Ambulance Archive, COVID-19 Information, & Legacy Files

COVID-19

• COVID-19 FAQs on Medicare Fee For Service Billing (PDF): See page 48 for Ambulance Services FAQs
• COVID-19 Emergency Declaration Blanket Waivers (PDF) : This revised modification to the data collection periods and data reporting periods impacts ground ambulance organizations that CMS selected for Years 1-2 of the Medicare Ground Ambulance Data Collection System: See page 32 / Ambulance Treat in Place: See page 33
• More resources on COVID-19

National Breakout of Geographic Area Definitions by ZIP Code

• 2017 End of Year ZIP Code File (ZIP) - Updated 11/15/2017
• 2016 End of Year ZIP Code File (ZIP)
• 2015 End of Year ZIP Code File (ZIP)
• 2014 End of Year ZIP Code File (ZIP)  

Manuals

• Historical (Pre-Transition to the Ambulance Fee Schedule) Medicare Claims Processing Manual - Pub. 100.04, Chapter 15 (PDF)  

Ambulance Fee Schedule Public Use Files (PUFs)

• CY 2017 File (ZIP)
• CY 2016 File (ZIP)
• CY 2015 File (ZIP)
• CY 2014 File (ZIP) - Updated 04/16/2014
• CY 2013 File (ZIP)
• CY 2012 File (ZIP)
• CY 2011 File (ZIP)
• CY 2010 File (ZIP) - Updated 07/01/2010
• CY 2009 File (ZIP) - Updated 04/10/2009
• CY 2008 File (ZIP) - Updated 10/01/2008
• CY 2007 File (ZIP)
• CY 2006 File (ZIP)
• CY 2005 File (ZIP)
• July - December 2004 AFS PUF (ZIP)
• January - June 2004 AFS PUF (ZIP)

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 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 prepared these tables located in the CY2015 Final Rule ZIP Code Files ZIP file:

• 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
• 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 also revised these 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
• 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. These 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
• 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, these tables are available in the CY 2016 Final Rule file 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
• A complete list of ZIP Codes identifying their designation as super rural, rural, or urban