CMS will also provide contractors with a national Ambulance FS file that will contain payment amounts for the applicable HCPCS codes. The file will include FS payment amounts by locality for all FS localities. The FS file will be available via the CMS Mainframe Telecommunications System. Contractors are responsible for retrieving this file when it becomes available. The full FS amount will be included in this file. CMS will notify contractors of updates to the FS and when the updated files will be available for retrieval. CMS will send a full-replacement file for annual updates and for any other updates that may occur.
The following is a record layout of the Ambulance Fee Schedule file:
Field Name Position Format Description
HCPCS 1-5 X(5) Level 2 HCPCs code number for the service.
Carrier Number 6-10 X(5) Contractor Number
Locality Code 11-12 X(2) Identification of Pricing Locality
RVU 13-18 9(4)V2 Relative Value Units set a numeric value for ambulance services relative to the value of a base level ambulance service.
GPCI (PE) 19-22 9V3 The GPCI for the practice expense portion of the Medicare physician fee schedule is used to adjust payment to account for regional differences.
Base Rate 23-29 9(5)V2 A nationally uniform “base” amount used to calculate each HCPCS’ payment amount.
Urban Rate 30-36 9(5)V2 Urban Ground/Air mileage rate.
Rural Rate 37-43 9(5)V2 Rural Ground/Air mileage rate.
Current Year 44-47 x(4) 4 digit current effective year.
Current Quarter 48-48 x(1) 1 digit current effective quarter: 1=January, 2=April, 3=July, 4 =October.
Current Date 49-56 x(8) Current Effective Start Date.
Filler 57-80 X(26) Future use
Medicare Ambulance billing. Ambulance billing codes, Air ambulance billing guide and reimbursement. How and what code to use for correct payment.
Saturday, July 30, 2016
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