NON-CONTRACT GROUND EMERGENCY MEDICAL TRANSPORT PAYMENT OBLIGATIONS

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California Department of Health Care Services

ALL PLAN LETTER 20-002

DATE: January 31, 2020

TO: ALL MEDI-CAL MANAGED CARE HEALTH PLANS

SUBJECT: NON-CONTRACT GROUND EMERGENCY MEDICAL TRANSPORT PAYMENT OBLIGATIONS

The purpose of this All Plan Letter (APL) is to provide Medi-Cal managed care health plans (MCPs) with pertinent information concerning enhanced reimbursement obligations for Fee-For-Service (FFS) ground emergency medical transport (GEMT) services reported using Current Procedural Terminology (CPT) codes A0429, A0427,
A0433, A0434, and A0225. These payment standards impact MCP reimbursement of out-of-network GEMT services, as required by Title 42 of the United States Code (USC) section 1396u-2(b)(2)(D), commonly referred to as “Rogers Rates.”

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