Ambulance

Ambulance services are emergency services which treat illnesses and injuries that require an urgent medical response, providing out-of-hospital treatment and transport to definitive care. All information found in. All information can be found in CMS Internet Only Manual (IOM), Publication 100-08, Chapter 15, Section 15.4.2.5

Transports: Levels of Service

Ambulance payment is based on the level of service furnished (if medically necessary), not simply on the vehicle used. View the Ambulance Transports: Levels of Service webpage for details. 

Vehicles and Vehicle Personnel

Any vehicle used as an ambulance must be designed and equipped to respond to medical emergencies and, in nonemergency situations, be capable of transporting beneficiaries with acute medical conditions. The vehicle (air or ground) must comply with State or local laws governing the licensing and certification of an emergency medical transportation vehicle. View the Ambulance Vehicles webpage for details.

In addition to vehicle requirements, there are personnel requirements as well. See the Ambulance Personnel webpage for details.

Effective Dates

Medicare can go back 30 days from when the application is submitted, or all signatures are received in PECOS.

An application can be submitted 60 days in advance of when the enrollment will be active.

Application Completion

  • If completing application via PECOS, ensure application questionnaire is answered correctly. CMS-855B, CMS-588 (Electronic Funds Transfer (EFT)) application will populate.
  • If completing application via paper, the following must be submitted:
  • A voided check or signed bank letter is necessary documentation for EFT portion of application
  • Must include legal business name (LBN) of the enrollment, routing and account number and practice address
  • Submit application fee
    • Fee is required for application. Can be paid on PECOS website
    • Select pay application fee on right-hand side under Helpful Links

Attachment 1

  • If submitting the application via CMS-855B, complete Attachment 1 in its entirety
  • This will automatically populate when completing an application via PECOS

Supporting Documents

  • IRS document when:
    • Initial enrollment
    • A change of legal business name
  • A voided check or signed bank letter is necessary documentation for EFT portion of application
  • Copies of all licenses and registrations must be submitted for each vehicle

Resources

 

Last Updated Wed, 26 May 2021 19:11:05 +0000