User Guide for the Cost Data Collection Instrument

Other Costs  As its name would imply, this section is designed to capture costs related to your ground ambulance operation  that were not captured in other sections.   

Outside Contracted Services 

CMS wants to see the total costs your agency incurred for outside contracted services for which you paid a fee  (including labor, supplies, etc.).  More specifically, you will be asked if your agency utilized any of the following  service types, and if so, the cost for those services.   

Contracted  Service 

If shared service,  the allocated cost 

Type 

Total Cost 

Billing   Accounting  Vehicle maintenance/repair  Dispatch/call center  Facilities maintenance  IT support 

*For agencies that have a parent organization, you will need to track and allocate to your NPI the portion of  these services incurred at the level of the parent organization, based on your organizational approach for  allocating costs to specific NPIs.    For the next table, you will be asked if your agency incurred any of the expenses listed in the categories below  (that were partly or entirely related to supporting the ground ambulance operation).  As a reminder, don’t  report costs here if they were already reported elsewhere.   

 Medical or Ambulance‐Related   Administrative or General   Fees, Fines & Taxes 

Let’s visualize this as a table:

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