Ambulance Prior Authorization

Published 01/12/2016

The Prior Authorization Demonstration for South Carolina began on December 1, 2014 and is expanding to North Carolina, Virginia and West Virginia on January 1, 2016. Ambulance suppliers that are not institutionally (hospital) based that provide Part B Medicare covered ambulance services and are enrolled as an independent ambulance suppliers will be participants. Prior authorization is a process through which a request for affirmation of coverage is submitted for review before a service is rendered to a beneficiary and before a claim is submitted for payment. Prior authorization helps ensure that applicable coverage, payment and coding rules are met before services are rendered.

View our Prior Authorization website for more information about the program.