Use the Medicare Ambulance Fee Schedule to determine payment rates for covered ambulance transport. The national fee schedule applies to all ambulance services, including private, independent, institutional, and skilled nursing facility ambulance services.

Fees

When billing ambulance mileage, report only loaded miles, which are the miles traveled while the beneficiary is on board the ambulance. Medicare does not pay for miles traveled to the point of pickup (POP). Report only payable mileage on the claim to help ensure accurate billing and reimbursement

Effective January 2024 - Ambulance Fee Schedule files can be found on the CMS Ambulance Fee Schedule & ZIP Code Files and access the Public Use Files (PUFs) link."

AIF

Review the annual Ambulance Inflation Factor (AIF) when determining current reimbursement amounts. Medicare adjusts air and ground ambulance payment rates each year using the AIF.

Refer to the CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 15, Section 20.1.4 - Components of the Ambulance Fee Schedule for additional information on how ambulance fee schedule amounts are calculated.

Resources

• Claims Processing/Reimbursement
  • CMS 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 Change Request (CR) 8269 - Ambulance Payment Reduction for Non-Emergency Basic Life Support (BLS) Transports to and from Renal Dialysis Facilities
• Ambulance Fee Schedule webpage.