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MEDICARE GEOGRAPHIC CLASSIFICATION REVIEW BOARD 2520 Lord Baltimore Drive, Suite L, Baltimore, MD 21244-2670 2014 INDIVIDUAL HOSPITAL APPLICATION FOR GEOGRAPHIC RECLASSIFICATION EFFECTIVE FEDERAL

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What is mgcrb individual application for?

The mgcrb individual application is used to apply for individual reimbursement under the Medicare Ground Ambulance Data Collection System.

Who is required to file mgcrb individual application for?

Ambulance providers and suppliers who are participating in the Medicare Ground Ambulance Data Collection System are required to file the mgcrb individual application.

How to fill out mgcrb individual application for?

The mgcrb individual application can be filled out online through the CMS website or submitted via mail. Providers must provide accurate information about their ambulance services and patient transports.

What is the purpose of mgcrb individual application for?

The purpose of the mgcrb individual application is to collect data on ambulance services provided to Medicare beneficiaries in order to establish reimbursement rates.

What information must be reported on mgcrb individual application for?

Providers must report information such as the number of patient transports, miles traveled, and the cost of providing ambulance services.

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