Information for Data Submitters: Ambulance and Wheelchair Van Cost Reports

Overview

The Center for Health Information and Analysis (CHIA) is now collecting the Fiscal Year (FY)2023 Ambulance and Wheelchair Van Cost Report from ambulance and wheelchair van providers. CHIA collects cost reports pursuant to regulation 957 CMR 6.00. The reports are used by CHIA and other public entities for monitoring costs and for health care payment policy development.

What's New for FY2023

• The separate revenue report is no longer a requirement of the FY23 Ambulance and Wheelchair Van reporting. Instead, the revenue report data elements have been incorporated into the overall Ambulance and Wheelchair Van Cost Report. Based on cost report filing criteria, all non-municipal ground ambulance providers providing services in Massachusetts in FY2023 are required to submit either the partial or full FY2023 Ambulance Cost Report.

• Tab 7. Revenue: All Massachusetts ground ambulance revenue should be reported in this section, split out by advanced life support (ALS) emergency and non-emergency, and basic life support (BLS) emergency and non-emergency revenue. All revenue should be reported net of bad debt, charity care, and payer discounts.

• Tab 9. Reconciliation: The fields in this section have been reorganized for formatting consistency with other tabs.

Non-municipal ambulance and wheelchair van providers are required to submit the FY2023 Ambulance and Wheelchair Van Cost Report. Providers that earned more than $100,000 from MassHealth for services provided in FY2023 are required to fill out the full cost report.  Providers that earned less than $100,000 from MassHealth for services provided in FY2023 are only required to fill out a partial report. Please see the Cost Report Instructions for more information. A complete submission includes the following:

• FY2023 Ambulance and Wheelchair Van Cost Report (Excel Template)

• FY2023 Financial Statements

Municipal providers are exempt from filing the cost report.

To be considered exempt from completing the full cost report, a provider must claim an exemption using the FY2023 Ambulance Cost Report Exemption Request Form, available as a Word document on the website listed above. Email the completed form to data@chiamass.gov.

The cost report and financial statements, if applicable, are due no later than August 19th, 2024.

Links to instruction documents are posted on this webpage. Please read all instructions carefully.

If you have questions, please email the Pricing Cost Reports Helpdesk at CostReports.Pricing@chiamass.gov with the following information in the subject line of your email:

1. Name of the agency with MassHealth ID #
2. Name of the report you are asking about
3. Reporting year

Subject Line Example: Question on FY2023 Ambulance Cost Report – ABC agency, ID# 123456789A.