CMS Issues Final Rule on Ambulance Fee Schedule Changes for 2012

11/2/2011 11:43:14 AM

On November 1, 2011, CMS released an advance copy of its final rule on changes to the Ambulance Fee Schedule for calendar year 2012.

On November 1, 2011, CMS released an advance copy of its final rule on changes to the Ambulance Fee Schedule for calendar year 2012.  The final rule, titled "Medicare Program; End-Stage Renal Disease Prospective Payment System and Quality Incentive Program; Ambulance Fee Schedule; Durable Medical Equipment; and Competitive Acquisition of Certain Durable Medical Equipment, Prosthetics, Orthotics (CMS-1577-F)", will appear in the Federal Register on November 28, 2011.

Unlike prior years, CMS is not making any substantive changes to its coverage of ambulance services.  Instead, CMS is simply updating its regulations to reflect the extension of the temporary increases for ground and air ambulance services through December 31, 2011, which was part of the Medicare and Medicaid Extenders Act of 2010.  In other words, while the final rule references calendar year 2012, the changes CMS is proposing to make actually reflect the current statutory requirements for 2011.  These temporary adjustments include:

• the 2% increase for ground ambulance transports furnished in urban areas;
• the 3% increase for ground ambulance transports furnished in rural areas;
• the 22.6% adjustment for ground ambulance transports furnished in "super rural" areas; and
• the rural "hold harmless" for air ambulance transports that were furnished in areas that were designated as rural as of December 31, 2006.

CMS also finalized a technical correction to 42 C.F.R. §414.610(c)(1), which is the regulation that sets forth the specific calculations used to determine payments under the Ambulance Fee Schedule.  When CMS made some changes to that regulation last year, it inadvertently deleted the first sentence.  In the final rule, CMS restored that sentence to the regulation.