Monday, October 18, 2010

Rural Adjustment Factor (RAF) in ambulance billing

Rural Adjustment Factor (RAF)

The Rural Adjustment Factor (RAF) is an adjustment applied to the payment amount for ambulance services when the POP is in a rural area.

1. For ground ambulance services furnished before July 1, 2004, a 50 percent increase is applied to the urban ambulance fee schedule mileage rate for each of the first 17 miles of a rural POP.

2. For services furnished on or after July 1, 2004, a 50 percent increase is applied to the rural ambulance fee schedule mileage rate for each of the first 17 miles of a rural POP.

3. For services furnished before January 1, 2004, a 25 percent increase is applied to the urban ambulance fee schedule mileage rate for mileage between 18 and 50 miles of a rural POP; and the urban ambulance fee schedule mileage rate applies to every mile of a rural POP over 50 miles.

4. For services furnished during the period January 1, 2004 through June 30, 2004, the urban ambulance fee schedule mileage rate applies to every mile of a rural POP over 17 miles.

5. For services furnished on or after July 1, 2004, the rural ambulance fee schedule mileage rate applies to every mile of a rural POP over 17 miles (and this amount is used when applying the bonus amount for long rural trips, as described below).

6. For services furnished during the period July 1, 2004 through December 31, 2009, the base rate portion of the payment under the fee schedule for ground ambulance transports furnished in certain rural areas is increased by an amount to be determined by CMS. This increase applies where the POP is in a rural county (or Goldsmith area) that is comprised by the lowest quartile by population of all such rural areas arrayed by population density.

7. For services furnished during the period July 1, 2004 through December 31, 2008, a 25 percent increase is applied to the appropriate ambulance fee schedule mileage rate to each mile of a transport (both urban and rural POP) that exceeds 50 miles (i.e., mile 51 and greater).

No comments:

Post a Comment

Popular Posts