Skip to main content

Senate Cloture on Shutdown Package

Written by AAA Staff on . Posted in Government Affairs, Legislative, Medicare, Member Advisories, Member-Only, News, Reimbursement.

The Senate has made progress towards ending the government shutdown. The Senate, by a vote of 60 to 40, invoked cloture on consideration of the House-passed Continuing Resolution after an agreement was reached yesterday with eight Senate Democrats on replacement language, which the Senate will vote on next.

On our specific issues, the language would do the following:
1. Extend the temporary Medicare ambulance add-ons payments through January 30, 2026
2. Prevent PAYGO cuts to Medicare providers and suppliers from H.R. 1
3. Extend Medicare sequestration provider cuts for another month

We will keep you posted on new developments.

Contact your member of Congress today!

Written by AAA Staff on . Posted in Advocacy Priorities, Government Affairs, Legislative, Medicare, Member Advisories.

With the Medicare ambulance add-ons having expired at least temporarily, it is critical that you contact your Members of Congress now to ask for their support in reinstating and making permanent this vital financial relief. They can demonstrate their support by cosponsoring the Protecting Access to Ground Ambulance Medical Services Act (H.R. 2232, S. 1643). Please customize the sample template letter to let them know of the financial impact of the loss of the additional 2% urban, 3% rural and 22.6% super rural in additional Medicare payments on your operation.

Click the link below and write your members of Congress today about reinstating and extending the add-on payments.

Contact your members of Congress here!

Congressional Letter on Updating Medicare Zip Codes

Written by Tristan North on . Posted in Advocacy Priorities, Government Affairs, Medicare.

On September 18, Congresswoman Carol Miller (R-WV) was joined by 13 members of Congress in a letter to CMS requesting that the agency update the zip code designations under the Medicare ambulance fee schedule based on the 2020 census.

According to an analysis by AAA data firm of Health Management Associates, the update would result in a net of 1,490 zip codes being redesigned as super rural instead of rural and 782 zip codes being rural instead of urban. Ground ambulance service organizations that serve these rural and super rural areas would thus benefit from the additional reimbursement for rural and super rural areas.

CMS is overdue in automatically updating the zip codes based on the 2020 census data.
.

Impact of Potential Federal Government Shutdown on Medicare Payments

Written by Brian Werfel on . Posted in Government Affairs, Medicare, Member Advisories, Reimbursement.

Impact of Potential Federal Government Shutdown on Medicare Payments, Including  the Temporary Aad-ons for Ground Ambulance Services

 

The federal government is funded through annual appropriations enacted by Congress.  Funding for the federal government’s current fiscal year is currently set to expire today, September 30, 2025.  If Congress fails to pass a spending package for the full year – – or a temporary funding package for a shorter period (known as a “continuing resolution”) – – many federal agencies will have to curtail their activities.  On September 18, 2025, the House of Representatives passed a continuing resolution that would have funded the federal government through November 21, 2025; however, that bill failed to pass the Senate.  As a result, barring a last-minute deal, a federal government shutdown will commence on October 1, 2025.

A government shutdown is not expected to impact Medicare payments to health care providers, i.e., Medicare Administrative Contractors will continue to process and pay Medicare claims.  However, past government shutdowns have impacted other Medicare operations, including provider enrollment and pre- and post-payment audit activities.  Providers that are currently in the process of enrolling and/or revalidating their Medicare enrollment may experience delays in the processing of these applications.

As a reminder, existing law requires that Medicare Administrative Contractors hold claims for a minimum of fourteen (14) days.  This “payment floor” would provide a bit of breathing room in the event of a relatively short federal shutdown.  If, however, a shutdown continues for longer than 2 weeks, it is likely that Medicare contractors would be forced to pay ambulance claims with dates of service on or after October 1, 2025 at the statutorily required amount (i.e., an amount that does not take into account the current add-ons).  If the spending deal to reopen the government includes the retroactive extension of those add-ons, the MACs would need to subsequently adjust any payments made at that lower amount.  There is precedent for such retroactive adjustments.  Of course, the current hope is that a deal can be reached early enough to avoid the need for any retroactive adjustments.

Thus, while Medicare payments for ambulance services will continue without interruption, the payment amounts will be impacted.  This is because the temporary add-ons for ground ambulance services (i.e., the 2% urban, 3% rural, and super-rural bonuses) are currently set to expire on September 30, 2025.  The hope is that any deal to avert a shutdown and/or to reopen the government after any potential shutdown will include an extension of these critical add-ons.

