New Hampshire Code of Administrative Rules
He - Department of Health and Human Services
Subtitle He-W - Former Division of Human Services
Chapter He-W 500 - MEDICAL ASSISTANCE
Part He-W 572 - AMBULANCE SERVICES
Section He-W 572.10 - Payment for Services

Universal Citation: NH Admin Rules He-W 572.10

Current through Register No. 40, October 3, 2024

(a) Payment for ambulance services shall be made in accordance with the rates established by the department in accordance with RSA 161:4, VI(a) .

(b) Payment shall consist of the following separate components, as applicable:

(1) A base rate;

(2) A mileage rate, which shall be paid for the most direct route to and from a destination and for loaded miles only, which:
a. Shall be the distance traveled while transporting a recipient from a pick-up point to a drop-off point; and

b. Does not include mileage incurred on the way to pick up a recipient or after dropping off a recipient;

(3) Payment for waiting time, as allowed by He-W 572.04(a) (3) and (d) ; and

(4) Payment for routine disposable supplies used en-route.

(c) Payment shall be made for only one mileage charge per trip regardless of the number of recipients transported.

(d) Payment shall be based on the level of service provided, not on the vehicle used, even if the local government requires an ALS response for all calls.

(e) The ambulance provider shall not bill medicaid for transporting a recipient from an acute care hospital to another acute care hospital or medical provider to obtain necessary treatment or diagnostic testing not available while the recipient is still an inpatient of the originating acute care hospital.

(f) The ambulance provider shall submit claims for payment to the department's fiscal agent.

#10294, eff 12-1-13 (from He-W 572.09)

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