Medicare Ambulance billing. Ambulance billing codes, Air ambulance billing guide and reimbursement. How and what code to use for correct payment.
Thursday, June 30, 2016
Ambulance Fee schedule
Payment Under the Ambulance Fee Schedule
Payment under the fee schedule for ambulance services:
• Includes a base rate payment plus a separate payment for mileage;
• Covers both the transport of the beneficiary to the nearest appropriate facility and all items and services associated with such transport; and
• Does not include a separate payment for items and services furnished under the ambulance benefit.
Payment for items and services is included in the fee schedule payment. Such items and services include but are not limited to oxygen, drugs, extra attendants, and EKG testing (e.g., ancillary services) - but only when such items and services are both medically necessary and covered by Medicare under the ambulance benefit.
For additional information on the fee schedule, contractors may refer to the “Ambulance Services Center” on the CMS Web site at http://www.cms.hhs.gov/center/ambulance.asp.
Jurisdiction
Claims jurisdiction for suppliers is considered to be where the ambulance vehicle is garaged or hangared. Claims jurisdiction for institutional based providers is based on the primary location of the institution.
Services Provided
Payment is based on the level of service provided, not on the vehicle used. Occasionally, local jurisdictions require the dispatch of an ambulance that is above the level of service that ends up being provided to the Medicare beneficiary. In this, as in most instances, Medicare pays only for the level of service provided, and then only when the service provided is medically necessary.
Labels:
Fee shedule,
Medical billing basic,
Medicare
Subscribe to:
Post Comments (Atom)
Popular Posts
-
I have received a denial for my submission of specialty care transport HCPCS code A0434. What could be wrong? Answer: Did you submit a p...
-
HCPCS A0429 – Ambulance service, BLS, emergency transport, all inclusive Basic Life Support (BLS) Emergency – When medically necessary, th...
-
Procedure code and description A0425 Ground mileage, per statute mile A0426 Ambulance service, advanced life support, nonemergency trans...
-
HCPCS A0433 – Advanced Life Support, Level 2 Advanced Life Support, Level 2 (ALS 2) – ALS2 is the transportation by ground ambulance vehic...
-
Procedure code and Description A0425 Ground mileage, per statute mile No PAR A0426 Ambulance service, advanced life support, nonemergency...
-
HCPCS procedure codes are used for Ambulance service The HCPCS procedure codes listed in the following table are the only reimbursable pro...
-
Origin and Destination Modifier Table The modifiers listed in the following Origin and Destination Modifier table are required for billin...
-
Procedure Codes for Air Services HCPCS A0430 – Ambulance service, conventional air services, transport, one way, fixed wing Fixed Wing (F...
-
HCPCS A0432 – Paramedic Intercept (PI), rural area transport furnished by a volunteer ambulance company, which is prohibited by state law fr...
-
Coverage Guidance Coverage Indications, Limitations, and/or Medical Necessity The autonomic nervous system (ANS) regulates physiologic p...

No comments:
Post a Comment