Code of Massachusetts Regulations
101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES
Title 101 CMR 327.00 - Rates of Payment for Ambulance and Wheelchair Van Services
Section 327.03 - General Rate Provisions and Payment

Universal Citation: 101 MA Code of Regs 101.327

Current through Register 1531, September 27, 2024

(1) Rate Determination. The rates for authorized ambulance and wheelchair van services under 101 CMR 327.00 are the lowest of:

(a) the eligible provider's usual fee to patients other than publicly-aided individuals; or

(b) the eligible provider's actual charge submitted; or

(c) the schedule of fees set forth in 101 CMR 327.03.

(2) Allowable Trip Fees for Ambulance Services.

Code

Allowable Fee

Description of Code

A0425

$6.45

Ground mileage, per statute mile (loaded mileage)

A0426

$250.65

Ambulance service, advanced life support, nonemergency transport, level 1 (ALS 1)

A0427

$396.86

Ambulance service, advanced life support, emergency transport, level 1 (ALS 1 -emergency)

A0428

$208.87

Ambulance service, basic life support, nonemergency transport (BLS)

A0429

$334.19

Ambulance service, basic life support, emergency transport (BLS-emergency)

A0430

$4,036.04

Ambulance service, conventional air services, transport, one way (fixed wing)

A0431

$4,036.04

Ambulance service, conventional air services, transport, one way (rotary wing)

A0433

$574.40

Advanced life support, level 2 (ALS 2)

A0434

$678.83

Specialty care transport (SCT)

A0170

I.C.

Transportation ancillary; parking fees, tolls, other (used only for ferry charges)

A0999

I.C.

Unlisted ambulance service. (Used for transporting patients who require special resources to be safely transported including, but not limited to, bariatric patients.)

(3) Billing Certification. Each eligible provider who submits an invoice to a governmental unit for authorized ambulance services must certify to the accuracy of the level of services provided, as listed on its invoice.

(4) Allowable Trip Fees for Wheelchair Van Services.

Code

Allowable Fee

Description of Code

A0130

$40.55

Nonemergency transportation; wheelchair van (each way)

S0215

$1.46

Nonemergency transportation; mileage, per mile (wheelchair van, loaded mileage)

T2001

$8.00

Nonemergency transportation; patient attendant/escort (wheelchair van, each way)

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