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US · guidance

CMS Pub. 100-04, ch. 23, § 50.8

Institutional Claim Record Layout for the Ambulance Fee Schedule

activein force · 2026-08-25 – presentas-observed

This is a physician fee schedule abstract file for ambulance services payment. The CMS will provide the

specific file names when the prices are released. The file name will contain the label AMBFS.

Record Length - 80

Record Format - FB

Block Size - 27920

Character Code - EBCDIC

Sort Sequence - HCPCS, A/B MAC (B), Locality

Field Name Format Position Description

1-HCPCS X(05) 1 - 5 HCFA Common Procedure Coding

System

2- A/B MAC (B)

Number

X(05) 6 - 10

3-Locality Code X(02) 11-12

4-Base RVU 9(4)v99 13 - 18 Relative Value Unit

5-Non-Facility PE

GPCI

9v9(3) 19 - 22 Geographic Adjustment Factor

6-Conversion Factor 9(5)v99 23 - 29 Conversion Factor

7-Urban Mileage 9(5)v99 30 - 36 Urban payment rate or base rate

mileage rate (determined by HCPCS)

8-Rural Mileage 9(5)v99 37 - 43 Rural payment rate or base rate mileage

rate (determined by HCPCS)

9-Current Year 9(04) 44- 47 YYYY

10-Current Quarter 9(01) 48 Calendar Quarter-value 1-4

11-Effective Date 9(8) 49- 56 Effective date of fee schedule file

12-Filler X(24) 57 - 80 Future Use

History

(Rev. 2643, Issued: 01-31-13, Effective: 07-01-13, Implementation: 07-01-13)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
287c6873105745f66968ba66747b849e461ab9df0c1d6296218c080b41e10d65
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