Cal. Code Regs. Tit. 22, § 51527 - Medical Transportation Services

(a) General Provision.

(1) The reimbursement for medical transportation services shall be in accordance with maximum reimbursement rates as follows: however, billing shall not exceed charges made to the general public.

(b) Maximum reimbursement rates for medical transportation services shall be as follows:

Procedure Code	Maximum Allowance
(1) Ambulance Transportation
X0030	Ambulance service, basic life support (BLS) base rate, emergency transport, one way (includes allowance for emergency run)..........................	$118.20
X0032	Non-emergency transportation, ambulance, base rate one way..........................	107.16
X0002	Response to call, 2 patients, each patient (does not include an allowance for emergency run)..........................	37.02
X0034	Ambulance service, (BLS) per mile, transport one way..........................	3.55
X0004	Night call--7:00 p.m. to 7:00 a.m...........................	9.88
X0006	Emergency run..........................	9.88
X0036	Ambulance service, oxygen, administration and supplies, life sustaining situation..........................	9.88
X0008	Neonatal intensive care incubator..........................	51.49
X0010	Waiting time over 15 min.--each 15 min..........................	9.88
X0012	Compressed air for infant respirator..........................	10.23
Extra attendant--RN, EMT, or equivalent; (in addition to normal crew of two):
X0014	First hour..........................	16.44
X0016	Second and third hour, each hour..........................	11.51
X0018	Each additional hour..........................	5.25
X0020	Cost of IV fluids (invoice must be attached)..........................	By Report
X0022	ECG in ambulance..........................	16.07
A0999	Unlisted..........................	By Report
(2) Air Ambulance Transportation
A0430	Ambulance service, conventional air services, transport, one way (fixed wing)..........................	$ 1,275.00
A0431	Ambulance service, conventional air services, transport, one way (rotary wing)..........................	1,800.00
X0500	Patient on board miles, helicopter, per mile..........................	22.10
X0502	Patient on board miles, fixed-wing, per mile..........................	14.25
X0504	Night call, 7:00 p.m. to 7:00 a.m..........................	100.00
X0506	Waiting time over 15 minutes, each 15 minutes..........................	25.00
X0508	Federal excise tax for fixed-wing aircraft over 6,000 pounds..........................	10% of loaded mileage charge
X0510	Oxygen--per tank..........................	9.88
X0512	Neonatal intensive care incubator..........................	51.49
X0514	Compressed air for infant respirator..........................	10.23
X0516	Administration of IV solution, 1000cc, including tubing and other supplies..........................	13.00
X0518	Administration of IV solution, 500cc, including tubing and other supplies..........................	7.00
X0522	Unlisted air transportation..........................	By Report
(3) Wheelchair Van and Litter Van Transportation
X0200	Response to call, nonlitter patient: 1 patient..........................	$17.65
X0202	2 patients, each patient..........................	14.10
X0204	3 patients, each patient..........................	11.71
X0206	4, or more patients, each patient..........................	10.01
X0208	Wheelchair use..........................	0.89
X0210	Response to call, litter patient in litter van..........................	26.29
X0212	Attendant..........................	5.52
X0214	Waiting time over 15 min.--each 15 min..........................	5.65
X0216	Mileage one way--per mile..........................	1.30
X0218	Night call--7:00 p.m. to 7:00 a.m...........................	6.13
X0220	Oxygen--per tank..........................	11.86
X0222	Unlisted..........................	By Report
(4) Patient transfer from discharging acute care hospital to a receiving skilled nursing facility or intermediate care facility.
X0400	Response to call, ambulance..........................	$107.16
X0402	Ambulance mileage, one way--per mile..........................	3.55
X0404	Response to call, litter patient in litter van..........................	26.29
X0406	Response to call, non-litter patient..........................	17.65
X0408	Litter van and wheelchair van mileage, one way--per mile..........................	1.30
X0410	Wheelchair use..........................	0.89
X0412	Oxygen--per tank..........................	11.86
X0414	Attendant..........................	5.52
X0416	Unlisted..........................	By Report

