Ambulance - JE Part B
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 ambulance related information below from this page.
Ambulance CERT Findings - Explore common CERT findings for ambulance services, including documentation deficiencies, medical necessity requirements, missing Physician Certification Statements (PCS), Assignment of Benefits (AOB) issues, and signature-related errors that may result in claim denials
Ambulance Personnel - Explore Medicare staffing requirements for BLS and ALS ambulances, including EMT qualification standards, crew staffing requirements, and compliance with state and local regulations. Learn how staffing requirements are verified during Medicare enrollment and revalidation inspections, and how noncompliance may result in denied enrollment applications or termination of billing privileges
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 what supporting documentation is needed
Medicare Ground Ambulance Data Collection System - From 2020 through 2024, selected ground ambulance providers and suppliers participated in the Medicare Ground Ambulance Data Collection System (GADCS). Participants collected information on costs, utilization, revenue, and other service characteristics using the Medicare Ground Ambulance Data Collection Instrument during a continuous 12-month reporting 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
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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 .
