MA pbp section b10 amb trans

What it is

1. 1CMS Medicare Advantage Plan Benefit Package PBP Section B-10: ambulance B-10a emergency Medicare-covered and transportation B-10b supplemental non-emergency benefit design and member cost-sharing for every MA plan as filed with CMS.
2. 2A member out-of-pocket reference of copays, coinsurance percent, deductibles, MOOP, trip limits, and prior-auth or referral rules.
3. 3The cost it carries is what the enrollee pays, not provider payment rates.

Grain

How to read it

1. 1For the latest filed ambulance and transportation cost-sharing for 2026 plans, filter report_year to 2026 and pick the max quarter per plan, then read pbp_b10a_copay_gas_amt_min for ground ambulance copay, pbp_b10a_coins_aas_pct_min for air ambulance coinsurance percent, pbp_b10b_bendesc_yn for whether a supplemental transportation benefit is offered, and pbp_b10b_bendesc_amt_pal for trips per year.

Traps

1. 1Grain is 5 columns not the profiler 14. The profiler superset padded the real key with constant attribute pbp_a_plan_type, benefit data columns pbp_b10b_maxplan and pbp_b_10b_maxplan_yesno, redundant bid_id, and year-derived effective_period_start and observed_period. Group only by the 5 real keys.
2. 2No is_current or snapshot flag, and multiple quarterly snapshots exist per plan-year: 38598 plan-years span 2 to 4 quarters while 75577 are single-quarter. report_year alone is not unique per plan since contract plan segment report_year gives 114175 not 201488. Dedup to max quarter for one current row per plan-year.
3. 3bid_id is a derived redundant key equal to contract plan segment and is NULL for 8316 rows in years 2001 to 2006. Do not use it as grain or full-history join key, use the three id columns. For non-null rows bid_id report_year quarter is unique but silently drops the early years.
4. 4All yes-no fields use CMS codes 1 Yes and 2 No, not booleans, and NULL means not-applicable or not-collected. Proven copay_yn 1 always has a copay amount and copay_yn 2 never does. Treat NULL as unknown not zero.
5. 5pbp_b10a is ambulance emergency Medicare-covered with gas ground aas air mc generic, pbp_b10b is supplemental non-emergency transportation. Two different benefits in one table, do not conflate them, and this is member cost-sharing not provider reimbursement.
6. 6asserted_at is the Vlada load date and observed_period and effective_period_start are just Jan 1 of report_year, none are a snapshot selector. cms_vintage_sequence usually equals quarter but not always, so use quarter. Sibling table pbp_b10_b19b_amb_trans_vbid_uf holds the VBID variant of this benefit, keep distinct.

Columns (118)

Query it

describe_data_source(source_fqn="medicare_silver.pbp_section_b10_amb_trans")     # the card, live
query_substrate(sql="SELECT * FROM medicare_silver.pbp_section_b10_amb_trans WHERE contract_id = '<value>' AND plan_id = '<value>' AND segment_id = '<value>' AND report_year = '<value>' AND quarter = '<value>' LIMIT 100")