Notes

Cal. Code Regs. Tit. 22, § 51527

1. New subsection (b)(3) filed 4-11-84; effective thirtieth day thereafter (Register 84, No. 15). For prior history, see Register 81, No. 52.
2. Amendment of subsection (b) filed 8-1-84 as an emergency; effective upon filing (Register 84, No. 31). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 11-29-84.
3. Certificate of Compliance transmitted to OAL 11-27-84 and filed 12-27-84 (Register 84, No. 52).
4. Amendment of subsection (b) filed 8-1-85 as an emergency; effective upon filing (Register 85, No. 32). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 11-29-85.
5. Certificate of Compliance transmitted to OAL 11-20-85 and filed 12-27-85 (Register 85, No. 52).
6. Editorial correction of printing error in subsection (b)(2) and HISTORY 4. (Register 91, No. 30).
7. Amendment of subsection (b)(1), new subsection (b)(2) and amendment and redesignation of subsections (b)(3)-(b)(4) filed 9-25-92 as an emergency; operative 10-1-92 (Register 92, No. 40). A Certificate of Compliance must be transmitted to OAL 1-25-93 or emergency language will be repealed by operation of law on the following day.
8. Certificate of Compliance as to 9-25-92 order transmitted to OAL 1-22-93 and filed 3-9-93 (Register 93, No. 11).
9. Amendment of subsection (b)(1) filed 8-2-95 as an emergency; operative 8-2-95 (Register 95, No. 31). A Certificate of Compliance must be transmitted to OAL by 11-30-95 or emergency language will be repealed by operation of law on the following day.
10. Certificate of Compliance as to 8-2-95 order transmitted to OAL 11-22-95 and filed 1-3-96 (Register 96, No. 1).
11. Amendment of subsections (b)(1) and (b)(4) amendment of NOTE filed 3-1-99 as an emergency; operative 3-1-99 (Register 99, No. 10). A Certificate of Compliance must be transmitted to OAL by 6-29-99 or emergency language will be repealed by operation of law on the following day.
12. Reinstatement of section as it existed prior to 3-1-99 emergency amendment by operation of Government Code section 11346.1(f) (Register 99, No. 33).
13. Amendment of subsections (b)(1) and (b)(4) and amendment of NOTE filed 8-10-99 as an emergency; operative 8-10-99 (Register 99, No. 33). A Certificate of Compliance must be transmitted to OAL by 12-8-99 or emergency language will be repealed by operation of law on the following day.
14. Certificate of Compliance as to 8-10-99 order transmitted to OAL 12-2-99 and filed 1-13-2000 (Register 2000, No. 2).
15. Amendment of subsections (b)(1) and (b)(4) and amendment of NOTE filed 11-13-2000 as an emergency; operative 11-13-2000 (Register 2000, No. 46). A Certificate of Compliance must be transmitted to OAL by 3-13-2001 or emergency language will be repealed by operation of law on the following day.
16. Certificate of Compliance as to 11-13-2000 order transmitted to OAL 3-13-2001 and filed 4-4-2001 (Register 2001, No. 14).
17. Amendment of subsection (b)(2) filed 12-19-2001 as an emergency; operative 12-19-2001 (Register 2001, No. 51). A Certificate of Compliance must be transmitted to OAL by 4-18-2002 or emergency language will be repealed by operation of law on the following day.
18. Certificate of Compliance as to 12-19-2001 order transmitted to OAL 4-9-2002 and filed 4-30-2002 (Register 2002, No. 18).
19. Amendment of subsections (b)(3)-(4), new subsection (c) and amendment of NOTE filed 7-16-2002; operative rates for services provided on or after 8-1-2000 pursuant to Stats. 2000, c. 52, Items 4260-101-0001 and 0890 (Register 2002, No. 29).
20. Certificate of Compliance as to 7-16-2002 order, including repealer of subsection (c), transmitted to OAL 11-12-2002 and filed 12-24-2002 (Register 2002, No. 52).

Note: Authority cited: Sections 10725, 14105 and 14124.5, Welfare and Institutions Code. Reference: Sections 14105 and 14136.5, Welfare and Institutions Code; Statutes of 1984, Chapter 258, Items 4260-106-001 and 890; Statutes of 1985, Chapter 111, Items 4260-106-001 and 890; Statutes of 1998, Chapter 324, Items 4260-101-0001 and 0890; Statutes of 1999, Chapter 50, Items 4260-101-0001 and 0890; and Statutes of 2000, Chapter 52, Items 4260-101-0001 and 0890.

