On the other hand, say hello to a 2.1 percent cost-of-doing-business increase. Ambulance suppliers that had their fingers crossed that the Centers for Medicare & Medicaid Services' failure to include a phase-out of extra payments for rural mileage in its fee schedule meant that the added cash would keep rolling in got some bad news Dec. 5. CMS made clear in a final rule published in the Federal Register that bonus payments for rural mileage from mile 18 through mile 50 sunsets on Dec. 31, 2003, as prescribed by statute. To see the rule, go to www.access.gpo.gov/su_docs/fedreg/a031205c.html. Lesson Learned: Rural ambulance suppliers should prepare for the phase-out of transitional rural bonus payments at year's end.
In the rule, CMS also unveiled a 2.1 percent inflation increase for ambulance payments in 2004. The ambulance fee schedule is still in its transitional ramp-up phase, so the ambulance inflation factor applies both to the fee schedule portion of the blended payment amount and to the reasonable charge/cost portion.