Ambulance rates increased to offset federal funding reduction
Those transported by a Pipestone County ambulance in 2018 will be charged 20 percent more than in recent years.
The increase, approved by the Pipestone County Commissioners on Jan. 2, raises the base rate for basic life support (BLS) emergency calls, which constitute most of the ambulance service’s calls, to $832 and the base rate for an advanced life support (ALS) 2 calls, which are the most severe cases and less frequent, to $1,133. The fee increase is the first for the ambulance service since 2015.
Steve Ewing, Pipestone County Emergency Services director, suggested the increase as a “stop gap measure” to make up for an expired provision by the Centers for Medicare and Medicaid Services (CMS) that provided a higher reimbursement rate for people who use ambulance services located in the lowest populated rural areas.That super rural bonus was part of the Medicare and CHIP Reauthorization Act (MACRA) that expired on Dec. 31, 2017.
Ewing said over half of the fees paid to the ambulance service are based on the Medicare fee schedule. That fee schedule paid $446 for BLS service in 2017 and will pay $356 in 2018, Ewing said. He estimated based on 2017 figures that the expiration of the super rural bonus could mean a $36,325 reduction in ambulance service revenue in 2018.
“This is a huge hit,” Ewing said.
Ewing said the 20 percent increase in fees could increase revenue by up to $50,000, not only offsetting the lost revenue, but helping to pay for increasing costs of operation.
Ewing said most insurance companies use a fee scale and don’t pay the full fee charged for ambulance services, so the fee increases will primarily affect a limited number of insurance providers that pay the full fee and the uninsured who pay out of pocket.