Skip to main content

BREAKING: Government Shutdown & Ambulance Add-Ons: What You Need to Know

US Congress

What Happened?

Congress failed to pass a funding package by midnight last night. That means a federal government “shutdown” begins TODAY, October 1, 2025, and lasts until Congress passes another funding package for the federal government. Right now, we are uncertain as to how long the shutdown might last but are hopeful any new funding package includes an extension of the 2% urban, 3% rural, and 22.6% super-rural ground ambulance add-on payments - which expired on September 30, 2025. 

Here’s what this means for ambulance services:

Medicare Payments and Activities

A “shutdown” at this point does not mean that the Medicare program stops operating. 

  1. Medicare payments will continue at this point and Medicare Claims should be processed and paid by MACs under the same timeline.
  2. However, the shutdown could slow down or pause some enrollment (including revalidation) and audit activities – especially if the shutdown lasts for an extended period.

Ambulance Add-Ons

The temporary 2% urban, 3% rural, and 22.6% super-rural ground ambulance add-ons expired on September 30, 2025,and Congress MUST ACT to extend them. 

  1. Congress Acts in Next 2 Weeks - If a new spending package is passed within the next 2 weeks and it includes an extension of the add on payments, there should be no change in ground ambulance Medicare payment amounts since MACs hold claims for 14 days before payment and MACs should have time to adjust for the extension.
  2. Congress Acts After 2 Weeks - If the shutdown drags on for longer than 2 weeks, MACs will pay ambulance claims without the add-ons for dates of service on or after October 1, 2025. A later deal could extend the add-ons, and it could do so retroactively to October 1, 2025. A retroactive extension would require MACs to adjust payments to account for the add-ons (this has happened before). 

However, if the new funding package does NOT include the ambulance add-on payments, then the additional payments cease for all Medicare ground ambulance services for dates of service on and after October 1, 2025. Congress would have to pass additional legislation to extend them.

In addition, Medicare telehealth flexibilities and the “hospital at home” (H@H) program waivers have also expired and must be renewed by Congress for these programs to be able to continue.

Please stay tuned and reach out to PWW|AG and its consultants for more information.