(1) When more than one client is transported in the same ground ambulance at the same time, the medicaid agency:

(a) Pays the ambulance providers at a reduced base rate for the second client who is being transported in the ambulance for medical treatment. This rate is set at seventy-five percent of the base rate for the applicable level of service (ALS or BLS) for the first client;

(b) Does not pay the ambulance provider a separate mileage charge for the second client being transported in the ambulance for medical treatment. The total payable mileage for the transport is from the first point of pickup.

(2) The agency pays an ambulance provider at the appropriate base rate (BLS or ALS) if no transportation takes place because the client died before transport could occur but after the ambulance crew provided medical interventions/supplies to the client at the scene prior to the client's death. The intervention(s)/supplies provided must be documented in the client's record. No mileage charge is allowed with the base rate when the client dies after medical interventions/supplies are provided but before transport takes place.

(3) In situations where a BLS entity provides the transport of the client and an ALS entity provides a service that meets the agency's fee schedule definition of an ALS intervention, the BLS provider may bill the agency the ALS rate for the transport, provided a written reimbursement agreement between the BLS and ALS entities exists. The provider must give the agency a copy of the agreement upon request. If a written agreement does not exist between the BLS and ALS entities, the agency will pay only for the BLS level of service. Only one ambulance provider may bill the agency for the transport.

(4) In ambulance service areas/jurisdictions that distinguish between residents and nonresidents, the provider must bill the agency the same rate for ambulance services provided to a client in a particular jurisdiction as would be billed for ambulance services to residents of the same jurisdiction.