Does your agency provide ambulance services? If so, it is time to get prepared for a new federal reporting requirement related to Medicare. The Bipartisan Budget Act of 2018 (BBA) includes a major Medicare ambulance services provision pertaining to the development of a data collection system for ground ambulance service providers and suppliers.

The Centers for Medicare and Medicaid Services (CMS) is requiring that all providers of ground ambulance services collect and report expenditures, revenues, utilization, and other departmental statistics. Originally, data collection was required to begin on January 1, 2020, but this was postponed to January 1, 2021. Collection of these statistics will be required via the Medicare Cost Survey. Failure to gather the required data can result in a penalty, so it is imperative that the Cost Survey be conducted accurately.

What is the Medicare Cost Survey?

The Medicare Cost Survey is a data collection instrument used to evaluate costs related to payment rates under the Medicare Part B Ambulance Fee Schedule (AFS). Sufficient data collection is necessary for CMS to establish appropriate rates in the future. If a provider or supplier does not submit a sufficient Cost Survey, a penalty equal to a 10% payment reduction to the Ambulance Fee Schedule (AFS) payments will be applied.

CMS has designated various Ground Ambulance Services providers and suppliers required to submit a Cost Survey each year continuing through 2024. Find out if your agency was selected to begin data collection in 2021 by visiting the Ambulance Services Center on the CMS website.

Why are providers required to submit the Medicare Cost Survey for Ambulance Services?

Currently, assessing how Medicare payment rates are related to costs is complicated by the significant variation in ambulance organizations and by differences in how ambulance services are delivered and financed across communities. Little data exists to evaluate the relationship between Medicare payments and the costs realized by ambulance organizations. The data collected by the Bipartisan Budget Act of 2018 will compile comprehensive information on ambulance costs, revenue, and services samples of all ambulance organizations. This data will be used to evaluate costs related to payment rates under the Medicare Part B Ambulance Fee Schedule (AFS).

Source: Ambulance Services Center,

What can NBS do for you?

NBS can help navigate the data collection process and complete the new Medicare Cost Survey. We have worked with ambulance services organizations to generate over $20 million in supplemental payments through Medicaid supplemental payment programs. Our team has more than 10 years of experience working with ambulance services organizations on cost report submissions. We understand the cost structures of ambulance services organizations, which enables us to ensure that the Medicare Cost Survey is completed accurately.