525 FEES AND BILLING

525.1 The following fees are hereby established for emergency ambulance life support service, and for the transportation of a person in a District of Columbia Fire and Emergency Medical Services Department emergency ambulance vehicle:

(a) Basic Life Support (BLS) Unit Transportation Fee: A fee of five hundred thirty dollars ($530) shall be charged for the transportation of each person in any ambulance staffed by an Emergency Medical Technician, an Emergency Medical Technician/Driver or a Paramedic who administers basic life support to the person or persons being transported;

(b) Advanced Life Support (ALS) Unit Transportation Fee: A fee of eight hundred thirty two dollars ($832) shall be charged for the transportation of each person in any ambulance staffed by Paramedics if advanced life support is actually administered, by such Paramedics, to the person being transported;

(c) Advanced Life Support-Level 2 (ALS2) Unit Transportation Fee: A fee of nine hundred fifty three dollars ($953) shall be charged for the transportation of each person by ground ambulance vehicle requiring the provision of medically necessary supplies and services including (1) at least three separate administrations of one or more medications by intravenous push/bolus or by continuous infusion (excluding crystalloid fluids) or (2) ground ambulance transport, medically necessary supplies and services, and the provision of at least one of the ALS2 procedures listed below:

1. Manual defibrillation/cardioversion;

2. Endotracheal intubation;

3. Central venous line;

4. Cardiac pacing;

5. Chest decompression;

6. Surgical airway; or

7. Intraosseous line; and

(d) Total Mileage Transportation Fee: A fee of six dollars and six cents ($6.06) per mile traveled, or any fraction thereof, shall be charged to each patient transported in any of the above noted methods.

525.2 Any person transported in a Department emergency ambulance vehicle, or that person's legal guardian or duly authorized representative (collectively referred to in this section as the "person") shall be responsible for payment of the fee in effect for the service except as follows:

(a) The Department shall accept assignment of any Medicare or Medicaid related benefits which may cover in whole or in part the costs of necessary emergency ambulance transportation;

(b) The Department shall bill Medicaid for the services provided by the Department to anyone enrolled in the Medicaid program; and

(c) The Department shall not bill, nor hold responsible, anyone enrolled in the D.C.

Medical Charities program.

525.3 Any person transported shall remain personally liable for any fee or portion of a fee not covered by any of the entities listed in §525.3.525.4 In no event shall any person be denied emergency ambulance service because of inability to pay, nor shall any person be questioned about the ability to pay at the time service is requested.525.5 The Department, through its duly authorized representative, shall attempt to obtain from each person transported by a Department emergency ambulance vehicle sufficient information to enable the Department to bill that person for the transportation provided. This information may include, but shall not be limited to, the following information about the person:- (a) Name;

- (b) Address;

- (c) Date of birth;

- (d) Sex; and

- (e) If applicable, the person's Medicare, Medicaid, or D.C. Medical Charities identification number.525.6 Billings shall be by mail to the person transported.525.7 Department employees operating emergency ambulance vehicles shall not be permitted to accept payment of any fee, or any portion of any fee, from any person.525.8 The person transported shall complete the billing form received by mail and return it to the Department in the envelope provided, together with full payment or with a valid Medicare identification number and assignment of benefits or with a valid Medicaid or D.C. Medical Charities identification number.525.9 Checks or money orders shall be made payable to the order of the 'D.C. Treasurer.' Payment may be also made in person to any District Treasury cashier.525.10 The Department shall not direct a bill to any insurance carrier or third party other than Medicare, Medicaid, or D.C. Medical Charities.525.11 Whenever any person has paid a fee for transportation in a Department emergency ambulance vehicle and is entitled to reimbursement of that payment by an insurance carrier or other party, the reimbursement shall be a matter to be resolved between that person and the carrier or party.525.12 If the person responsible for payment of the fee has not fulfilled his or her obligations as set forth in this section after receiving the initial billing and two (2) subsequent notices at least thirty (30) days apart, the Fire Chief, or his or her duly authorized representative, may, at his or her discretion, request the Office of the Corporation Counsel to undertake legal proceedings to collect the unpaid portion of any fee.

AUTHORITY: The authority for § 525.1 is D.C. Code, 2001 Ed. § 5-416.

SOURCE: Final Rulemaking published at 24 DCR 5184 (December 23, 1977); as amended by Final Rulemaking published at 38 DCR 4445 (July 19, 1991); and by Final Rulemaking published at 43 DCR 6441 (December 6, 1996); as amended by Final Rulemaking published at 55 DCR 4373 (April 18, 2008).