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Services Selected in Year 1 & 2 Start Collecting Data in:


What is Cost Collection?

Cost collection, the result of the Bipartisan Budget Act of 2018, requires all ambulance services that bill Medicare to report certain cost-related data to CMS. The goal of this cost-data collection is to allow CMS to assess the adequacy of the Ambulance Fee Schedule. 

Why is Cost Collection Important? 

This is the first time ambulance cost-related data has been systematically collected and analyzed by CMS. The American Ambulance Association (AAA) believes that this cost collection process will reveal that the Ambulance Fee Schedule is inadequate to reimburse ambulance service providers for the provision of ambulance services. The CMS ambulance cost collection process will likely set Medicare payment policy for many years to come. Additionally, this data will be publicly available and will likely be used by CMS and other payors to structure their reimbursement rates.  

What if I Don’t?

EMS agencies that fail to report their cost data to CMS will have a 10% reduction in their reimbursement from CMS for a period of one year. But that’s not the full picture. 

75% of EMS agencies across the US bill Medicare for 1,000 or fewer transports per year. That means MOST of our nation’s EMS services are small, rural, or even volunteer services. If small, rural, and volunteer services choose not to report, the data will skew to larger services. This will result in inaccurate cost data and, likely, reductions in Medicare reimbursement rates. 

EMS is already the most underfunded healthcare service – further cuts would decimate our EMS system coast-to-coast. 

What do Ambulance Services Need to Do? 

There are many things that EMS agencies need to be doing now to prepare for when they are selected to electronically report.

  1. Check the Provider Enrollment and Chain of Ownership System (PECOS) to ensure your enrollment data is accurate and up to date
  2. Check the CMS Ambulance Services Resource Page to see if your EMS agency has been selected to report.
  3. Access AMBER, the AAA’s cost collection software which was specifically designed around the CMS cost collection requirements. Familiarize yourself with the process and start entering & testing your data now.
  4. Attend the AAA’s Ambulance Cost Education (ACE) programs (in-person & virtual) to ensure that you and your team understand what cost collection data elements must be reported and how they are calculated.
  5. Establish a Cost Collection Project Manager for your agency.

What is the American Ambulance Association Doing to Help?

The American Ambulance Association has created Ambulance Cost Education (ACE) – a set of tools and information created by industry experts to prepare for the CMS cost collection requirements. With in-depth educational programs, topic-focused webinars, and cutting-edge tools, including AMBER, the AAA’s cost collection software, Ambulance Cost Education is a turnkey solution to learning and thriving with the CMS cost data collection requirements.

We’ve also partnered with the Savvik Foundation on a Cost Collection Grant for small, rural, and super-rural services. This grant provides a 1-year membership to the AAA, including all of our ACE resources and access to the Amber software. 

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