Information for Data Submitters: Ambulance and Wheelchair Van Revenue Reports

Data Submission Resources

• FY 2025 Ambulance and Wheelchair Van Revenue Report Template (Excel)
• FY 2025 CHIA Submissions User Guide (PDF)
• FY 2025 Revenue Report Instructions (PDF)
• FY 2025 Revenue Report Exemption Form (Word)
• CHIA Submissions Portal

Overview

The Center for Health Information and Analysis (CHIA) is now collecting the Fiscal Year (FY) 2025 Ambulance and Wheelchair Van Revenue Report from ambulance and wheelchair van providers. CHIA collects these reports on behalf of the Executive Office of Health and Human Service (EOHHS) as per regulation 101 CMR 324.00.

Reporting Requirements

• Ambulance and Wheelchair Van Revenue Report from ambulance and wheelchair van providers are required to submit the following, due no later than July 1, 2026.
• In previous years, providers were required to submit either a partial or full cost report depending on the revenue amount received from MassHealth. This year, providers are only required to fill out the partial cost report, which will be referred to as the “Revenue Report” moving forward.
• Providers are no longer required to submit financial statements with the Revenue Report.
• Municipal providers are exempt from filing the revenue report.
• To be considered exempt from completing the revenue report, a provider must claim an exemption using the FY 2025 Ambulance Revenue Report Exemption Request Form, available as a Word document listed in the blue box above. Email the completed form to data@chiamass.gov.
• Providers are required to submit completed Revenue Reports through CHIA’s online submission portal, CHIA Submissions.
• If your agency has not registered with CHIA, you must complete a Data Reporter User Agreement to file the Revenue Report. 

Additional Information

1. All non-municipal ground ambulance providers providing services in Massachusetts in FY 2025 are required to submit the FY 2025 Ambulance Revenue Report no later than July 1, 2026.
   
   
2. Tab 2 - 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.
   
   
3. Links to instruction documents are posted on this webpage. Please read all instructions carefully.

Registration Instructions

New users must register to submit data via CHIA Submissions.

1. Complete and sign the CHIA Data Reporter User Agreement after reviewing the DRUA instructions. Note that each individual user for an organization must complete the form.
2. Submit the completed Data Reporter User Agreement to DL-Data-Submitter-HelpDesk@chiamass.gov.
3. You will be notified when your account is ready to use.

For help with registration, email DL-Data-Submitter-HelpDesk@chiamass.gov or call 617-701-8100 (9am-5pm Monday through Friday).

Contact

If you have questions, please email the Pricing Cost Reports Help Desk 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 in question
3. Reporting year

Question on FY 2025 Ambulance Revenue Report – ABC agency, ID# 123456789A

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