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Date
12/21/2011
Subject
Attention Ambulance Services Suppliers: Information Regarding the Holding of 2012 Date-of-Service Claims for Services Paid Under the 2012 Medicare Ambulance Fee Schedule (MAFS)
Audience
Ambulance

The e-News for Wed Dec 21

Attention Ambulance Services Suppliers: Information Regarding the Holding of 2012 Date-of-Service Claims for Services Paid Under the 2012 Medicare Ambulance Fee Schedule (MAFS)

Congress is considering legislation to extend certain expiring provisions of the Social Security Act that have increased payments for ground and air ambulance services. These provisions expire six business days from today. Pending action by Congress, the 2012 MAFS will not include increased fee schedule amounts that reflect the expiring provisions.

However, because CMS anticipates that Congress may extend the expiring provisions, CMS is instructing its Medicare claims administration contractors to hold claims containing 2012 services paid under the Medicare Ambulance Fee Schedule for the first 10 business days of January, 2012 (i.e., Sun, Jan 1, through Tue, Jan 17). The hold should have minimal impact on supplier cash flow because, under current law, clean electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt.

Ambulance claims for services furnished on or before Sat, Dec 31, are unaffected by the 2012 claims hold and will be processed and paid under normal procedures and time frames.

CMS will notify you on or before Wed, Jan 11, with more information about the status of Congressional action concerning the expiring provisions and next steps regarding the claims hold.

* This issue of the e-News will be made available in PDF format no later than 24 hours after its release, and can be found in the archivewith other past issues.