Ambulance - JE Part B
Ambulance Fee Schedules
There is a national fee schedule for ambulance services furnished as a benefit under Medicare Part B. It applies to all ambulance services, including volunteer, municipal, private, independent, and institutional providers, i.e., hospitals, critical access hospitals (except when it is the only ambulance service within 35 miles), and skilled nursing facilities.
Air and Ground ambulance mileage rates are adjusted by the yearly ambulance inflation factor (AIF). See the CMS Internet Only Manual (IOM), Publication 100-04, Chapter 15, Section 20.1.4 - Components of the Ambulance Fee Schedule to see how the amounts are determined.
- 2021 = 0.2%
- 2020 = 0.9%
- 2019 = 2.3%
Medicare pays for "loaded" miles only. These are miles traveled while the patient is on board. Medicare does not pay for miles traveled to the point of pick up.
To access the Proposed Rule for Payment under the Ambulance Fee Schedule (AFS), the National Breakout of Geographic Area Definitions by Zip Code and the zip codes file downloads, go to the Ambulance Fee Schedule webpage.
- Claims Processing/Reimbursement
- CMS Internet Only Manual (IOM), Publication 100-02, Medicare Benefit Policy Manual, Publication, Chapter 10 - Ambulance Services
- CMS IOM, Publication 100-04, Medicare Claims Processing Manual, Chapter 15 - Ambulance
- CMS IOM, Publication 100-08, Medicare Program Integrity Manual, Chapter 6 - Medicare Contractor Medical Review Guidelines for Specific Services
- CMS Medicare Learning Network (MLN) Matters (MM)8269 - Ambulance Payment Reduction for Non-Emergency Basic Life Support (BLS) Transports to and from Renal Dialysis Facilities
Last Updated Thu, 18 Mar 2021 19:31:34 +0000