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Dear Ground Ambulance Providers and Suppliers,

We wanted you to be aware that we posted the following announcement on our Ambulances Services Center [ https://www.cms.gov/medicare/coverage/ambulances-services-center ] website:

*Calendar Year (CY) 2025 Physician Fee Schedule (PFS) Proposed Rule*

CMS issued the CY 2025 PFS proposed rule: https://www.federalregister.gov/public-inspection/2024-14828/medicare-and-medicaid-programs-calendar-year-2025-payment-policies-under-the-physician-fee-schedule that announces proposed policy changes for Medicare payments under the PFS and other Medicare Part B payment policy issues including ambulance services. CMS is proposing to modify the definition of advanced life support level two (ALS2) at 42 CFR §414.605 by adding the administration of low titer O+ whole blood transfusion (WBT) to the list of ALS2 procedures. For patients in hemorrhagic shock, the use of WBT has demonstrated a survival benefit when compared to traditional hemorrhagic resuscitative therapy. Under this proposal, a ground ambulance transport that provides WBT would itself constitute an ALS2-level transport.

We are also seeking comments on whether we should add alternative blood product treatments such as the administration of packed red blood cells and plasma to the list of ALS2 procedures. We are aware that some established Emergency Medical Services (EMS) systems may already provide WBT to treat patients in hemorrhagic shock, while other jurisdictions, including those in rural areas, may rely on alternative blood product treatments. 

We encourage you to submit comments on this proposal by September 9, 2024, to the website provided in the CY 2025 PFS proposed rule.




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