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Annual Service Revenue Report Due April 15, 2018

All Tennessee ground ambulance providers must submit an annual revenue report to TennCare by April 15, 2018. This report is required by TennCare and the Comptroller’s office to comply with CMS rules for the Ground Ambulance Assessment Act (Enhanced Medicaid Reimbursement Program). Within the spreadsheet are instructions on the first tab and data entry fields on the second tab. You MUST type your name in the “signature” line and enter the date before submitting the whole spreadsheet as an attachment to TennCare at

Download the notice from TennCare regarding this report HERE

Download the revenue report spreadsheet HERE