Ambulance Archive & Legacy Files

Ambulance Archive & Legacy Files

National Breakout of Geographic Area Definitions by ZIP Code

Manuals

Ambulance Fee Schedule Public Use Files (PUFs)

View CY 2018-2022 PUFs.

Changes in Geographic Area Delineations for Ambulance Payment:

CY 2015 Proposed Rule

In the CY 2015 Physician Fee Schedule (PFS) proposed rule (79 FR 40376), CMS proposed to implement the new OMB delineations as described in the February 28, 2013 OMB Bulletin (No. 13-01) based on 2010 Census to more accurately identify urban and rural areas for ambulance fee schedule payment purposes. We have prepared tables identifying the ZIP Codes that would be affected by these proposed changes. These tables are located in the CY 2015 NPRM ZIP Codes (ZIP) file.

CY 2015 Final Rule

In the CY 2015 PFS final rule, CMS finalized our proposals to adopt, beginning in CY 2015, the revised OMB delineations as set forth in OMB’s February 28, 2013 bulletin (No. 13-01) and the most recent modifications of the RUCA codes for purposes of payment under the ambulance fee schedule. As we proposed, using the updated RUCA codes definitions, we will continue to designate any census tracts falling at or above RUCA level 4.0 as rural areas. None of the current super rural areas will lose their super rural status upon implementation of the revised OMB delineations and the updated RUCA codes. We have prepared the following tables located in the CY2015 Final Rule ZIP Code Files (ZIP):

  • ZIP Codes by state that changed from urban to rural,
  • ZIP Codes by state that changed from rural to urban,
  • List of ZIP Codes with RUCA code designations, and
  • A complete list of ZIP Codes identifying their designation as super rural, rural, or urban

CY 2015 Final Rule Correction Notice

In the CY 2015 final rule discussion of the updated ZIP Code analysis based on OMB’s revised delineations and updated Rural-Urban Commuting Area (RUCA) codes (see 79 FR 67744 - 67750, November 13, 2014), the percentages and totals of the ZIP Codes changing from urban to rural and from rural to urban, the percentages and totals of the ZIP Codes not changed, and the referenced state impacts are incorrect due to a technical error in the application of the updated RUCA codes. In addition, the total number of ZIP Codes is incorrect. We issued a correction notice on December 31, 2014 (79 FR 78716 - 78719). We have also revised the following tables located in the CY 2015 Final Rule Correction Notice (ZIP) file:

  • ZIP Codes by state that changed from urban to rural
  • ZIP Codes by state that changed from rural to urban, and
  • A complete list of ZIP Codes identifying their designation as super rural, rural, or urban 

CY 2016 Proposed Rule

For CY 2016 and subsequent CYs, we proposed to continue implementation of the revised OMB delineations and the most recent modifications of the RUCA codes that we adopted for the CY 2015 ambulance fee schedule. The following tables are available in the CY 2016 Proposed Rule (ZIP) file:

  • ZIP Codes by state that changed from urban to rural
  • ZIP Codes by state that changed from rural to urban
  • A list of ZIP Codes with RUCA code designations and
  • A complete list of ZIP Codes identifying their designation as super rural, rural or urban 

CY 2016 Final Rule

For the CY 2016 Final Rule, the following tables are available in the CY 2016 Final Rule file (ZIP):

  • ZIP Codes by state that changed from urban to rural
  • ZIP Codes by state that changed from rural to urban
  • A list of ZIP Codes with RUCA code designations and
  • A complete list of ZIP Codes identifying their designation as super rural, rural, or urban 
Page Last Modified:
09/06/2023 05:05 PM
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