Ambulance Rate Regulations and San Diego County 2017 Rate Survey The Centers for Medicare and Medicaid Services (CMS) allow reimbursement based on the following. California follows these rules for Medi-Cal: BLS (Basic Life Support) EMT      Dispatched as part of a 911 system An immediate response is one in which the ambulance provider/supplier begins as quickly as possible to take the steps necessary to respond to the call Requires an BLS response, in accordance with its dispatch protocols An BLS provider arrives at the scene and performs an assessment of the patient Meets reasonableness and medical necessity standards ALS 1 (Advanced Life Support) Paramedic      Dispatched as part of a 911 system An immediate response is one in which the ambulance provider/supplier begins as quickly as possible to take the steps necessary to respond to the call Requires an ALS response, in accordance with its dispatch protocols An ALS provider arrives at the scene and performs an assessment of the patient Meets reasonableness and medical necessity standards ALS 2 (Advanced Life Support) Paramedic To bill at this level the additional requirement is based on specific ALS interventions At least three separate administrations of one or more medications by IV push/bolus or by continuous infusion or at least one of the listed ALS interventions listed:      Manual defibrillation/cardioversion Endotracheal intubation Cardiac pacing Chest decompression Intraosseous line In the San Diego system, the majority of the calls will be paid at the fixed ALS 1 rate Medicare BLS ALS 1 ALS 2 $453.44 $538.45 $779.34 Medicaid BLS ALS 1 ALS 2 $118.20 $118.20 $118.20 Current Base Rate ALS 2 Proposed Base Rate ALS 2 Lemon Grove $3,470.00 Lemon Grove $3,470.00 San Miguel $3,031.60 San Miguel $3,031.60 La Mesa $2,701.80 La Mesa $2,701.80 Chula Vista $2,675.78 Chula Vista $2,675.78 National City $2,651.01 San Diego $2,671.00 Imperial Beach $2,326.60 National City $2,651.01 San Diego $2,154.31 El Cajon $1,781.00 El Cajon $1,781.00 Bonita $1,771.39 Poway Coronado $1,366.00 $1,050.00 Poway Coronado $1,366.00 $1,050.00 Median $2,488.81 Median ALS 1 $2,661.01 ALS 1 Lemon Grove $3,134.38 Lemon Grove $3,134.38 San Miguel $2,739.04 San Miguel $2,739.04 Chula Vista $2,507.48 Chula Vista $2,507.48 La Mesa $2,412.58 La Mesa $2,412.58 National City $2,291.62 San Diego $2,396.00 Imperial Beach $2,158.29 National City $2,291.62 San Diego $1,933.05 El Cajon $1,598.00 El Cajon $1,598.00 Barona $1,458.61 Poway Coronado $1,366.00 $1,050.00 Poway Coronado $1,366.00 $1,050.00 Median $2,224.96 Median BLS $2,343.81 BLS San Diego $1,631.27 San Diego $2,022.71 Poway Lemon Grove $1,196.00 $1,092.13 Poway Lemon Grove $1,196.00 $1,092.13 San Miguel $975.55 San Miguel $975.55 El Cajon $939.41 El Cajon $939.41 La Mesa $939.41 La Mesa $939.41 Coronado $935.00 Coronado $935.00 Chula Vista $914.28 Bonita $914.28 Imperial Beach $914.28 Chula Vista $914.28 National City $724.23 National City $724.23 Median $939.41 Median $939.41