Cost Data Collection

In 2018, Congress passed the Bipartisan Budget Act of 2018. This piece of legislation has a large impact on the ambulance industry. The Act extended the ground ambulance add-on payments through December 31, 2022. The temporary add-on payments include: 3 percent increase in the base and mileage rate for ground ambulance transports that originate in rural areas, 2 percent increase in the base and mileage rate for ground ambulance transports that originate in urban areas; and 22.6 percent increase in the base rate for ground ambulance transports that originate in super rural areas. 

Additionally, the Act directs the Secretary of Health and Human Services to develop a data collection system (which may include use of a cost survey) to collect cost, revenue, utilization, and other information determined appropriate by the Secretary with respect to providers and suppliers of ground ambulance services. Not later than December 31, 2019, the Secretary must specify the data collection system and identify a representative sample of providers and suppliers required to submit information under the data collection system for the first year. This system will be developed and published through the federal rulemaking process in 2019. Actual reporting will not take place until 2020. Data will be collected each year from 2020 through 2024. Cost data collection will continue at least every three years from 2025 on.

In addition, among other things, the Act allows for a 10 percent reduction to ambulance fee schedule payments made to a provider or supplier that is required to submit information under the data collection system with respect to a period, and does not sufficiently submit such information, as determined by the Secretary.

 A cost data collection tool was developed by CMS and a final rule was codified on 11/15/19. The rule can be viewed in its entirety at Soon thereafter, the first set of providers were chosen to participate in the cost data collection program. 

It is of the utmost importance that ambulance providers become familiar with the cost data collection process due to the fact reimbursement will be dependent on the accuracy and completeness of the data compiled. If the data submitted by providers is flawed, there could be a negative impact to the ambulance industry as a whole. 

The Alliance has compiled a list of resources which should assist providers in preparing to report mandated cost elements to CMS. 

American Ambulance Association 

The American Ambulance Association (AAA) has put together information on cost data collection and has been working with providers through webinars and educational events to prepare them for cost data reporting. In addition, the AAA website ( provides updates through its website. 

CMS Ambulance Service Center

CMS also has an informational website ( to help assist providers in collecting and reporting cost data information. It provides all the information released by CMS regarding ambulance cost data collection. 

Specifically, the website provides links to Frequently Asked Questions, Medicare Learning Network webinars, slide presentations along with several other resources. 

A PDF version of the cost data collection system can be viewed at