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Medicare & Medicaid Services rule could limit ground emergency transport reimbursements

The proposed rule would cap some Medicaid supplemental payments for ambulance providers at Medicare Ambulance Fee Schedule rates beginning in 2029

ems counts act ambulance in front of capitol stock image

AP Photo/Patrick Semansky

WASHINGTON — A proposed rule could significantly affect long-term reimbursement for Ground Emergency Medical Transportation programs nationwide.

The rule, proposed Centers for Medicare & Medicaid Services (CMS), would etablish a formal provider-specific payment limit on certain targeted Medicaid supplemental payments to transportation providers, including GEMT, air ambulance and NEMT providers, PWW|AG said in a press release.

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The proposed limits would not take effect until rating periods beginning Jan. 1, 2029, but could have long-term implications for EMS reimbursement strategy and supplemental payment programs, PWW|AG said.

Under the proposal, targeted Medicaid supplemental payments for GEMT providers would be capped at equivalent Medicare Ambulance Fee Schedule rates for comparable services.

CMS said those payments could not exceed applicable Medicare AFS amounts, including base rates, mileage, geographic adjustments and rural or super-rural add-ons.

For example, if the Medicare Ambulance Fee Schedule rate for an ALS emergency transport in a provider’s area is $450, that amount could become the maximum reimbursement available through the GEMT program, including payments already received from Medicaid.

If finalized, the rule could change how GEMT programs are funded and limit future Medicaid supplemental reimbursement for ambulance agencies nationwide, PWW|AG said.

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Bill Carey is the associate editor for FireRescue1.com and EMS1.com. A former Maryland volunteer firefighter, sergeant, and lieutenant, Bill has written for several fire service publications and platforms. His work on firefighter behavioral health garnered a 2014 Neal Award nomination. His ongoing research and writings about line-of-duty death data is frequently cited in articles, presentations, and trainings. Have a news tip? He can be reached at news@lexipol.com.