053-9 Wyo. Code R. § 9-8
Current through April 27, 2019
Ambulance services shall be paid the lesser of the billed charge or the maximum allowable rate for the code appropriate for the documented service. The maximum allowable rates are all-inclusive. Mileage shall be reimbursed per documented loaded statute mile. See Chapter 9, Section 1 for additional guidelines.
(a) The following codes shall be recognized by the Division:
| Code | Short Descriptor | Maximum Allowable |
| A0425 | Mileage, Ground | $9.18 per statute mile |
| A0426 | Advance Life Support - 1 | $342.93 |
| A0427 | Advance Life Support - 1, | $542.98 |
| A0428 | Basic Life Support | $285.78 |
| A0429 | Basic Life Support, Emergent | $457.25 |
| A0430 | Air, Fixed Wing | $3,350.00 |
| A0431 | Air, Rotary Wing | $3,900.66 |
| A0433 | Advance Life Support - 2 | $785.90 |
| A0434 | Specialty Care Transport | $928.79 |
| A0435 | Mileage, Air, Fixed Wing | $10.30 per statute mile |
| A0436 | Mileage, Air, Rotary Wing | $27.47 per statute mile |
053-9 Wyo. Code R. § 9-8
Amended, Eff. 12/12/2017.
Amended, Eff. 5/23/2018.