The add-on amount is $220.80 and will be provided for eligible emergency Medi-Cal GEMT transports billed with HCPCS codes A0427, A0429, A0433, A0225, and A0434.
GEMT providers are required to periodically submit data reports that include the following:
DHCS will utilize the data collected to develop the QAF rate annually as follows:
FY 2025-26
GEMT QAF Rate for FY 2025-26, effective July 1, 2025
A GEMT QAF Rate was calculated for Fiscal Year (FY) 2025-26, in accordance with SB 523. The QAF is assessed on each qualified emergency medical transport, regardless of payer type. The QAF was adjusted based on the transport data submitted for calendar year 2024 for emergency transport codes A0429, A0427, A0433, A0225, and A0434. The QAF rate in effect for FY 2025-26 will be assessed on ground emergency medical transports with dates of service beginning January 1, 2025, through December 31, 2025. DHCS intends to submit the GEMT QAF SPA 25-0003 to the Centers for Medicare and Medicaid Services (CMS) for federal approval in the third quarter of 2025.
• The QAF Rate for FY 2025-26 is: $36.74
Gross Receipt Data Submission
On or before August 14, 2025, providers are required to submit data on gross receipts received for ground emergency medical transports between July 1, 2024, through June 30, 2025. The Gross Receipt Data Submission Form must be submitted to GEMTQAF@dhcs.ca.gov by August 14, 2025. Providers are to use the Gross Receipt Data Submission Form provided below:
Gross Receipt Data Submission Form
FY 2024-25
GEMT QAF SPA Approval and Payment Schedule FY 2024-25:
The Centers for Medicare & Medicaid Services (CMS) approved SPA 24-0025 to continue the GEMT QAF Program for FY 2024-25. Below is the QAF payment schedule DHCS established for collecting the quarterly QAF assessments, beginning with the July 1, 2024, state fiscal quarter.
QAF Assessment Due
| QAF Payment Due Date (Revised)
| Reporting Period
| Transport Date of Service
|
July 1, 2024
| March 3, 2025 (Revised)
| Apr - Jun 2024
| Jan - Mar 2024
|
October 1, 2024
| April 1, 2025 (Revised)
| July - Sept 2024
| Apr - Jun 2024
|
January 1, 2025
| May 1, 2025 (Revised)
| Oct - Dec 2024
| Jul - Sept 2024
|
April 1, 2025
| June 2, 2025 (Revised)
| Jan - Mar 2025
| Oct - Dec 2024
|
PP-GEMT IGT Program
In accordance with Assembly Bill (AB) 1705 (Chapter 544, Statutes of 2019), the Department of Health Care Services (DHCS) establishes the Public Provider Ground Emergency Medical Transportation (PP-GEMT) Intergovernmental Transfer (IGT) Program for eligible public GEMT providers.
Providers are eligible to participate in the PP-GEMT IGT program if they meet all of the following criteria:
- provide GEMT services to Medi-Cal beneficiaries
- are enrolled as a Medi-Cal provider for the period being claimed, and
- are owned or operated by the state, a city, county, city and county, fire protection, special districts, community services districts, health care district, or a federally recognized Indian tribe.
The PP-GEMT IGT Program provides an add-on increase to the associated Medi-Cal fee-for-service fee schedule of emergency medical transports billed with the following codes: A0429, A0427, A0433, A0225, and A0434, for eligible providers.
The Centers for Medicare & Medicaid Services (CMS) approved State Plan Amendment (SPA) 22-0015 on December 21, 2022 establishing the PP-GEMT IGT Program. Effective January 1, 2023, public providers as defined in AB 1705 are no longer eligible to participate in the GEMT QAF program and have transitioned to the new PP-GEMT IGT program. Public providers are no longer assessed the QAF prospectively and are not eligible to receive the add-on through the GEMT QAF program.