Extend the Medicare Extenders have been Extended!!!

By Chuck Humphrey, B.A., EMT-B, CAC, CACO, CADS, *


The Gift in Numbers…

Remember these numbers 2037 and 2454. That’s S2037 and HR2454 as Congress passed these companion measures in a late-year Omnibus funding package that gifts two very big items to the ambulance industry this year.

Toy Ambulance sitting on several hundred dollar bills with a stethoscope and question mark next to itExtenders Extended!

It’s official. The Extender payments have been extended!

The industry, while celebrating the largest Ambulance Inflation Factor (AIF) ever at 8.7% was in danger of having most of that increase removed when the Medicare fee schedule extender payments of 2% urban, 3% rural and 22.6% super rural were set to expire at the end of 2022. 

But, thanks to a Congress motivated by control issues as the Democratic party will lose its trifecta hold on the White House, Senate, and House when the House leadership rolls to the Republicans on January 1, 2023…Congress acted by including the extension of the extenders in the Omnibus acts.

This means the Extender payments get new life through December 31, 2024, and most likely even then will be extended until the Legislature has the chance to review the results of the Ground Ambulance Data Collection System (GADCS) initiative.


The second gift is the delay in the 4% hit that was set to come in the form of PAYGO, come January 1st. PAYGO now also sees a two-year delay and is not to be implemented until 2025.

Atop the 2% sequestration cuts, the additional 4% set to be deducted from Medicare payments at the beginning of 2023 would have been completed deflating to the ambulance industry- really deflating to the entire healthcare industry.

PAYGO a budget rule requiring that new legislation that affects revenues and spending on entitlement programs, taken as a whole, does not increase projected budget deficits. PAYGO or “pay as you go” is a budget rule requiring tax cuts and mandatory spending increases must be offset or “paid for” by tax increases or cuts in mandatory spending, ergo Medicare.

Putting the freeze to this initiative further protects that the generous bump coming from the AIF is not to be diluted.

Bi-Partisan Support and Killer Lobbying

Let’s thank the real Santa this year.

First, thanks to our legislators in Congress on both sides of the aisle for recognizing the seriousness of making this legislation happen. It’s good to know that both political sides can come together to support life-saving infrastructure.

Second, let us send out a huge KUDOS to the American Ambulance Association for their tireless lobbying efforts in making this happen. Without their work on Capitol Hill, it’s likely the ambulance industry would have been forgotten in this decision-making process.

And with that…

And with that, let me personally wish you the warmest of Holiday seasons. If you’re working any one day or days over the Holidays, PLEASE BE SAFE OUT THERE!  

A HUGE THANK YOU goes out to those of you who tirelessly keep the wheels turning, the rotors spinning and the sirens blaring. You are the Santa’s of the world to those in need, delivering the gift of your life-saving skills to those in their most dire time of need. This gift of funding is for you! May your days be merry and bright!

*Chuck Humphrey is the Senior Director of Compliance and a Territory Sales Manager for Quick Med Claims. He is one of our industry experts with over 30 years of experience in the EMS industry.

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