Annual Update

90.3.2 – Annual Update (Rev. 13150; Issued:04-11-25; Effective: 01-01-25; Implementation:05-12-25) The MACs are required to update the rate on an annual basis using independently determined measures of the cost of providing the service. There are several readily available measures that are used by the Medicare program to adjust payment rates for other types of services, which are appropriate to use to update the transportation rate for years that the MAC does not perform a periodic review. Each MAC has the flexibility to identify the index it will use to update the rate and may consider existing adjustment factors such as the Ambulance Inflation Factor, Medicare Economic Index, or Consumer Price Index for all urban consumers, to reflect changes in the costs of providing services including portable x-ray on an annual basis. In addition, the MACs can consider locally identified factors that are measured independently of CMS as a supplement to the annual adjustment, so long as they are reflective of changes in the costs of providing portable x- ray transportation services. The MAC must disclose the rationale for the index selected and, if applicable, locally identified factors when determining the annual update amount. The MACs also must explain whether the selected index is changing year over year and the rationale for that change.