User Guide for the Cost Data Collection Instrument

Organizational Characteristics  This section seeks to gather basic identification and contact info, as well as key defining characteristics.  

NPI, Legal Business Name, Point of Contact 

 Your NPI   If your agency uses more than one NPI 

 Your legal business name   Name of contact person   Title of contact person   Phone for contact person   Email for contact person 

Collection Period 

 If you will collect and report based on calendar or fiscal year 

Agency Type 

 If you are for profit   If you are nonprofit (excluding gov’t)   If you are gov’t (any level)   If you are a public/private partnership 

Agency Category 

 If you are fire department‐based   If you are police or other public safety department‐based   If you are gov’t standalone    If you are hospital or other Medicare provider    If you are independent/proprietary organization primarily involving EMS   If you are independent/proprietary organization providing non‐emergency services 

Shared Service 

 If your agency shares operational costs, e.g. building, personnel, etc., with other operations.   

Volunteers 

 If your agency uses volunteer labor for any positions related to your ground ambulance service.    o This would include volunteers even if they receive small stipends, allowances or other incentives  from your organization.  This would not include staff who are paid on an hourly or salary basis  even if they perform some activities on a volunteer basis.

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