1. New subsection (b)(3) filed 4-11-84; effective thirtieth day thereafter (Register 84, No. 15). For prior history, see Register 81, No. 52.
2. Amendment of subsection (b) filed 8-1-84 as an emergency; effective upon filing (Register 84, No. 31). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 11-29-84.
3. Certificate of Compliance transmitted to OAL 11-27-84 and filed 12-27-84 (Register 84, No. 52).
4. Amendment of subsection (b) filed 8-1-85 as an emergency; effective upon filing (Register 85, No. 32). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 11-29-85.
5. Certificate of Compliance transmitted to OAL 11-20-85 and filed 12-27-85 (Register 85, No. 52).
6. Editorial correction of printing error in subsection (b)(2) and History 4. (Register 91, No. 30).
7. Amendment of subsection (b)(1), new subsection (b)(2) and amendment and redesignation of subsections (b)(3)-(b)(4) filed 9-25-92 as an emergency; operative 10-1-92 (Register 92, No. 40). A Certificate of Compliance must be transmitted to OAL 1-25-93 or emergency language will be repealed by operation of law on the following day.
8. Certificate of Compliance as to 9-25-92 order transmitted to OAL 1-22-93 and filed 3-9-93 (Register 93, No. 11).
9. Amendment of subsection (b)(1) filed 8-2-95 as an emergency; operative 8-2-95 (Register 95, No. 31). A Certificate of Compliance must be transmitted to OAL by 11-30-95 or emergency language will be repealed by operation of law on the following day.
10. Certificate of Compliance as to 8-2-95 order transmitted to OAL 11-22-95 and filed 1-3-96 (Register 96, No. 1).
11. Amendment of subsections (b)(1) and (b)(4) amendment of Note filed 3-1-99 as an emergency; operative 3-1-99 (Register 99, No. 10). A Certificate of Compliance must be transmitted to OAL by 6-29-99 or emergency language will be repealed by operation of law on the following day.
12. Reinstatement of section as it existed prior to 3-1-99 emergency amendment by operation of Government Code section 11346.1(f) (Register 99, No. 33).
13. Amendment of subsections (b)(1) and (b)(4) and amendment of Note filed 8-10-99 as an emergency; operative 8-10-99 (Register 99, No. 33). A Certificate of Compliance must be transmitted to OAL by 12-8-99 or emergency language will be repealed by operation of law on the following day.
14. Certificate of Compliance as to 8-10-99 order transmitted to OAL 12-2-99 and filed 1-13-2000 (Register 2000, No. 2).
15. Amendment of subsections (b)(1) and (b)(4) and amendment of Note filed 11-13-2000 as an emergency; operative 11-13-2000 (Register 2000, No. 46). A Certificate of Compliance must be transmitted to OAL by 3-13-2001 or emergency language will be repealed by operation of law on the following day.
16. Certificate of Compliance as to 11-13-2000 order transmitted to OAL 3-13-2001 and filed 4-4-2001 (Register 2001, No. 14).
17. Amendment of subsection (b)(2) filed 12-19-2001 as an emergency; operative 12-19-2001 (Register 2001, No. 51). A Certificate of Compliance must be transmitted to OAL by 4-18-2002 or emergency language will be repealed by operation of law on the following day.
18. Certificate of Compliance as to 12-19-2001 order transmitted to OAL 4-9-2002 and filed 4-30-2002 (Register 2002, No. 18).
19. Amendment of subsections (b)(3)-(4), new subsection (c) and amendment of Note filed 7-16-2002; operative rates for services provided on or after 8-1-2000 pursuant to Stats. 2000, c. 52 Items 4260-101-0001 and 0890 (Register 2002, No. 29).
20. Certificate of Compliance as to 7-16-2002 order, including repealer of subsection (c), transmitted to OAL 11-12-2002 and filed 12-24-2002 (Register 2002, No. 52).