCS codes (except mileage) will be implemented January 1st. - There will be no grace period for old codes except the mileage codes. - ZIP CODES MUST BE USED on claims and bills to determine the point of patient pickup effective January 1st.
• In addition, carriers may be asking ambulance suppliers to convert to a single carrier-wide billing method until such time as the Fee Schedule is implemented.