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.
Providers vs Suppliers - View identifying differences
Vehicles - View vehicle equipment requirements and access staffing requirements for such vehicles
Resources
- CMS Ambulance Fee Schedule
- CMS IOM, Publication 100-04, Ch. 6 - Ambulance - Section 20.3.1
- CMS Medicare Learning Network (MLN) Matters (MM)7058 - Ambulance Service Definitions
- CMS MM7161 - Air Ambulance Services
- Sections 1861(e)(1) or 1861(j)(1) of the Social Security Act
Last Updated Aug 29, 2019
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The below are topic specific articles which have been published to "Latest Updates" and sent out in Noridian emails within the past two years. Exclusions to this include time sensitive related announcements such as: Noridian and CMS educational events, Ask-the-Contractor Teleconferences and claims processing downtime.