Ambulance Fee Schedule & ZIP Code Files

The Medicare Part B Ambulance Fee Schedule (AFS) is a national fee schedule for ambulance services:

• Find Public Use Files (PUFs) with payment amounts for each calendar year and ZIP Code Geographic Designations Files
• Learn about the Medicare Ground Ambulance Data Collection System (GADCS)
• Read Code of Federal Regulations (CFR)

This webpage is for ambulance services providers and suppliers. If you're a person with Medicare, learn more about your coverage for ambulance services.

Payment under the AFS

The fee schedule applies to all ambulance services provided by:

• Volunteer, municipal, private, and independent ambulance suppliers
• Institutional providers, including hospitals and skilled nursing facilities
• Critical access hospitals, except when they’re the only ambulance service within 35 miles

Ambulance providers and suppliers must:

• Accept Medicare allowed charges as payment in full
• Only bill beneficiaries for Part B coinsurance and deductible

National Breakout of Geographic Area Definitions by ZIP Code

• ZIP Code to Carrier Locality File (ZIP) - Revised 11/15/2024
• ZIP Codes requiring 4 extension (ZIP) - Revised 11/15/2024
• Changes to ZIP Code File (ZIP) - Revised 11/15/2024
• 2024 End of Year Zip Code File (ZIP)
• 2023 End of Year Zip Code File (ZIP)
• 2022 End of Year ZIP Code File (ZIP)
• 2021 End of Year ZIP Code File (ZIP) - Revised 05/27/2022
• 2020 End of Year ZIP Code File (ZIP)
• 2019 End of Year ZIP Code File (ZIP)
• 2018 End of Year ZIP Code File (ZIP)
• Claim Adjustment Reason and Remittance Advice Remark Codes
• Electronic Billing & EDI Transactions

View archive & legacy files.

AFS Medical Conditions List & Coding for the Emergency Triage, Treat, and Transport (ET3) Model

• Ambulance Fee Schedule - Medical Conditions List (PDF)
• Ambulance Fee Schedule - Medical Conditions List & Transportation Indicators (PDF)
• ICD-10-CM Cross Walk for Medical Conditions List (ZIP)
  • CY 2017 ICD-10-CM Updates to Ambulance Medical Conditions List (ZIP)
• Origin and Destination Codes Specific to Ambulance Service Claims and Emergency Triage, Treat, and Transport (ET3) Model claims (PDF)

Report

• Report to Congress, 2015 (PDF) : Evaluations of Hospitals’ Ambulance Data on Medicare Cost Reports and Feasibility of Obtaining Cost Data from All Ambulance Providers and Suppliers