Extend Payments for Ambulance Service
The Center for Medicare and Medicaid Services (CMS) provides additional 2%, 3%, and 22.6% payments for ambulance transports originating in urban, rural, and super-rural zip codes, respectively. These payments are crucial in stretching CMS’ reimbursements closer to the actual cost of providing EMS and transport services. Despite the seemingly small percentages that these payments represent, they can add up to be a significant source of funding for fire departments.

Unless Congress acts, these payments will expire at the end of 2022. The Protecting Access to Ground Ambulance Medical Services Act of 2021 (H.R. 2454) will preserve these important payments by extending their authorization until January 1, 2028. Additionally, H.R. 2454 makes important changes to how CMS classifies a zip code as urban, rural, or super-rural. These changes will make it harder for CMS to decrease the additional payment by moving a zip code into a more densely populated status. If a zip code does get re-classified, then H.R. 2454 also establishes an appeals process for this decision. 

The IAFC urges Congress to pass H.R. 2454 as soon as possible. CMS’ reimbursements already are significantly below the actual cost of providing care. Congress’ must not allow the extenders to expire and even further decrease EMS reimbursement rates. 

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