CMS Pub. 100-04, ch. 15, § 20.4

Section 1834(l)(3)(B) of the Social Security Act (the Act) provides the basis for an update to

the payment limits for ambulance services that is equal to the percentage increase in the

consumer price index for all urban consumers (CPI-U) for the 12-month period ending with

June of the previous year. Section 3401 of the Affordable Care Act amended Section

1834(l)(3) of the Act to apply a productivity adjustment to this update equal to the 10-year

moving average of changes in economy-wide private nonfarm business multi- factor

productivity beginning January 1, 2011. The resulting update percentage is referred to as the

Ambulance Inflation Factor (AIF). These updated percentages are issued via Recurring

Update Notifications.

Part B coinsurance and deductible requirements apply to payments under the ambulance

fee schedule. Following is a chart tracking the history of the AIF:

CY AIF

2003 1.1

2004 2.1

2005 3.3

2006 2.5

2007 4.3

2008 2.7

2009 5.0

2010 0.0

2011 -0.1

2012 2.4

2013 0.8

2014 1.0

2015 1.5

2016 -0.4

2017 0.7

2018 1.1

2019 2.3

2020 0.9

2021 0.2

2022 5.1

2023 8.7

2024 2.6

2025 2.4

2026 2.0