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CMS Releases Final Cost Reporting Rules

Above photo by Jeff Frankel/JEMS Managing Editor

The Centers of Medicare and Medicaid (CMS) has published its final cost reporting metrics.

Every ambulance service in the country (25% of them each year over the next four years) that bills Medicare will be required to report costs. Departments selected to cost report in 2020 will not have to submit their data until May 2021.

According to CMS:

Effective January 1, 2020 and continuing through 2024, ground ambulance providers and suppliers that have been selected to participate in the Medicare Ground Ambulance Data Collection System must collect information on cost, utilization, revenue, and other service characteristics in accordance with the Medicare Ground Ambulance Data Collection Instrument for a continuous 12-month period.

The information collected will be used to evaluate the extent to which reported costs relate to payment rates under the Medicare Part B Ambulance Fee Schedule (AFS), as well as to collect information on the utilization of capital equipment and ambulance capacity, and the different types of ground ambulance services furnished in different geographic locations, including rural areas and low population density areas (super rural areas).

Failure to sufficiently submit the required information will result in a 10 percent reduction to payments under the AFS for one year, unless a hardship exemption has been granted or an informal review has determined that your organization is not subject to the 10 percent reduction to payments.

The agency is holding its planned Ambulance Open Door Forum series tomorrow at 2 p.m. EST where the cost reporting process will be discussed.