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July 6, 2005      
 
MEDICAID INFORMATION RELEASE 2005-17
 
TO:                 All Hospital-Based Ambulance Service Providers
 
FROM:           Leslie M. Clement, Deputy Administrator
                        Division of Medicaid
           
SUBJECT:      CHANGES IN REIMBURSEMENT METHODOLOGY FOR HOSPITAL-BASED AMBULANCE SERVICES
 
Medicaid will change to a fee-for-service reimbursement methodology for hospital-based ambulance services, effective for claims with dates of service on or after 8/1/2005. These changes comply with rule Docket 16-0309-0405 that was approved by the 2005 Legislature. A copy of this rule docket is available online at: http://www2.state.id.us/adm/adminrules/bulletin/bul/04octvol2.pdf  (see pages 44 to 49).
 
Reimbursement changes for hospital-based ambulance services provided on and after August 1, 2005:
 
·         The initial fee schedule used will be each hospital’s Usual and Customary charges multiplied by their outpatient hospital reimbursement percentage. The Usual and Customary ambulance service charges used will be those that were previously submitted by each hospital as requested by Medicaid. This interim fee schedule for each hospital will be used until the Department can develop a common fee schedule for all ambulance service providers.
 
·         Hospital-based providers should not expect a change in the initial amount of Medicaid reimbursement for ambulance services if they bill their Usual and Customary charges. Medicaid’s reimbursement will be considered final reimbursement under the new fee-for-service methodology and will not be subject to the cost-settlement process.
 
·         These changes will have no impact on current billing procedures. Please continue to bill as usual.
 
If you have questions regarding the information in this notice, please contact Arla Farmer at farmera@idhw.state.id.us, or by phone at (208) 364-1958.
 
Thank you for your continued participation in the Idaho Medicaid Program.
 
IDAHO MEDICAID PROVIDER HANDBOOK
This Information Release does not replace information in your Idaho Medicaid Provider Handbook.
 
LMC/amf