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Elizabeth M. Whitehorn, Director

SMART Act Ambulance Services

Problem:

As a result of an administrative rule change, the reimbursement rates to ambulance providers were changed effective with dates of service 07/01/13. In addition, the SMART Act 2.7% reimbursement rate reduction no longer applies to ambulance services. Since the rule affected reimbursements already made to providers for dates of service back to 07/01/13, HFS has underpaid providers.

Providers Impacted:

Ambulance Service Providers

Procedure Codes Impacted:

A0422, A0425, A0426, A0427, A0428, A0429, A0431, A0431(H), A0434

Problem Begin Date:

Claims Received: 07/01/13

Problem Fix Date:

April 9, 2014

Resolution for Impacted Claims:

Claims previously paid with the incorrect rate will be systematically adjusted by the Department, and providers are not required to take action. Please continue to access this site for updated announcements.