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Ambulance Fee Schedule Methodology

Jan. 1, 2019, EGID will implement a change to their ambulance reimbursement methodology as discussed at the public hearing on Oct. 16, 2018. The change will be effective Jan. 1, 2019, for providers of ambulance services to HealthChoice and the Department of Corrections. A fee schedule will be adopted for ambulance HCPCS billing codes. The fee schedule will be based on the rates published by the Centers for Medicare & Medicaid Services with a multiple applied. The fee schedule effective Jan. 1, 2019, will be based on the CMS CY 2019 Oklahoma Medicare rates, which have not yet been released. A pro forma fee schedule modeled using the CMS CY 2018 Oklahoma Medicare rates would be as follows: 

HCPCS Description EGID Modeled Fees Based on CMS CY 2018 for Oklahoma
A0425 GROUND MILEAGE PER STATUTE MILE 18.00
A0426 AMB SERVICE ALS NONEMERGENCY TRANSPORT LEVEL 1 705.60
A0427 AMB SERVICE ALS EMERGENCY TRANSPORT LEVEL 1 1,300.00
A0428 AMBULANCE SERVICE BLS NONEMERGENCY TRANSPORT 588.01
A0429 AMBULANCE SERVICE BLS EMERGENCY TRANSPORT 940.80
A0430 AMB SERVICE CONVNTION AIR SRVC TRANSPORT 1 WAY 20,544.80
A0431 AMB SERVICE CONVNTION AIR SRVC TRANSPORT 1 WAY 23,886.42
A0432 PARAMED INTRCPT RURL AMB NO BILL 3 PARTY PAYER NC
A0433 ADVANCED LIFE SUPPORT LEVEL 2 1,617.03
A0434 SPECIALTY CARE TRANSPORT 1,911.03
A0435 FIXED WING AIR MILEAGE PER STATUTE MILE 61.66
A0436 ROTARY WING AIR MILEAGE PER STATUTE MILE 164.54

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