Department of Health Care Services
Fee For Service Rates Development Division
State of California
Gavin Newsom, Governor
NOTICE OF GENERAL PUBLIC INTEREST
RELEASE DATE: DECEMBER 10, 2024
PROPOSED STATE PLAN AMENDMENT TO EXTEND THE
PUBLIC PROVIDER GROUND EMERGENCY MEDICAL
TRANSPORT INTERGOVERNMENTAL TRANSFER PROGRAM
This notice is to provide information of public interest about a proposed State Plan Amendment (SPA) by the Department of Health Care Services (DHCS). SPA 25-0002 proposes to continue the Public Provider Ground Emergency Medical Transport Intergovernmental Transfer (PP-GEMT IGT) Program in calendar year (CY) 2025 to continue providing an add-on increase for eligible Ground Emergency Medical Transport (GEMT) services for dates of service January 1, 2025 to December 31, 2025.
California Welfare and Institutions Code (WIC) section 14105.945, enacted by Assembly Bill (AB) 1705 (Chapter 544, Statutes of 2019), authorizes DHCS to implement the PP- GEMT IGT Program for public providers of GEMT services. Providers are eligible to participate in the program if they meet all of the following criteria: (1) provide GEMT services to Medi-Cal beneficiaries, (2) are enrolled as a Medi-Cal provider for the period being claimed, and (3) are owned or operated by the state, a city, county, city and county, fire protection, special, community services, or health care district, or a federally recognized Indian tribe. The add-on increase will be in addition to the fee-for-service fee schedule rates for GEMT services billed using the procedure codes listed below.
Pursuant to SPA 22-0015, the Department was authorized to provide an add-on through the PP-GEMT IGT Program for dates of service January 1, 2023 through December 31, 2023. SPA 22-0015 established an initial add-on rate of $946.92 for each qualifying transport for CY 2023 pursuant to the requirements of WIC section 14105.945(d)(1) and (2). Pursuant to WIC section 14105.945(d)(3), for subsequent rating periods, DHCS is authorized to periodically adjust the initial add-on rate to account for inflation, trend adjustments, or other material changes. In SPA 24-0002, which is pending Centers for Medicare and Medicaid Services (CMS) approval, DHCS proposes to adjust the initial add-on rate for CY 2024 pursuant to Section 14105.945(d)(3). Through this SPA, DHCS proposes to adjust the initial PP-GEMT IGT Program add-on for CY 2025 pursuant to
ATTACHMENT B
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DHCS – NOTICE OF GENERAL PUBLIC INTEREST 2
Section 14105.945(d)(3). Effective January 1, 2025, through December 31, 2025, eligible public providers may receive an add-on increase for the following procedure codes:
Procedure
Code
Description Estimated Medi- Cal PP-
GEMT IGT Add-on Amount
A0429 Basic Life Support $1,478.68
A0427 Advanced Life Support, Level 1 $1,478.68
A0433 Advanced Life Support, Level 2 $1,478.68
A0434 Specialty Care Transport $1,478.68
A0225 Neonatal Emergency Transport $1,478.68
Public providers are not eligible to participate in the GEMT Quality Assurance Fee (QAF) program for periods when the PP-GEMT IGT Program is in effect.
DHCS estimates that the annual aggregate Medi-Cal expenditures for GEMT services will increase by $24.5 million in total funds for Calendar Year 2025.
The effective date of the proposed SPA is January 1, 2025. All proposed SPAs are subject to approval by the CMS.
Public Review and Comments
Upon submission to CMS, a copy of proposed SPA #25-0002 will be published at the following internet address:
https://dhcscagovauthoring/formsandpubs/laws/Pages/Pending-2025.aspx If you would like to view the SPA in person once it becomes available, please visit your local county welfare department. You may also request a copy of proposed SPA #25- 0002 using the mailing or email address listed below.
Written comments may be sent to the following address:
Department of Health Care Services
Fee-For-Service Rate Development Division
Attn: Michelle Tamai
P.O. Box 997413, MS 46000
Sacramento, California 95899-7417
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DHCS – NOTICE OF GENERAL PUBLIC INTEREST 3
Comments may also be emailed to [email protected]. Please indicate SPA #25- 0002 in the subject line or message.
A copy of submitted public comments to SPA #25-0002 may be requested in writing to the mailing or email address identified above.
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