Cal. Code Regs. tit. 22 § 51527
Current through Register 2024 Notice Reg. No. 49, December 6, 2024
| Procedure Code | Maximum Allowance | |||
| (1) Ambulance Transportation | ||||
| X0030 | Ambulance service, basic life support (BLS) base rate, emergency transport, one way (includes allowance for emergency run).......................... | $118.20 | ||
| X0032 | Non-emergency transportation, ambulance, base rate one way.......................... | 107.16 | ||
| X0002 | Response to call, 2 patients, each patient (does not include an allowance for emergency run).......................... | 37.02 | ||
| X0034 | Ambulance service, (BLS) per mile, transport one way.......................... | 3.55 | ||
| X0004 | Night call--7:00 p.m. to 7:00 a.m........................... | 9.88 | ||
| X0006 | Emergency run.......................... | 9.88 | ||
| X0036 | Ambulance service, oxygen, administration and supplies, life sustaining situation.......................... | 9.88 | ||
| X0008 | Neonatal intensive care incubator.......................... | 51.49 | ||
| X0010 | Waiting time over 15 min.--each 15 min.......................... | 9.88 | ||
| X0012 | Compressed air for infant respirator.......................... | 10.23 | ||
| Extra attendant--RN, EMT, or equivalent; (in addition to normal crew of two): | ||||
| X0014 | First hour.......................... | 16.44 | ||
| X0016 | Second and third hour, each hour.......................... | 11.51 | ||
| X0018 | Each additional hour.......................... | 5.25 | ||
| X0020 | Cost of IV fluids (invoice must be attached).......................... | By Report | ||
| X0022 | ECG in ambulance.......................... | 16.07 | ||
| A0999 | Unlisted.......................... | By Report | ||
| (2) Air Ambulance Transportation | ||||
| A0430 | Ambulance service, conventional air services, transport, one way (fixed wing).......................... | $ 1,275.00 | ||
| A0431 | Ambulance service, conventional air services, transport, one way (rotary wing).......................... | 1,800.00 | ||
| X0500 | Patient on board miles, helicopter, per mile.......................... | 22.10 | ||
| X0502 | Patient on board miles, fixed-wing, per mile.......................... | 14.25 | ||
| X0504 | Night call, 7:00 p.m. to 7:00 a.m.......................... | 100.00 | ||
| X0506 | Waiting time over 15 minutes, each 15 minutes.......................... | 25.00 | ||
| X0508 | Federal excise tax for fixed-wing aircraft over 6,000 pounds.......................... | 10% of loaded mileage charge | ||
| X0510 | Oxygen--per tank.......................... | 9.88 | ||
| X0512 | Neonatal intensive care incubator.......................... | 51.49 | ||
| X0514 | Compressed air for infant respirator.......................... | 10.23 | ||
| X0516 | Administration of IV solution, 1000cc, including tubing and other supplies.......................... | 13.00 | ||
| X0518 | Administration of IV solution, 500cc, including tubing and other supplies.......................... | 7.00 | ||
| X0522 | Unlisted air transportation.......................... | By Report | ||
| (3) Wheelchair Van and Litter Van Transportation | ||||
| X0200 | Response to call, nonlitter patient: 1 patient.......................... | $17.65 | ||
| X0202 | 2 patients, each patient.......................... | 14.10 | ||
| X0204 | 3 patients, each patient.......................... | 11.71 | ||
| X0206 | 4, or more patients, each patient.......................... | 10.01 | ||
| X0208 | Wheelchair use.......................... | 0.89 | ||
| X0210 | Response to call, litter patient in litter van.......................... | 26.29 | ||
| X0212 | Attendant.......................... | 5.52 | ||
| X0214 | Waiting time over 15 min.--each 15 min.......................... | 5.65 | ||
| X0216 | Mileage one way--per mile.......................... | 1.30 | ||
| X0218 | Night call--7:00 p.m. to 7:00 a.m........................... | 6.13 | ||
| X0220 | Oxygen--per tank.......................... | 11.86 | ||
| X0222 | Unlisted.......................... | By Report | ||
| (4) Patient transfer from discharging acute care hospital to a receiving skilled nursing facility or intermediate care facility. | ||||
| X0400 | Response to call, ambulance.......................... | $107.16 | ||
| X0402 | Ambulance mileage, one way--per mile.......................... | 3.55 | ||
| X0404 | Response to call, litter patient in litter van.......................... | 26.29 | ||
| X0406 | Response to call, non-litter patient.......................... | 17.65 | ||
| X0408 | Litter van and wheelchair van mileage, one way--per mile.......................... | 1.30 | ||
| X0410 | Wheelchair use.......................... | 0.89 | ||
| X0412 | Oxygen--per tank.......................... | 11.86 | ||
| X0414 | Attendant.......................... | 5.52 | ||
| X0416 | Unlisted.......................... | By Report | ||
Cal. Code Regs. Tit. 22, § 51527
2. Amendment of subsection (b) filed 8-1-84 as an emergency; effective upon filing (Register 84, No. 31). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 11-29-84.
