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New Payment Model For Emergency Ambulance Services

The Center for Medicare and Medicaid Innovation announced a new Medicare payment model for emergency ambulance services that encourages treatment outside the emergency department (ED).

The Emergency Triage, Treat, and Transport (ET3) model will test two new ambulance payments for Medicare beneficiaries who have accessed 911 services:

  • payment for treatment with a qualified health provider in place, either on the scene or through telehealth services; and
  • payment for unscheduled emergency transport to alternative destinations, including primary care physician offices, urgent care clinics, and other destinations not covered under current regulations.

Medicare will continue to pay for emergency transport to a hospital ED or other destination covered under current regulations.

The voluntary model will have a five-year performance period and is expected to start in 2020, with a phased-in application approach. Participating ambulance suppliers and providers can earn up to a 5 percent payment adjustment in later years of the model, based on their quality measure performance.

The Centers for Medicare & Medicaid Services (CMS) plans to release a request for applications in summer 2019 to solicit the first round of ET3 model participants. CMS encourages ET3 model participants to partner with other payers, including state Medicaid agencies.

The ET3 model also will encourage medical triage lines for low-acuity 911 calls in regions with participating ambulance providers and suppliers. CMS plans to issue a notice of funding opportunity in fall 2019 for up to 40 two-year cooperative agreements among local governments, their designees, or other organizations with authority over 911 dispatches.

Informational Webinar

An upcoming webinar for providers, payers, beneficiaries, and other stakeholders will offer an overview of the new model, including a timeline for release of the request for applications and the notice of funding opportunity.

The webinar will be held Feb. 27 from 1–2 p.m. EST. 

For additional information or questions about the ET3 model, please contact

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Emily Schweich is a communications manager at America's Essential Hospitals.

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