News Brief: '50-mile rule' does not cover where patients can go
'50-mile rule' does not cover where patients can go
A fee schedule change affecting payment for ground ambulance charges under Section 414 of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 provides increased payments for urban and rural services, adds an increased payment for ambulance transports originating in certain low-density population areas, and provides a 25% bonus on the mileage rate for ground transports of 51 miles or greater. The bonus on the mileage rate for ground transports of 51 miles or more has been misinterpreted by some providers to mean that a Medicare patient cannot be placed in a bed more than 51 miles away an interpretation that is not correct.
During the five-year period covered by the schedule change (July 1, 2004-Dec. 31, 2009), fees for urban and rural transports are increased, and through the end of 2008, a 25% increase is applied to the base mileage rate for each mile of transport that exceeds 50 miles when the Medicare beneficiary is on board the ambulance.
Though the fee changes affect reimbursement for ambulance services, the "50-mile rule" does not restrict Medicare patients from being placed in facilities 50 miles away from their starting point. t
A fee schedule change affecting payment for ground ambulance charges under Section 414 of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 provides increased payments for urban and rural services, adds an increased payment for ambulance transports originating in certain low-density population areas, and provides a 25% bonus on the mileage rate for ground transports of 51 miles or greater.Subscribe Now for Access
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