Changes in the fee structure were proposed by department officials last month because of a pending change in the way Medicare pays for ambulance services.

“Since Medicare patients comprise about 48 percent of our patient transports, we are structuring our rates around Medicare’s new fee schedule system,” Maj. Eric Hunter, Winchester Fire/EMS, said.

The changes were approved by the city and will go before the Clark County Fiscal Court for approval. An agreement between the city and county for county ambulance service stipulates the fees must be approved by both bodies.

Previously, the categories for ambulance care were divided into two categories, Basic Life Support (BLS) and Advanced Life Support (ALS). Under the new Medicare system, they allow for six categories — BLS, BLS emergency, ALS-1, ALS-1 emergency, ALS-2 and special care transport. The distinction between the categories is the level of care needed, Hunter explained.

Fees under the new schedule are $160 for BLS (down from $175), $260 for BLS Emergency, $195 for ALS-1 (down from $275), $305 for ALS-1 emergency, $440 for ALS-2, and $520 for special care transport.

The special care transport is for a patient being transferred who requires additional care, such as a ventilator.

The department also will charge $5.50 per loaded mile, whereas the previous charge was $3.50 per loaded mile outside the county. A loaded mile is every mile that a patient is transported to a medical facility.

Hunter told the commission the changes would help the department recover some of the expenses it had to write off because Medicare would not cover them.