Sequestration is here, how does it affect your EMS billing?

Southfield, Michigan

March 21, 2013

Written by Ken Slinker
Director, Revenue Cycle

Sequestration (a Washington DC term used to identify mandatory budget cuts) has now arrived.  This required action is the result of commitments made previously in Washington DC and the inability to reach a compromise.  On March 1, 2013 mandated cuts were ordered on a broad range of federal spending measures.  One area that will be impacted is Medicare and a mandatory 2% reduction in payments to providers at all levels.  This includes those providing EMS services, emergency, non-emergency, fire service based or private service, the impact is the same.
 
In January of this year, Medicare did enact a .08% increase for all levels of service and those rates have already been recognized.  However, the advances of this increase, albeit quite small, will be lost and then some under sequestration. Sequestration is scheduled to impact all claims with a date of service 4/1/2013 or after.  
 
Parastar would like to share with you a few examples of the impact of both of these changes so that you better understand how this impacts your service.  These are examples and based on base rates for Medicare in Michigan.  Similar results can be expected in other states.
 
Level  Priority 2013 Reimbursement

2013 Post
Sequestration Reduction

ALS 1 Emergency $425.72 $417.21
ALS 1 Non-Emergency $268.88 $263.50
ALS 2   $616.18 $603.86
BLS  Emergency $358.50 $351.33
BLS  Non-Emergency $224.06 $219.58
Mileage     $7.09 $6.95
 
In addition to these cuts, your cash will be impacted should CMS order the Medicare Administrative Contractors to discontinue payment while they reprogram their computers for proper payment.  This reprogramming period often takes a few weeks to complete.
 
Parastar is monitoring this situation very closely and will update you as we progress through these complicated and trying times.