The American Ambulance Association is monitoring the situation closely, and will continue to keep our members updated as new information become available.

Update on House Budget Reconciliation Process

Written by Meghan Winesett on . Posted in Government Affairs, Legislative, Medicaid, Medicare.

Earlier this week, the House Committees on Ways & Means and Energy & Commerce reported out favorably their respective language on tax and Medicaid changes as part of Budget Reconciliation. Tomorrow, the House Committee on the Budget is scheduled to mark up the Budget Reconciliation package comprised of the combined pieces of language from the House Energy & Commerce and Ways & Means Committees. The package is scheduled to be considered on the House floor next week.

We will continue to keep our membership informed following the Budget Committee markup tomorrow and the House floor consideration schedule for next week.

House Reintroduces Vital Medicare Extender and EMS Workforce Bills

Written by Tristan North on . Posted in Government Affairs, Legislative, Medicare, Reimbursement, Workforce Shortage.

Medicare Ambulance Extender Bill Introduced in House

Yesterday, March 18, Representatives Claudia Tenney (R-NY), Terry Sewell (D-AL), Cliff Bentz (R-OR), Paul Tonko (D-NY), Mike Carey (R-OH), Danny Davis (D-IL), Carol Miller (R-WV) and Marie Gluesenkamp Perez (D-WA) reintroduced the Protecting Access to Ground Ambulance Medical Services Act (H.R. 2232). This legislation would extend the temporary Medicare ambulance add-on payments at their current levels of 2% urban, 3% rural and 22.6% super rural until January 1, 2028.
The AAA and our partners at the International Association of Fire Chiefs (IAFC), International Association of Fire Fighters (IAFF), National Association of Emergency Medical Technicians (NAEMT) and National Rural Health Association (NRHA) have spearheaded efforts to extend and increase the levels of the Medicare ambulance add-on payments. We expect to see a Senate bill with the higher levels of 3.4% urban, 4.3% rural and 26.7% super rural introduced in the near future.

EMS Workforce Shortage Bill Introduced in House

Additionally, yesterday Representatives Marie Gluesenkamp Perez (D-WA), Brad Finstad (R-MN), Randy Feenstra (R-IA), Suzanne Bonamici (D-OR), Michael Lawler (R-NY), Josh Harder (D-CA) reintroduced the Preserve Access to Rapid Ambulance Emergency Medical Treatment Act (PARA-EMT Act). H.R. 2220 would provide funding for grants to help recruit and train paramedics and EMTs, reduce barriers that prevent veteran medics transitioning to civilian paramedics and EMTs, and request the Secretary of Labor to conduct a study on the EMS workforce shortage and report their findings.
The legislation is supported by the AAA, NAEMT and NRHA. A copy of the press release on the introduction of H.R. 2220 can be found here.

Congress Extends Ambulance Add-On Payments Through September 30

Written by Tristan North on . Posted in Advocacy Priorities, Government Affairs, Legislative, Medicare.

Yesterday evening, March 14, the United States Senate by a vote of 54 to 46 passed the Full-Year Continuining Appropriations and Extensions Act, 2025 (H.R. 1968) to fund the federal government through the end of the 2025 fiscal year ending September 30. An extension of the current levels of the temporary Medicare ambulance add-on payments was included in H.R. 1968 with an expiration date of also September 30. President Trump is expected to sign H.R. 1968 into law shortly.

The AAA, our champions and supporters on Capitol Hill, and EMS partner organizations fought hard to ensure the ambulance extension was included in the lean bill of just 99 pages. We greatly appreciate the outreach by the AAA membership and state EMS associations to their members of Congress in support of the extension of the ambulance add-on payments. The AAA will continue to advocate for a long-term extension of the add-on payments at the higher levels of 3.4% urban, 4.3% rural and 26.7% super rural.

Revised versions of the Protecting Access to Ground Ambulance Medical Services Act with a long-term extension of the add-on payments, and at the higher levels in the Senate bill, will be reintroduced in the near future. Once introduced, we will be launching a new Call To Action asking you to contact your members of Congress to cosponsor the legislation

AAA Releases 2025 Medicare Rate Calculator

Written by Brian Werfel on . Posted in Medicare, Member-Only, Regulatory, Reimbursement.

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

2025.AmbulanceFeeSchedule.StateLocalHeadings.

Stay In Touch!

By signing up, you agree to the AAA Privacy Policy & Terms of Use.