ARIZONA AIR AMBULANCE SERVICE RATE SCHEDULE ARIZONA DEPARTMENT OF HEALTH SERVICES Bureau of Emergency Medical Service Trauma Sys

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ARIZONA AIR AMBULANCE SERVICE RATE SCHEDULE ARIZONA DEPARTMENT OF HEALTH SERVICES Bureau of Emergency Medical Service Trauma Sys Powered By Docstoc
					                                            ARIZONA AIR AMBULANCE SERVICE RATE SCHEDULE
                        ARIZONA DEPARTMENT OF HEALTH SERVICES, Bureau of Emergency Medical Service & Trauma System
                                             150 North 18th Avenue, Suite 540, Phoenix, AZ 85007-3248
                                                       Phone: (602)364-3150; Fax (602) 364-3568
                              In accordance with Federal Regulations, the State is not allowed to regulate air ambulance provider routes or rates


Updated: October 5, 2011
                                                              Fixed Wing            Fixed Wing        Rotor-Wing             Rotor-Wing               As
                Entity dba                                    *Based Rate        **Mileage Rate      *Base Rate           **Mileage Rate        Submitted On
Aerocare Medical Transport Inc. (OK)                           $11,200.00            $118.00               N/A                   N/A                 07/06/07
(LIC# 205)


Aerocare Medical Transport Systems, Inc. (IL)                  $12,500.00            $125.00               N/A                   N/A                 06/13/08
(LIC# 730)


Air Evac (LIC# 10)                                             $13,866.00   $181 (First 70 miles)       $13,866.00      $181 (First 70 miles)        07/01/11
                                                                            $73 (After 70 miles)                         $73 (After 70 miles)


Air Ambulance Specialist, Inc. (LIC# 746)                      $8,400.00              $24.00               N/A                   N/A                 10/08/08


AirCARE1 International (LIC# 739)                              $11,000.00             $75.00               N/A                   N/A                 07/01/11


Angel Medflight (LIC# 750)                                     $15,500.00            $185.00               N/A                   N/A                 04/11/11


Apache Medical Transport                                       $12,000.00            $140.00               N/A                   N/A                 07/01/11
(LIC# 732)


Arizona Lifeline (LIC# 197)                                       N/A                   N/A             $7,950.00              $75.00                11/03/06


Classic Lifeguard Air Ambulance (LIC# 194)                     $12,100.00            $140.00            $12,100.00            $140.00                04/01/10


Coast to Coast Air Ambulance (LIC# 758)                         $11,998              $139.00               N/A                   N/A                 11/21/08


Desert Air Ambulance, Inc. (LIC# 772)                          $7,900.00              $75.00               N/A                   N/A                09/16/11


Eagle Air Medical (LIC# 14)                                    $12,500.00            $125.00               N/A                   N/A                 05/30/06


Guardian Air (LIC# 330)                                        $12,111.80            $140.06            $14,460.52            $153.76                07/01/11
 Neonatal Transport                                            $13,406.63            $140.06            $15,756.58            $153.76
 Pediatric Transport                                           $12,760.45            $140.06            $15,110.41            $153.76
 Stable Baby                                                   $10,046.02            $140.06               N/A                   N/A
 **Rotor Wing Oxygen (per unit)                    $103.64
 **Rotor Wing Monitoring                           $434.67
 **Rotor Wing Balloon Pump                        $5,026.06
 **Fixed Wing Oxygen (per unit)                    $103.64
 **Fixed Wing Monitoring                           $434.67
 **Fixed Wing Balloon Pump                        $5,026.06


International Air Medical Services, Inc.                       $10,000.00            $125.00               N/A                   N/A                07/22/11


LifeNet (LIC# 17)
 (LifeNet Multi-Load Miles Mileage Rate $62.97)                   N/A                   N/A             $13,997.58            $125.43                10/01/10


Native American Air Ambulance (Area 1)                         $13,356.00            $159.00            $13,356.00            $159.00                02/07/08
Area 2 - Areas based on Zip Codes                              $9,934.00             $117.00            $9,934.00             $117.00
Area 3 - Areas based on Zip Codes                              $12,000.00            $100.00            $12,000.00            $100.00
(LIC# 13)


San Juan Regional Medical Center (LIC# 765)                    $5,250.00              $47.00            $5,560.00              $75.00
 (Patient Mile, 2nd (On Board) $32.00)


Sunrise Air Ambulance, L.L.C. (LIC# 773)                          $11,500            $139.00      N/A         N/A      07/13/11


Tri-State Care Flight (LIC# 464)
 Interfacility Transport                                        $11,750.00           $139.00   $11,750.00   $149.00   11/25/08
 Scene Costs                                                        N/A                N/A     $11,750.00   $149.00
 Critical Care Transport                                         $1,050.00           $25.00    $1,050.00    $25.00


* Base Rate is the minimum payment made to a provider, exclusive of mileage costs.
** Mileage - Air mileage on patient loaded miles flown (statute miles.)

				
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