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Ambulance Fee Schedule - Conversion Factor File for CY 2009 Ambulance Inflation Factor (AMB)
Posted May 13, 2008
MLN Matters Number: MM6000
Related Change Request (CR) #: 6000
Related CR Release Date: May 2, 2008
Related CR Transmittal #: R1499CP
Effective Date: January 1, 2009
Implementation Date: October 6, 2008
Don't Be Surprised on May 23…TRY NPI-ONLY NOW - Now that the National Provider Identifier (NPI) is required on all Medicare claims in the primary provider fields, if your claims are being successfully processed with NPI/legacy pairs (and most are) now is the time to begin sending a small batch of claims with NPI alone. If the Medicare NPI Crosswalk cannot match your NPI to your Medicare legacy number, the claim with an NPI-only will reject. You can and should try sending NPI-only now! If the claim is processed and you are paid, continue to increase the volume of claims sent with only your NPI. If the claims reject, go into your National Plan and Provider Enumeration System (NPPES) record and validate that the information you are sending on the claim is consistent with the information in NPPES. If it is different, make the updates in NPPES and resend a small batch of claims 3-4 days later. If your claims are still rejecting, you may need to update your Medicare enrollment information to correct this problem. Call the customer service representative at your Medicare carrier, fiscal intermediary (FI), Part A/B Medicare Administrative Contractor (A/B MAC), or Durable Medical Equipment Medicare Administrative Contractor (DME MAC) to discuss your situation and, if necessary, have it investigated. Have a copy of your NPPES record or your NPI Registry record available. The contractor telephone numbers are likely to be quite busy, so don't wait.
Provider Types Affected
Ambulance providers and suppliers submitting claims to Medicare contractors (carriers, fiscal intermediaries (FIs), and/or Part A/B Medicare Administrative Contractors (A/B MACs)) for ambulance services provided to Medicare beneficiaries.
What Providers Need to Know
This article is based on Change Request (CR) 6000, which revises the ambulance fee schedule file layout for Calendar Year (CY) 2009. Specifically, only the conversion factor field is being modified to:
- Remove the sign in the numeric field; and
- Expand the length of the conversion factor field.
For claims with dates of service on or after January 1, 2009, Medicare contractor(s) will recognize the new Ambulance Fee Schedule file layout. For claims with dates of service prior to January 1, 2009, Medicare contractors will recognize the current layout.
Additional Information
The official instruction, CR 6000, issued to your carrier, FI, or A/B MAC regarding this change may be viewed at www.cms.hhs.gov/Transmittals/downloads/R1499CP.pdf on the Centers for Medicare & Medicaid Services (CMS) Web site.
The ambulance fee schedule public use files are available at www.cms.hhs.gov/AmbulanceFeeSchedule/02_afspuf.asp on the CMS Web site.
If you have any questions, please contact your carrier, FI, or A/B MAC at their toll-free number, which may be found at www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip on the CMS Web site. For the Upstate Medicare Division (UMD), you can call the toll-free provider line at 877-567-7173.
Disclaimer
This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents. CPT only copyright 2007 American Medical Association. |
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