03/14/2026
CMS Improper Payment Data Sends a Clear Message to EMS: Documentation Presents Greater Risk Than Coding - https://ow.ly/oxex50Yta0M
The Centers for Medicare and Medicaid Services (CMS) recently released updated findings from the 2024 Medicare Fee-for-Service Supplemental Improper Payment Data Report.
The improper payment rate for ambulance services in 2024 was 13.2 percent, representing approximately $595 million in payments that CMS determined were improper.
The primary driver of improper payments is not coding mistakes or billing errors. Instead, the overwhelming majority stem from insufficient documentation.
Financial stability and compliance are closely tied to documentation practices in the field. Improving documentation quality requires attention from both clinical leadership and administrative teams.
One of the most effective steps organizations can take is strengthening documentation education for clinicians. Field providers should understand not only what they did during the call but also how to describe why ambulance transport was necessary. Narratives should clearly explain the patient’s condition, the risks associated with other forms of transportation, and the clinical reasoning behind treatment and transport decisions.
This does not mean writing a novel for every patient care report. But it does mean telling the clinical story clearly enough that someone reading the report months or years later, who was not on the call, can understand why the ambulance was necessary, as well as the individual clinical interventions provided.
