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Proc Procedure Description Mod FFS Rate

Arizona Health Care Cost Containment SystemFFS Air Ambulance RatesEffective 10/01/2017 ProcProcedure DescriptionModFFS RateA0225 Ambulance Service, Neonatal Transport, Base Rate, Emergency Transport, One Way$ Service, Conventional Air Services, Transport, One Way (Fixed Wing)$1, Service, Conventional Air Services, Transport, One Way (Fixed Wing)TH$2, Service, Conventional Air Services, Transport, One Way (Rotary Wing)$1, Service, Conventional Air Services, Transport, One Way (Rotary Wing)TH$2, Wing Air Mileage, Per Statute Mile$ Wing Air Mileage, Per Statute MileTH$ Wing Air Mileage, Per Statute Mile$ Wing Air Mileage, Per Statute MileTH$ Ambulance Mileage, Per Mile ( , For Miles Traveled Beyond Closest$ Ambulance Mileage, Per Mile ( , For Miles Traveled Beyond ClosestTH$ 09/18/2017))

Arizona Health Care Cost Containment System FFS Air Ambulance Rates Effective 10/01/2017 Proc Procedure Description Mod FFS Rate A0225 Ambulance Service, Neonatal Transport, Base Rate, Emergency Transport, One Way $848.87

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