Medicare Claims Processing Manual (Pub. 100-04), Ch. 15 § 20.4
Ambulance Inflation Factor (AIF)
20.4 - Ambulance Inflation Factor (AIF)
(Rev. 13464; Issued: 11-14-25; Effective:01-01-26; Implementation: 01-05-26)
Section 1834(l)(3)(B) of the Social Security Act (the Act) provides the basis for an update to
the payment limits for ambulance services that is equal to the percentage increase in the
consumer price index for all urban consumers (CPI-U) for the 12-month period ending with
June of the previous year. Section 3401 of the Affordable Care Act amended Section
1834(l)(3) of the Act to apply a productivity adjustment to this update equal to the 10-year
moving average of changes in economy-wide private nonfarm business multi- factor
productivity beginning January 1, 2011. The resulting update percentage is referred to as the
Ambulance Inflation Factor (AIF). These updated percentages are issued via Recurring
Update Notifications.
Part B coinsurance and deductible requirements apply to payments under the ambulance
fee schedule. Following is a chart tracking the history of the AIF:
CY
AIF
2003
1.1
2004
2.1
2005
3.3
2006
2.5
2007
4.3
2008
2.7
2009
5.0
2010
0.0
2011
-0.1
2012
2.4
2013
0.8
2014
1.0
2015
1.5
2016
-0.4
2017
0.7
2018
1.1
2019
2.3
2020
0.9
2021
0.2
2022
5.1
2023
8.7
2024
2.6
2025
2.4
2026
2.0