Medicare Fee Schedule Updates - July 2004
Contemporary Memo
The Medicare Modernization Act (MMA), otherwise known as
the Prescription Drug Bill, contained a few provisions for Ambulance
Suppliers. The following changes will be
effective for dates of service July 1, 2004.
·
Increase of 1% for urban providers and 2% for
rural providers will be added to the Medicare Fee Schedule portion of the
blended rate. This increase will apply
both to the base rate as well as the mileage procedures. Reimbursement will depend upon the point of
pickup as either an urban or rural zip code as defined by CMS.
·
Increase of 25% for mileage for long transports
(50 miles or greater), beginning with mile 51, for both urban and rural
transports
·
Increase of 22.6% for those suppliers providing
services in the rural areas in the lowest quartile. In NC, the only counties that are ranked in
the lowest quartile and eligible for this increase are Tyrrell and Hyde.
Based on the above changes,
the following represents the new Medicare Fee Schedule (MFS) rates for NC.
|
|
2004 Medicare Fee Schedule
|
07/04 Urban MFS
|
07/04 Rural MFS
|
07/04 Rural MFS
(Lowest Quart.)
|
|
ALS NE (A0426)
|
$201.04
|
$203.05
|
$205.06
|
$251.40
|
|
ALS E (A0427)
|
$318.32
|
$321.50
|
$324.69
|
$398.07
|
|
BLS NE (A0428)
|
$167.54
|
$169.22
|
$170.89
|
$209.51
|
|
BLS E (A0429)
|
$268.06
|
$270.74
|
$273.42
|
$335.21
|
|
ALS 2 (A0433)
|
$460.73
|
$465.34
|
$469.94
|
$576.15
|
|
SCT (A0434)
|
$544.50
|
$549.95
|
$555.39
|
$680.91
|
|
BLS/ALS E (Q3019)
|
$268.06
|
$270.74
|
$273.42
|
$335.21
|
|
BLS/ALS NE (Q3020)
|
$167.54
|
$169.22
|
$170.89
|
$209.51
|
|
MILEAGE (A0425)
|
$5.65
|
$5.71
|
$5.76
|
$7.07
|
|
Rural Mileage (1-17)
|
$8.48
|
8.56
|
$8.64
|
$10.60
|
|
Mileage beyond 50
|
$7.06
|
$7.13
|
$7.20
|
$8.83
|
|