Committee to include treat‑no‑transport in second ambulance cost study, examine reimbursement options

The Commerce and Consumer Affairs committee instructed staff to include ‘‘treat‑no‑transport’’ calls in the scope of a second, deeper ground ambulance cost study and asked the Insurance Department to brief the committee on how reimbursement could work for those responses.

Committee members described treat‑no‑transport situations—emergency responders treat a patient on‑scene and do not transport to a hospital—as a source of unreimbursed costs for ambulance providers. Department staff said initial claims data show few treat‑no‑transport claims are submitted, partly because Medicare and other government programs historically have not reimbursed for that code and because many ambulance providers were out of network. The department said roughly 80% of ambulance rides involve Medicare, Medicaid or TRICARE patients and that lower Medicare coverage for treat‑no‑transport contributes to confusion.

The department reported that implementation of previously passed ground ambulance legislation is proceeding and that bids for the second cost study were due and being scored. Committee members said they want treat‑no‑transport included in the cost study, noting it may affect how future reimbursement standards are set under the 325% of Medicare framework that governs some payments.

No immediate reimbursement change was adopted. The department will include treat‑no‑transport in the cost‑study scope and return with analysis on how codes are billed, whether insurers reimburse those claims, and what statutory or administrative solutions may address low billing frequency and provider revenue gaps.