Ambulance - JE Part B
Ambulance Zip Code Definition Lookup
Enter the five-digit zip code being billed to determine if it is urban, rural or super rural:
To learn more about these definitions, refer to the CMS Medicare Claims Processing Manual, Publication 100-04, Chapter 15 .
Ambulance
Medicare ambulance services are typically a Part B covered benefit; however, in some situations, it may be covered by Part A. An ambulance transport benefit is a transport provided by an ambulance to beneficiary by land, water or air.
Access the below ambulance related information from this page.
Billing - Access details on claim form completion, fees, mileage requirements, appropriate modifiers, beneficiary death, transports and refusal, and services provided outside the United States
Coverage - Access coverage information on transport levels of service, aborted flights, bed-confinement, destinations, and documentation requirements
Destinations: Covered/Noncovered - View transport destination coverage requirements
Enrollment - Learn how to enroll and supporting documentation needed.
Medicare Ground Ambulance Data Collection System - Effective January 1, 2020 and continuing through 2024, ground ambulance providers and suppliers that have been selected to participate in the Medicare Ground Ambulance Data Collection System must collect information on cost, utilization, revenue, and other service characteristics in accordance with the Medicare Ground Ambulance Data Collection Instrument for a continuous 12-month period.
Prior Authorization for Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) Services - View Ambulance services that require prior authorization, the authorization process, how to submit a prior authorization request, the documentation requirements and coverage for the 2 services: A0426 - Ambulance service, advanced life support, nonemergency transport, level 1 (ALS 1); and A0428 - Ambulance service, basic life support, nonemergency transport (BLS).
Providers vs Suppliers - View identifying differences
Vehicles - View vehicle equipment requirements and access staffing requirements for such vehicles
Resources
- CMS Ambulance Fee Schedule
- CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 6, Section 20.3.1
- CMS Change Request (CR) 7058 - Ambulance Service Definitions
- CMS CR 7161 - Air Ambulance Services
- Sections 1861(e)(1) or 1861(j)(1) of the Social Security Act
