Frequently Asked Questions
Cost collection, the result of the Bipartisan Budget Act of 2018, requires all ambulance services that bill Medicare or Medicaid to collect and report cost-related data to the Center for Medicare and Medicaid Services (CMS).
The goal of this cost-data collection is to allow CMS to assess the adequacy of the Ambulance Fee Schedule.
This is the first time ambulance cost-related data has been systematically collected and analyzed by CMS. Industry experts believe that this cost collection process will reveal the Ambulance Fee Schedule as inadequate to reimburse ambulance service providers for their services. The CMS ambulance cost collection process will likely set Medicare payment policy for many years to come. Additionally, this data will be publicly available and will likely be used by CMS and other payors to structure their reimbursement rates.
CMS has released information on Year 1 and Year 2 services selected to submit their data. Year 1 organizations would have started receiving letters from CMS in November of 2021.
(These links are external downloads directly from the CMS website)
- Ground Ambulance Providers and Suppliers Selected to Submit Data in Year 1 (ZIP)
- Ground Ambulance Providers and Suppliers Selected to Submit Data in Year 2 (ZIP)
If your organization is not on these lists, it is very likely that you will be selected for Year 3 or Year 4.
Data must be submitted to CMS within 5 months of the end of the calander year. CMS is developing a web-based portal that will launch in late 2022 to use for reporting.
EMS agencies that fail to report their cost data to CMS will have a 10% reduction in their reimbursement from CMS for a period of one year. But that’s not the full picture.
Given that the last time the Medicare reimbursement model was last updated over 20 years ago, Inaccurate cost data may set Medicare payment policy for decades to come.
75% of EMS agencies across the US bill Medicare for 1,000 or fewer transports per year. That means MOST of our nation’s EMS services are small, rural, or even volunteer services. If small, rural, and volunteer services choose not to report, the data will skew to larger services. This will result in inaccurate cost data and, likely, reductions in Medicare reimbursement rates.
EMS is already the most underfunded healthcare service – further cuts would decimate our EMS system coast-to-coast.
All organizations that run ground ambulance transports can be selected by CMS to do Cost Collection reporting, regardless of whether your organization is structured as Fire or EMS.
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