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AAA Releases 2025 Medicare Rate Calculator

January 24, 2025, by Brian Werfel

On December 23, 2024, CMS posted a revised version of the CY 2025 Ambulance Fee Schedule Public Use Files on its website.  These files contain the Medicare allowed amounts for the various levels of ambulance service and mileage.  The file is organized by state, and by payment locality within each state.  The 2025 Ambulance Fee Schedule Public Use File can be viewed by clicking here.

Unfortunately, CMS has elected in recent years to release its Public Use Files without state and payment locality headings.  As a result, in order to look up the rates in your service area, you would need to know the CMS contract number assigned to your state.  This is not something the typical ambulance service would necessarily have on hand.  For this reason, the AAA has created a reformatted version of the CMS Medicare Ambulance Fee Schedule, which includes the state and payment locality headings.  Members can access this reformatted fee schedule below.

The American Ambulance Association is also pleased to announce the release of its 2025 Medicare Rate Calculator tool.  The AAA believes this is a valuable tool that can assist members in budgeting for the current year.  This calculator has been updated to account for recent changes in Medicare policies, including the 2025 Ambulance Inflation Factor and the extension of the temporary adjustments for ground ambulance services (i.e., 2% urban, 3% rural, and super rural bonus) through March 31, 2025.  This extension was the result of Section 3203 of the American Relief Act, 2025.  Barring further legislation, these temporary adjustments will expire on March 31, 2025.

Note on Medicare Sequestration: Both the Ambulance Fee Schedule Public Use Files and the AAA Medicare Rate Calculator display the current Medicare allowables.  Neither takes into account the impact of so-called “budget sequestration” on Medicare payments.  By law, the sequester requires Medicare contractors (and Medicare Advantage insurers) to reduce the amounts they pay under the Medicare Ambulance Fee Schedule by 2% (i.e., 2% off the 80% of the Medicare allowable typically paid by the Medicare contractor).

2025-Medicare-Rate-Calculator

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