Update to Previous State Plan Emergency Ambulance Service Rates
The South Carolina Department of Health and Human Services (SCDHHS) is updating a previously announced reimbursement rate increase for specific emergency ambulance services described in this bulletin.
In Medicaid Bulletin 22-011, SCDHHS announced an increase in the rate for procedure code A0427, “Emergency Transport, Advanced Life Support, Level 1” from $158.96 (per trip) to $170 (per trip); however, this rate should have reflected an increase to $174.86 (per trip) at the time of publication.
SCDHHS has updated its claims system to reflect the correct reimbursement rate of $174.86 (per trip) for claims submitted for dates of service on or after July 1, 2022. Providers do not need to take any action to receive the corrected payment for previously submitted claims for procedure code A0427. These claims will be recycled for payment of the corrected rate.
A table containing the updated emergency ambulance services rates effective July 1, 2022, is included below.
| Description | Code | Current Rate | New Rate |
|---|---|---|---|
| Ground Mileage, per Statute Mile (ALS/BLS) | A0425 | $2.42 (per mile) | $2.66 (per mile) |
| Emergency Transport, Advanced Life Support, Level 1 | A0427 | $158.96 (per trip) | $17 4.86 (per trip) (updated rate) |
| Ambulance Service, Basic Life Support, Emergency Transport | A0429 | $126.82 (per trip) | $139.50 (per trip) |
The new rates are reflected on the SCDHHS Ambulance Fee Schedule.
Providers should direct any questions related to this bulletin to the Provider Service Center at(888)289-0709. The Provider Service Center’s hours of operation are 7:30 a.m. – 5 p.m. Monday – Thursday and 8:30 a.m. – 5 p.m. Friday.
Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.