Understanding whether an organization is enrolled as an ambulance provider or ambulance supplier helps determine how transportation services are billed and reimbursed under Medicare.

Ambulance Providers

Ambulance providers are organizations that own and operate ambulance transportation services as part of their institutional healthcare operations. Examples include hospitals, Critical Access Hospitals (CAHs), Skilled Nursing Facilities (SNFs), Comprehensive Outpatient Rehabilitation Facilities (CORFs), Home Health Agencies (HHAs), and hospice programs.

Although ambulance transportation is generally a Medicare Part B benefit, beneficiary transportation between providers is often included under Medicare Part A when the beneficiary is an inpatient of a hospital, CAH, or SNF.

Transportation Included Under SNF Part A

Include ambulance transportation as part of the SNF stay when all the following requirements are met:

• The beneficiary is a resident of the SNF.
• The transportation is necessary to obtain a covered SNF service.
• The associated service is reimbursed under Medicare Part A.

If the service received is excluded from SNF Part A coverage, the ambulance transportation may be separately payable under Medicare Part B.

Ambulance Suppliers

Ambulance suppliers are independent entities that are not owned or operated by a healthcare institution and are enrolled in Medicare as ambulance suppliers.

Examples include:

• Volunteer fire department and ambulance companies
• Local government ambulance services
• Privately owned ambulance companies
• Independently owned and operated ambulance companies