Saturday, July 30, 2016

AMBULANCE FEE SCHEDULE FILE RECORD DESCRIPTION

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

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