3. Certificate of Compliance transmitted to OAL 11-27-84 and filed 12-27-84 (Register 84, No. 52).
4. Amendment of subsection (b) filed 8-1-85 as an emergency; effective upon filing (Register 85, No. 32). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 11-29-85.
5. Certificate of Compliance transmitted to OAL 11-20-85 and filed 12-27-85 (Register 85, No. 52).
6. Editorial correction of printing error in subsection (b)(2) and HISTORY 4. (Register 91, No. 30).
7. Amendment of subsection (b)(1), new subsection (b)(2) and amendment and redesignation of subsections (b)(3)-(b)(4) filed 9-25-92 as an emergency; operative 10-1-92 (Register 92, No. 40). A Certificate of Compliance must be transmitted to OAL 1-25-93 or emergency language will be repealed by operation of law on the following day.
8. Certificate of Compliance as to 9-25-92 order transmitted to OAL 1-22-93 and filed 3-9-93 (Register 93, No. 11).
9. Amendment of subsection (b)(1) filed 8-2-95 as an emergency; operative 8-2-95 (Register 95, No. 31). A Certificate of Compliance must be transmitted to OAL by 11-30-95 or emergency language will be repealed by operation of law on the following day.
10. Certificate of Compliance as to 8-2-95 order transmitted to OAL 11-22-95 and filed 1-3-96 (Register 96, No. 1).
11. Amendment of subsections (b)(1) and (b)(4) amendment of NOTE filed 3-1-99 as an emergency; operative 3-1-99 (Register 99, No. 10). A Certificate of Compliance must be transmitted to OAL by 6-29-99 or emergency language will be repealed by operation of law on the following day.
12. Reinstatement of section as it existed prior to 3-1-99 emergency amendment by operation of Government Code section 11346.1(f) (Register 99, No. 33).
13. Amendment of subsections (b)(1) and (b)(4) and amendment of NOTE filed 8-10-99 as an emergency; operative 8-10-99 (Register 99, No. 33). A Certificate of Compliance must be transmitted to OAL by 12-8-99 or emergency language will be repealed by operation of law on the following day.
14. Certificate of Compliance as to 8-10-99 order transmitted to OAL 12-2-99 and filed 1-13-2000 (Register 2000, No. 2).
15. Amendment of subsections (b)(1) and (b)(4) and amendment of NOTE filed 11-13-2000 as an emergency; operative 11-13-2000 (Register 2000, No. 46). A Certificate of Compliance must be transmitted to OAL by 3-13-2001 or emergency language will be repealed by operation of law on the following day.
16. Certificate of Compliance as to 11-13-2000 order transmitted to OAL 3-13-2001 and filed 4-4-2001 (Register 2001, No. 14).
17. Amendment of subsection (b)(2) filed 12-19-2001 as an emergency; operative 12-19-2001 (Register 2001, No. 51). A Certificate of Compliance must be transmitted to OAL by 4-18-2002 or emergency language will be repealed by operation of law on the following day.
18. Certificate of Compliance as to 12-19-2001 order transmitted to OAL 4-9-2002 and filed 4-30-2002 (Register 2002, No. 18).
19. Amendment of subsections (b)(3)-(4), new subsection (c) and amendment of NOTE filed 7-16-2002; operative rates for services provided on or after 8-1-2000 pursuant to Stats. 2000, c. 52, Items 4260-101-0001 and 0890 (Register 2002, No. 29).
20. Certificate of Compliance as to 7-16-2002 order, including repealer of subsection (c), transmitted to OAL 11-12-2002 and filed 12-24-2002 (Register 2002, No. 52).
