Transport Destinations - JE Part B
Ambulance Transport Destinations
Medicare covers transports to the nearest appropriate facility to obtain necessary diagnostic and/or therapeutic services as well as the return transport. In addition to all other coverage requirements, this situation is covered only to the extent of the payment that would be made for bringing the service to the patient.
Access the below ambulance transport destination related information from this page.
- Both Origin and Destination are Ambulance Providers
- Transport Destinations for Air
- Transport Destinations for Ground
- Covered - Transports (that meet all other program requirements for coverage) may be covered when destination is an acute care hospital only.
- Non-covered - Transports to nursing facilities, Physicians' offices, Beneficiaries' homes are not covered destinations
- Covered - Transports (that meet all other program requirements for coverage) may be covered when destination is one of the below.
- Critical Access Hospital (CAH)
- Skilled Nursing Facility (SNF)
- Beneficiary's home/residence
- Dialysis facility for ESRD patient who requires dialysis (Medicare covers transports for patients with ESRD from their place of residence to a hospital or free standing dialysis facility.)
- Non-covered - Transports to a physician's office is not a covered destination. Under special circumstances, an ambulance transport may temporarily stop at a physician's office without affecting coverage status of transport.
Generally, local transportation by ambulance is covered only, and therefore, only mileage to the nearest appropriate facility equipped to treat the patient is covered.
If a freestanding Emergency Department (ED) is provider based, a transport from ED to hospital is reimburseable only if the beneficiary has not been admitted as an inpatient prior to the transport.
- CMS Internet Only Manual (IOM), Publication 100-02, Medicare Benefit Policy Manual, Chapter 10, Section 10.
Last Updated Fri, 09 Dec 2022 18:17:57 +0000