2016-698 Emergency Svc - North State Medical Transport - Application for Services Franchise by Ordinance

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NORTH STATE Disclaimer:NSMT Is not a 911 provider,Rates are subject to change. Additionally,the information provided below is typical but not definite and is intended to assist customers understand pricing and which transportation best meets their needs. All pricing will be M l'l)1 CAL TRANS l't.)R l determined on a case by case basis. Specific questions can be answered by contacting ___ our office: P(919)261-8911;F(919)261-8991 North State Medical Transport Fee Schedule-11112/2015 ALS Advanced Life Support Base Cost each way plus Typical Provider Service Type mileage Customer(s) Level Description Any patient deemed emergent by a physician and requires Emergency $406 paramedic level monitoring,ie-IV fluids and/or cardiac monitor. Patient is deemed non-emergent by physician,but still requires Non-Emergency $249 Hospital Paramedic paramedic monitoring,ie-IV fluids and/or cardiac monitor. Patient requires the assistance of a ride-a-long specialist.LE- Specialty Care $694 Respiratory therapist or RN Patients are critical/extremely acute and require special ALS 2 $587 interventions during transfer. BLS Basic Life Support lJ0i1.loU71 Gal.11 way plus Typical Provider Service Type mileage Customer(s) Level Description Immediate response to call(Non-scheduled);Patient is not on any Hospital, drugs or IVs,doesn't need cardiac monitor.A BLS crew may SNFs, perform basic airway management,bleeding control,or patient Emergency $341 Hospice, stabilization while at the scene or during the transfer, Dialysis EMT Scheduled calls:Dialysis transfers,Hospital discharges,Medically Centers, necessary procedures,medical appointments not covered by Non-Emergency $213 Private Medicare or insurance Rural Emergency $332 Citizens Same as an emergency BLS but originating from a rural zipcode Rural Non-Emergency $207 zipcode Wheel Chair Van max l.,wl maw 1 way plus Typical Provider Service Type mileage Customer(s) Level Description SNFs, Hospice, Dialysis Patient does not have a diagnosis which requires stretcher Centers, EMT transport.Typically to medical appointments.Note-Wheelchair services are not available in all areas, Private Wheel Chair Van $63 Citizens Mileage Service Type Cost Pick-Up Explanation If the zipcode at the orgination of the call is considered urban(see attached ALS and BLS $7.16 Urban zipcode)this mileage rate will be used. If the zipcode at the orgination of the call is considered rural(see attached ALS and BLS $7.23 Rural zipcode)this mileage rate will be used. Wheel Chair $3.15 In-County Starting in the county of pick up the patient will be charged$3.15 per mile until they leave the county of orgination of the call at which time the cost will be$4.20 Wheel Chair $4.20 Out-County per mile. Wait Fee All calls are subject to a wait-fee depending upon the circumstances; $1 per minute after the first 30 minutes.