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7777777777.. 9 <br /> s. <br /> Effective January 1,2006,the Ambulance FS was <br /> fully implemented. Each year, an update is applied to <br /> the payment limits for ambulance services that is <br /> equal to the percentage increase'in the Consumer <br /> Price Index for All Urban Consumers(CPI-U)for the <br /> 12-month period ending with June of the previous year. <br /> Under the Affordable Care Act, Section 1834(1)(3)(B) <br /> of the Act was amended to apply a productivity <br /> adjustment to the update equal to the 10-year moving <br /> average of changes in economy wide private nonfarm <br /> business multi-factor productivity (MFP) beginning <br /> on January 1, 2011. The resulting update percentage <br /> is called the Ambulance Inflation Factor(AIF)_ For <br /> calendar year(CY)2012, the MFP is 1.2 percent and <br /> the CPI-U is 3.6 percent. Under the Affordable Care ELM <br /> Act, the CPI-U is reduced by the MFP, even if the <br /> reduction results in a negative AIF 'therefore, the AIF <br /> for CY 2012 is 2.4 percent. Air Ambulance Services <br /> Ground Ambulance Services As of January 1, 2006, the total payment amount for <br /> air ambulance providers and suppliers is based on <br /> 100 percent of the national Ambulance FS. Payments <br /> Effective January 1, 2008, the total payment amount for air ambulance services under the Ambulance FS <br /> for ground ambulance providers and suppliers is <br /> based on 100 percent of the national Ambulance FS. include the following elements: <br /> Payments for ground ambulance services under the •:• A nationally uniform base rate for fixed wing and a <br /> Ambulance FS include the following elements: nationally uniform base rate for rotary wing; <br /> •:• A nationally uniform base rate or conversion factor •:• A GAF for each Ambulance FS locality area (GPCI); <br /> for all ground ambulance services; .;. A nationally uniform loaded mileage rate for each <br /> •:• A numeric value for ambulance services relative to type of air service; and <br /> the value of a base level ambulance service called A rural adjustment to the base rate and mileage <br /> a relative value unit is assigned to each type of g <br /> ground ambulance service; for services furnished for a rural POP. <br /> •:• A geographic adjustment factor(GAF)for each <br /> Ambulance FS locality area (geographic practice <br /> cost index[GPCIj); <br /> ❖ A nationally uniform loaded mileage rate; , <br /> ❖ An additional amount for certain mileage for a <br /> rural point-of-pickup (POP); and <br /> •:+ Additional payments for certain specified <br /> temporary periods. <br /> Ambulance Fee Schedule <br /> 5 <br />