After much anticipation and a few delays, Ground Ambulance Cost Data Collection is finally happening! The result of the Bipartisan Act of 2018, Cost Collection requires all ambulance services that bill Medicare to report certain cost-related data to CMS. The goal of this cost-data collection is to allow CMS to assess the adequacy of the Ambulance Fee Schedule. 

Year 1 and Year 2 selected services enter their 12-month data collection period on January 1, 2022 (or on day 1 of their 2022 fiscal year) and must enter that data no later than May 2023. 

Services not yet selected WILL be selected as part of the Year 3 and Year 4 selection process. Due to the delays, both Year 3 & Year 4 services will collect data in 2023 and report in 2024.  

Why is Cost Collection Important?

This is our opportunity to reform reimbursement! An opportunity that we may not see again.

This is the first time ambulance cost-related data has been systematically collected and analyzed by CMS. The CMS ambulance cost collection process will likely set Medicare payment policy for many years to come. Additionally, this data will be publically available and will likely be used by CMS and other payors to structure their reimbursement rates.  

What if I Don’t? 

EMS agencies that fail to report their cost data to CMS will have a 10% reduction in their reimbursement from CMS for a period of one year.

But that is not the full picture. 

75% of EMS agencies across the US bill Medicare for 1,000 or fewer transports per year. That means MOST of our nation’s EMS services are small, rural, or even volunteer services. If small, rural, and volunteer services choose not to report the data will skew to large services will built-in efficiencies and, in some cases, lower costs. This will result in inaccurate cost data and, likely, reductions in Medicare reimbursement rates. 

EMS is already the most underfunded healthcare service – further cuts would decimate our nation’s EMS system coast-to-coast. 

What do Ambulance Services Need to Do?

There are many things EMS agencies need to be doing now to prepare for their data collecting and reporting periods. 

1. Check the Provider Enrollment and Chain of Ownership System (PECOS) to ensure enrollment data is accurate and up to date.
2. Check the CMS Ambulance Services Resource Page to see if your EMS agency has been selected to report. 
3. Access Amber, the cost data collection software specifically designed around the CMS cost collection requirements. Familiarize yourself with the process and start entering and testing your data now. Request FREE access to Amber!
4. Attend or host an Ambulance Cost Education (ACE) workshop or webinar to ensure you and your team understand what cost collection data elements must be reported and how they are calculated.
5. Establish a cost collection project manager for your agency.