UNDERSTANDING MEDICARE CHARGES: EXPLORING ESD 11 FEES

This page provides an insightful look into how ESD 11 charges interact with Medicare coverage, including specifics on Medicare eligibility, the fee schedule, and patient responsibilities. It aims to clarify the financial aspects of receiving emergency medical services for Medicare patients within ESD 11, ensuring transparency and understanding regarding the cost of care.

ESD 11 charges as a result of being treated & transported have no impact on the Medicare patient. Payment is based on the Medicare Ambulance Fee Schedule allowable rates. CMS publishes updates to these rates annually. The changes are based on annual inflation. The 2024 allowable amounts for our service area are as follows:

The difference between our base rates & the allowable rates are considered a contractual adjustment by virtue of ESD 11 participating in the Medicare program and are not the responsibility of the patient.
 
Medicare pays a percentage of the allowable amount. Traditional Medicare pays 80% of the Ambulance Fee Schedule allowable amount after the deductible has been met with the patient responsible for the remaining 20%. This could differ if you are enrolled in a Medicare Managed care plan. Consult your plan provider if you have questions.