What Your Agency Needs to Prepare for Medicare Ground Ambulance Data Collection


What is Medicare Ground Ambulance Data Collection?

The ground ambulance cost data collection system requires you to collect and report cost, revenue, utilization, and other information. Beginning in 2022, every ground ambulance service will be required to participate. Failure to comply will result in a 10% reduction to Medicare payments for a calendar year following the date which the Centers for Medicare and Medicaid Services (CMS) determines your agency failed to report.

A list of ground ambulance providers and suppliers selected to submit data in Year 1 and 2 are available here.

The Basics of the Program

  1. CMS will send notification via mail/email to the correspondence address listed in your PECOS record and associated with your National Provider Identifier (NPI), addressed to the Authorized Official on file.
  2. You have 30 days to respond, indicating if you will collect data according to calendar year or fiscal year. Failure to respond automatically enrolls you in the calendar year
  3. Once the collection period begins, you will need to track the data points relevant to your agency, in a way that enables you to then report those data points in the manner dictated by CMS.
  4. Once your collection year is complete, a period will start in which your agency will have up to 5-months to report. To do this, CMS will provide an online survey-type tool.
  5. If an agency fails to report within the 5-month reporting period, or if the data provided is deemed insufficient, CMS will take no longer than 3 months after the close of the reporting period to decide if the 10% penalty is warranted. This penalty would be assessed on Medicare payments for dates of service (DOS) in the calendar year that follows the decision to impose the penalty.

What Information is Needed?

To report data correctly, the data must be tracked according to the definitions and rules laid out by CMS.  This means assessing your current accounting and data management practices to ensure you are able to track the data as required.

Data required includes:

  • Organizational Characteristics
  • Service Area
  • Emergency Response Time
  • Ground Ambulance Service Volume
  • Service Mix
  • Labor Costs
  • Facilities Costs
  • Vehicle Costs
  • Equipment, Consumables & Supplies
  • Other Costs
  • Total Cost
  • Revenues

CMS will provide an online survey-type tool called the data collection instrument for the actual reporting component of the program.  Importantly, the instrument uses skip logic, which means the selections you make in the early part of the survey dictate what questions you will see later in the process.  In other words, not every data element will apply to your agency.  With this in mind, we recommend you apply the following questions as you review what is required of your agency:

  • Does this data element apply to my agency?
  • If so, is it currently being tracked?
  • If yes, am I tracking it in a way that conforms to the program?
  • If not, what do I need to do to track it in the required way?

Likewise, there are agencies that are part of a parent organization that uses multiple NPIs to bill Medicare for ground ambulance services.  In such cases, those agencies would need to track and allocate the portion of costs and revenues incurred at the level of the parent organization based on their existing organizational approach for allocating costs to specific NPIs.

For more information on preparing for the Medicare Ground Ambulance Data Collection System check out available resources provided by CMS. For our client partners, we have a user guide and instructional videos available in our secure client portal, CornerSource.

Be Prepared

As your billing partner, we will work with you to make sure you have the needed information as it relates to billing and billing generated revenue when the time comes to report. We strongly encourage our partners to visit the Medicare Ground Ambulance Data Collection System website to familiarize yourself with the tools available to assist in reporting and data collection.

Cornerstone Adminisystems is an employee-owned provider of billing, compliance, and revenue cycle management services to the EMS and medical transport community. Contact us for help improving your revenue cycle.

Improving Your Agency’s EMS Documentation


Improving Your Agency’s EMS Documentation

Now more than ever, documentation is being examined by payers using trained healthcare professionals. Since 2007, over $3.82 billion dollars has been recovered through audits and investigations. Although EMS represents a small fraction of this larger value, the government is looking to recoup every penny. The most effective way to ensure your agency is getting paid for all your services is through accurate EMS documentation.

Patient Care Report (PCR)

EMS documentation is a key component in the continuum of care.  Other healthcare professionals can make important decisions that affect patient health, based on the content of a PCR. Complete your PCR as soon as time permits after a call.

The role of a PCR includes:

  • Medical/QA Record
  • Legal/Compliance Documents
  • Basis for Reimbursement
  • Source of Data Collection

Fundamentals of a PCR include:

  • Demographics & Insurance
  • Accurately spelled name
  • Address
  • DOB
  • SSN
  • Copy of driver’s license
  • Copy of insurance card (front & back)
  • Hospital face sheet
  • Times
  • Dispatch
  • Enroute
  • At Scene
  • Time of Patient Contact
  • Depart Scene
  • At Destination
  • Available
  • Odometer
  • At scene
  • At destination
  • Remember to capture fractional
  • Multiple solutions available for tracking
  • Narrative
  • Main points of emphasis
  • The detail with which you write
  • The logic of how you write

How Documentation is Interpreted

Documentation is translated into ICD-10 codes, placed on claim forms, and submitted for payment. Each character within the ICD-1- Code adds a layer of detail, while specificity helps reveal the most appropriate codes.

Everyone at Cornerstone Adminisystems is a NAAC Certified Ambulance Coder.

Fundamentals of Good Documentation

Good documentation relies on details. We created a free downloadable Documentation Quick Reference Guide that outlines the necessary items that should be included in a PCR. This information includes:

Dispatch & Response

  • Dispatch
    • Was it 911 or equivalent?
    • If non-emergency, explain circumstances.
  • Response
    • Was response immediate?
  • Nature of Call
    • Explain if call was an emergency or non-emergency.
  • Class
    • Class I, II, III, IV (definitions can vary)
  • Chief Complaint
    • Patient’s condition as described during dispatch.
    • If non-emergency, precisely explain reason for transport.
  • Unit(s)
    • BLS, MICU, ALS Squad
    • Unit numbers
    • Assisting units (often for Paramedic Intercepts)

Arrival & Assessment

  • Scene Assessment
    • Explain what you find.
    • What’s the situation at hand?
  • Initial Observations
    • Your general impression of the patient, skin, eyes, breathing, is patient alert, oriented, etc.?
    • For non-emergencies, does the patient meet medical necessity for use of an ambulance?
  • Reported Complaint
    • What the patient (or family member, witness) tells you
  • Assessment
    • A head-to-toe assessment
    • Use mnemonics (consider explicitly explaining OPQRST reveals, AVPU reveals, etc.)

Treatment & Results

  • Treatment/Interventions
    • A thorough description of what you did
  • Results of Treatment/Interventions
    • The outcome of your treatment decisions
    • How patient responded to what you did
  • Packaging
    • Bandaged, boarded, C-spine stabilization, straps, no straps, etc.
  • How Patient Got to the Ambulance
    • Walked under own power, assisted, wheelchair, stretcher, etc.


  • Transport & Ongoing Condition
    • Patient’s condition enroute
    • Ongoing assessment, additional interventions
    • Patient’s response
    • Where you are taking patient and why
  • Transfer of Care
    • How patient was transferred, sheet lift, log roll, hospital workers assisted, bed number
  • Final Disposition
    • Patient’s condition as transfer is completed.
  • Refusals
    • Document these to the same extent as you would a transport, be thorough, explain what you said and did.
    • Protocols/Medical Command

EMS Documentation Workshop

We encourage everyone to take pride in their documentation.  It reflects on the provider, the agency, and their respective standards of professionalism.

Cornerstone Adminisystems offers EMS documentation workshops to all our client partners, with in-person and virtual options available. For information on hosting a class visit EMS documentation or contact us on becoming a Cornerstone partner.