Ground Emergency Medical Transportation (GEMT) Program
Ground Emergency Medical Transportation (GEMT) is a program where publicly owned or operated ambulance services can get extra payments. These payments help cover the gap between what it actually costs to transport patients in emergencies and what they receive from Medicaid, mileage and other reimbursements. It's a way to support ambulance providers in delivering essential services.
Providers get extra payments based on their costs for transporting Medicaid members in emergency ground ambulances. This applies specifically to Medicaid Fee-for-Service and Medicaid managed care members under Title XIX of the federal Social Security Act and the Affordable Care Act.
GEMT Tools and Resources
Provider participation is voluntary. Eligible providers must meet the following criteria:
Provide GEMT services to Iowa Medicaid members.
Be an enrolled Iowa Medicaid provider for the period being claimed.
Be publicly owned or operated by the state, a city, a county, a fire protection district, or a community services district, or federally recognized Indian tribe or any unit of government as defined in 42 CFR Sec. 433.50.
Eligible providers who choose to participate in the GEMT program must do the following:
Notify the Iowa Medicaid Enterprise (IME) Provider Cost Audit and Rate Setting (PCA) Unit.
GEMT providers are required to establish an indirect cost rate before any indirect costs can be claimed on the cost report (Cost report schedule 9).
45 CFR 75.412 indicates that there is no universal rule for classifying certain costs as either direct or indirect under every accounting system. A cost may be direct with respect to some specific service or function, but indirect with respect to the Federal award or other final cost objective. Therefore, it is critical that each item of cost incurred for the same purpose be treated consistently in like circumstances as either a direct or indirect cost in order to avoid possible double charging of Federal awards.
Any of the following methodologies are acceptable for identifying indirect costs:
A cost allocation plan (CAP) with the entity’s local government
An indirect rate negotiated with the entity’s local government
Direct identification through use of a cost report
Each eligible and voluntarily participating GEMT program provider must complete GEMT Program cost reports and submit the certified cost reports to the Iowa Medicaid PCA Unit annually by November 30.
GEMT providers eligible to participate will receive prospective payments based on the average cost per transport from the provider’s completed and reviewed annual cost report beginning July 1 of the next state fiscal year.
