This BadgerCare Plus Update issues a correction to the November 2007 Update (2007-87), titled “Ambulance Services Under BadgerCare Plus,” which incorrectly stated that the Healthcare Common Procedure Coding System procedure code S0207 is covered under the BadgerCare Plus Benchmark Plan. Effective for dates of service on and after February 1, 2008, procedure code S0207 is considered noncovered under the Benchmark Plan and the BadgerCare Plus Standard Plan.
Ambulance Services Covered Under the BadgerCare Plus Benchmark Plan
The November 2007 Update (2007-87), titled “Ambulance Services Under BadgerCare Plus,” incorrectly lists Healthcare Common Procedure Coding System (HCPCS) procedure code S0207 (Paramedic intercept, non-hospital-based ALS service [non‑voluntary], non-transport) as a covered service under the BadgerCare Plus Benchmark Plan that requires a $50.00 copayment. For dates of service on and after February 1, 2008, procedure code S0207 is a noncovered service under the BadgerCare Plus Standard Plan and the Benchmark Plan.
Ambulance services covered under the Benchmark Plan are the same as those covered under the Standard Plan. Providers can refer to the most current maximum allowable fee schedule, located at dhfs.wisconsin.gov/medicaid4/maxfees/maxfee.htm, for a complete list of covered services.
Information Regarding BadgerCare Plus HMOs
BadgerCare Plus HMOs are required to provide at least the same benefits as those provided under fee-for-service arrangements. For managed care policy, contact the appropriate managed care organization.
