CMS Updates Manual to Reflect Ambulance Fee Schedule Reduction for Non-Emergency BLS Transports of Patients With ESRD


On May 10, 2013, CMS issued a transmittal clarifying the requirement in Section 637 of the American Taxpayer Relief Act of 2012 (ATRA) that ambulance payments for non-emergency basic life support (BLS) transports for end stage renal disease (ESRD) patients to and from renal dialysis treatment will be reduced by 10 percent effective October 1, 2013, and updating Chapter 15 of the Medicare Claims Processing Manual (CMS Pub. 100-04) accordingly.  The payment reduction applies to transports to and from both hospital-based and freestanding dialysis facilities in rural, urban and “super rural” areas.  The reduction will be taken after the normal fee schedule amount plus any add-on or bonus payments are calculated, and it will be applied to both the base rate for non-emergency BLS transports and the mileage reimbursement.  CMS reminds providers in the Transmittal that neither payments for emergency transports nor payments for BLS transports to and from other destinations are affected. 

A copy of the CMS Transmittal is available here.

Reporter, Kate Stern, Atlanta, +1 404 572 4661,

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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