Note: Authority cited: Sections 10725, 14105 and 14124.5, Welfare and Institutions Code. Reference: Sections 14105 and 14136.5, Welfare and Institutions Code; Statutes of 1984, Chapter 258, Items 4260-106-001 and 890; Statutes of 1985, Chapter 111, Items 4260-106-001 and 890; Statutes of 1998, Chapter 324, Items 4260-101-0001 and 0890; Statutes of 1999, Chapter 50, Items 4260-101-0001 and 0890; and Statutes of 2000, Chapter 52, Items 4260-101-0001 and 0890.
2. Amendment of subsection (b) filed 8-1-84 as an emergency; effective upon filing (Register 84, No. 31). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 11-29-84.
3. Certificate of Compliance transmitted to OAL 11-27-84 and filed 12-27-84 (Register 84, No. 52).
4. Amendment of subsection (b) filed 8-1-85 as an emergency; effective upon filing (Register 85, No. 32). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 11-29-85.
5. Certificate of Compliance transmitted to OAL 11-20-85 and filed 12-27-85 (Register 85, No. 52).
6. Editorial correction of printing error in subsection (b)(2) and History 4. (Register 91, No. 30).
7. Amendment of subsection (b)(1), new subsection (b)(2) and amendment and redesignation of subsections (b)(3)-(b)(4) filed 9-25-92 as an emergency; operative 10-1-92 (Register 92, No. 40). A Certificate of Compliance must be transmitted to OAL 1-25-93 or emergency language will be repealed by operation of law on the following day.
8. Certificate of Compliance as to 9-25-92 order transmitted to OAL 1-22-93 and filed 3-9-93 (Register 93, No. 11).
9. Amendment of subsection (b)(1) filed 8-2-95 as an emergency; operative 8-2-95 (Register 95, No. 31). A Certificate of Compliance must be transmitted to OAL by 11-30-95 or emergency language will be repealed by operation of law on the following day.
10. Certificate of Compliance as to 8-2-95 order transmitted to OAL 11-22-95 and filed 1-3-96 (Register 96, No. 1).
11. Amendment of subsections (b)(1) and (b)(4) amendment of Note filed 3-1-99 as an emergency; operative 3-1-99 (Register 99, No. 10). A Certificate of Compliance must be transmitted to OAL by 6-29-99 or emergency language will be repealed by operation of law on the following day.
12. Reinstatement of section as it existed prior to 3-1-99 emergency amendment by operation of Government Code section 11346.1(f) (Register 99, No. 33).
13. Amendment of subsections (b)(1) and (b)(4) and amendment of Note filed 8-10-99 as an emergency; operative 8-10-99 (Register 99, No. 33). A Certificate of Compliance must be transmitted to OAL by 12-8-99 or emergency language will be repealed by operation of law on the following day.
14. Certificate of Compliance as to 8-10-99 order transmitted to OAL 12-2-99 and filed 1-13-2000 (Register 2000, No. 2).
15. Amendment of subsections (b)(1) and (b)(4) and amendment of Note filed 11-13-2000 as an emergency; operative 11-13-2000 (Register 2000, No. 46). A Certificate of Compliance must be transmitted to OAL by 3-13-2001 or emergency language will be repealed by operation of law on the following day.
16. Certificate of Compliance as to 11-13-2000 order transmitted to OAL 3-13-2001 and filed 4-4-2001 (Register 2001, No. 14).
17. Amendment of subsection (b)(2) filed 12-19-2001 as an emergency; operative 12-19-2001 (Register 2001, No. 51). A Certificate of Compliance must be transmitted to OAL by 4-18-2002 or emergency language will be repealed by operation of law on the following day.
18. Certificate of Compliance as to 12-19-2001 order transmitted to OAL 4-9-2002 and filed 4-30-2002 (Register 2002, No. 18).
19. Amendment of subsections (b)(3)-(4), new subsection (c) and amendment of Note filed 7-16-2002; operative rates for services provided on or after 8-1-2000 pursuant to Stats. 2000, c. 52 Items 4260-101-0001 and 0890 (Register 2002, No. 29).
20. Certificate of Compliance as to 7-16-2002 order, including repealer of subsection (c), transmitted to OAL 11-12-2002 and filed 12-24-2002 (Register 2002, No. 52).