On November 19, the Centers for Medicare and Medicaid Services (CMS) issued Transmittal 2103 (Change Request 7065) which provides instructions to carriers on implementing fractional mileage. The fractional mileage change is effective for services on and after January 1, 2011.

The key points of the Transmittal are as follows:
• Claims billed by suppliers and providers (except providers using a paper UB-04 form) must report all mileage less than 100 miles rounded up to the nearest tenth of a mile;
• Mileage over 100 miles should still be rounded up to the next whole number;
• When billing mileage less than one mile, use a "0" before the decimal, followed by the tenths of a mile. For example, two-tenths of a mile would be 0.2;
• Part A billers still using a paper UB-04 are allowed to still round up all mileage to the next whole number (until CMS completes a system change for the form);
• If you enter the HCPCS code for mileage, but do not enter any units, Carriers are directed to list "0.1" for the mileage. Part A intermediaries are directed to return the claim if mileage is not entered; and,
• These new fractional mileage requirements apply to ground as well as air ambulance claims.
In addition, the Federal Register from yesterday includes the official final rule entitled "Medicare Program: Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2011" on the fractional mileage change. To access a copy of the Final Rule from the Federal Register, please click here.

NAEMT and other EMS organizations continue to push for changes to the fractional mileage policy. However, even if we are successful, it is unlikely that the changes would impact the January 1, 2010 effective date. So please be prepared to implement the fractional mileage change.