Between January 1, 2001 and the date on which the fee schedule does take effect, ambulance services will continue to be reimbursed at payment levels based on the current reasonable charge methodology.

Although the fee schedule will not take effect on January 1, 2001, HCFA is moving forward on the implementation of HCPCS codes and the requirement to report the zip code of point of pickup on the claim form. Attached is a detailed summary of the Program Memorandum. The Program Memorandum (AB-00-118) has been posted in the Members Only section of the AAA website at www.the-aaa.org .

It is important that AAA members move forward with plans to adjust to the implementation of the fee schedule. You should have already heard from your Medicare carrier regarding HCFA required provider training. We recommend that you contact your carrier on a regular basis and check your carrier’s Internet website everyday.

The AAA is continuing to develop forums to help prepare you for the fee schedule. Listed below are some of the resources that the AAA is planning to offer for purchase:

-- Seminars at the AAA Reimbursement Conference in Las Vegas from February 6-8, 2001;

-- Audio conference calls with follow-up transcripts made available for order; and,

-- Internet-based reimbursement training for billing office staff.

We will keep you apprised of new developments and provide continual updates on the latest from HCFA on fee schedule issues.

  Summary of HCFA Program Memorandum Delaying Implementation

of the Medicare Ambulance Fee Schedule

  Although implementation of the fee schedule itself is delayed, HCFA will require the new HCPCS codes (other than those for mileage) to be used and for all claims to include the zip code of the point of pick up.

The new Program Memorandum states that, even though the fee schedule is delayed, most of the requirements of the earlier Program Memorandum (AB-00-88) will go into effect on January 1, 2001. The parts of that Program Memorandum that will NOT be implemented on that date are the following:

-- Payment will not be made based on the fee schedule and transition rules. Payment will continue to be made based on reasonable charge or reasonable cost, with the appropriate inflation increase for 2001.

-- Mandatory assignment for ambulance services will NOT be required at this time.

-- Where an ALS vehicle is used, but no ALS service is provided, use the new HCPCS code for ALS1 (A0426) or ALS1-emergency (A0427). (Payment amounts will continue under the current policy regarding ALS ordinances).

  -- Do not use the new mileage code, but continue to use the current codes for mileage, A0380 (BLS) and A0390 (ALS).

Other features of the Program Memorandum announcing the delay are the following:

-- Although carriers are encouraged to switch all suppliers to one billing method when the fee schedule is implemented, until that time, suppliers may continue to bill as they do now unless they agree with the carrier to change.

-- Even though new HCPCS codes are being implemented, the pricing method will not change. There is no grace period for the requirement that new codes (except mileage) be used beginning January 1, 2001.

-- Zip codes of the point of pick up must be included on all bills starting Jan. 1, 2001. Carriers will return as unprocessable any claim with an invalid zip code (although carriers can process out of locality claims).

-- Suppliers may use only one billing method within a carrier jurisdiction.