Transport Destinations - JE Part B
Ambulance Transport Destinations
Medicare covers ambulance transport to the nearest appropriate facility capable of providing the medically necessary diagnostic and/or therapeutic services required by the beneficiary. When all coverage requirements are met, Medicare may also cover the return transport. Coverage is generally limited to the amount that would have been paid to bring the necessary service to the beneficiary at the nearest appropriate facility.
Access the below ambulance transport destination related information from this page.
- Both Origin and Destination are Ambulance Providers
- Resources
- Air Ambulance Transport Destinations
- Ground Ambulance Transport Destinations
Air Ambulance Transport Destinations
Air ambulance transportation may be covered when all Medicare coverage requirements are met, and the patient is transported to an acute care hospital. Air ambulance transports to destinations that are not recognized as covered destinations are not covered by Medicare.
Examples of noncovered air ambulance destinations include:
- Nursing facilities
- Physician offices
- Beneficiary residences or homes
Ground Ambulance Transport Destinations
Ground ambulance transportation may be covered when all Medicare coverage requirements are met, and the patient is transported to an approved destination. Covered destinations include:
- Hospital
- Critical Access Hospital (CAH)
- Skilled Nursing Facility (SNF)
- Beneficiary's residence
- Dialysis facility for a beneficiary with End-Stage Renal Disease (ESRD) who requires dialysis treatment
For beneficiaries with ESRD, Medicare may cover transportation from the beneficiary's residence to a hospital-based or freestanding dialysis facility when all coverage requirements are met.
Transportation to a physician's office is generally not a covered ambulance destination. However, under limited circumstances, a transport may temporarily stop at a physician's office without affecting the coverage status of the overall transport.
Nearest Appropriate Facility Requirement
Medicare generally covers only the ambulance transport and mileage necessary to reach the nearest appropriate facility capable of treating the beneficiary's condition. If a more distant facility is chosen when a closer appropriate facility is available, Medicare payment may be limited.
Freestanding Emergency Departments
When a freestanding emergency department is provider-based, transport from the emergency department to the hospital may be reimbursable only when the beneficiary has not been admitted as an inpatient before the transport occurs.
