Public Notice: Amended Notice of 2022 Ambulance Rates

PUBLIC NOTICE

Department of Health Services

Adjustment to Medicaid Fee-for-Service Ambulance Rates: Effective January 1, 2022

The Wisconsin Department of Health Services (DHS) Division of Medicaid Services (DMS) will be implementing a rate adjustment to fee-for-service ambulance Medical Assistance (MA) maximum fee rates, effective January 1, 2022.

The impacted ambulance fee-for-service procedure codes are listed below:

January 1, 2022 Ambulance Rates Adjustment

HCPCS

HCPCS Description

CY 2021 Rates

CY2022 Rates

A0426

ALS 1

$ 185.58

$ 218.37

A0427

ALS1-EMERGENCY

$ 185.58

$ 345.74

A0428

BLS

$ 185.58

$ 181.97

A0429

BLS-EMERGENCY

$ 185.58

$ 291.15

A0433

ALS 2

$ 185.58

$ 500.42

A0434

SPECIALTY CARE TRANSPORT

$ 185.58

$ 591.40

Fiscal Impact

The change to Medicaid, BadgerCare, and BadgerCare Plus is projected to result in increased annual expenditures of $13,224,509 all funds (AF), composed of $8,233,979 federal match (FED) and $4,990,530 state funds/general purpose revenue (GPR), effective January 1, 2022 – December 31, 2022.

Copies of Changes

Copies of the state plan change may be obtained free of charge by calling or writing as follows:

Mail:

Matt DeLaBruere

Bureau of Fiscal Accountability and Management

Division of Medicaid Services

P.O. Box 309

Madison, WI 53701-0309

Phone:

[phone]

Fax:

[phone]

Attention: Matt DeLaBruere

E-Mail:

[e-mail]

Copies of the state plan change will be made available for review at the main office of any county department of social services or human services.

Written Comments

Written comments are welcome. Written comments on the proposed changes may be sent by FAX, e‑mail, or regular mail to the Division of Medicaid Services as described above. All written comments will be reviewed and considered.

The written comments will be available for public review between the hours of 7:45 a.m. and 4:30 p.m. daily in the State Office Building, 1 West Wilson Street, Madison, Wisconsin. Revisions may be made in the proposed change based on comments received.