405 IAC 5-30-1.5 Reimbursement rates for transportation services

Sec. 1.5. (a) Reimbursement rates for ambulance transportation services shall be the rates listed in this subsection. Updates to covered procedure codes and rates shall be published as a provider bulletin by the office as needed. Any such updates shall be made effective no earlier than permitted under IC 12-15-13-6(a). The reimbursement rates for ambulance transportation services are as follows: Procedure Code Rate A0140 Ticket Price A0225 $160.84 A0420 U1 $20.00 A0420 U2 $20.00 A0422 $15.00 A0424 $5.00 A0425 U1 $4.41 A0425 U2 $3.31 A0426 $95.84 A0427 $160.84 A0428 $95.84 A0429 $110.84 A0430 $2,788.24 A0431 $3,172.27 A0431 QL $3,172.27 A0433 $160.84 A0435 $8.07 A0436 $21.53 A0999 Manual Pricing (b) Reimbursement rates for nonemergency (nonambulance) transportation services shall be the rates listed in this subsection. Updates to covered procedure codes and rates shall be published as a provider bulletin by the office as needed. Any such updates shall be made effective no earlier than permitted under IC 12-15-13-6(a). The reimbursement rates for nonemergency (nonambulance) transportation services are as follows: Procedure Code Rate A0100 UA $6.00 A0100 UB $10.00 A0100 UC $15.00 A0100 U4 $15.00 A0100 TK UA $3.00 A0100 TK UB $5.00 A0100 TK UC $7.50 A0100 TT UA $3.00 A0100 TT UB $5.00 A0100 TT UC $7.50 A0110 Ticket Price A0130 $20.00 A0130 TK $10.00 A0130 TT $10.00 A0130 U6 $5.00 A0425 U3 $1.25 A0425 U5 $1.25 T2001 $5.00 T2003 $10.00 T2004 $5.00 T2007 U3 $4.25 T2007 U5 $4.25 (c) Notwithstanding all other provisions of this rule, the fee schedule rates listed in this section will be reduced by five percent (5%) for emergency transportation services (ambulance services) and by ten percent (10%) for nonemergency transportation services (nonambulance services). These rate reductions will be in effect for the period beginning upon the later of the effective date of LSA Document #10-792 or June 27, 2011, and continuing through June 30, 2013.