Medicare Benefit Policy Manual (Pub. 100-02), Ch. 10 § 20.1.1
Managed Care Providers/Suppliers
20.1.1 - Managed Care Providers/Suppliers
(Rev. 103; Issued: 02-20-09; Effective Date: 01-05-09; Implementation Date: 03-
20-09)
Mandatory assignment for ambulance services, in effect with the implementation of the
ambulance fee schedule, applies to ambulance providers/suppliers under managed care as
well as under fee-for-service. The ambulance fee schedule is effective for claims with a
date of service on or after April 1, 2002.
Any provider or supplier without a contract establishing payment amounts for services
provided to a beneficiary enrolled in a Medicare Advantage (MA) coordinated care plan
or MA private fee-for-service plan must accept, as payment in full, the amounts that they
could collect if the beneficiary were enrolled in original Medicare. The provider or
supplier can collect from the MA plan enrollee the cost-sharing amount required under
the MA plan, and collect the remainder from the MA organization.