Ambulance

The link to view the National A/B MAC Ambulance Coalition handout for the Thursday, May 22, 2025, session.

Learn about coverage, billing, and payment for ground and air ambulance transport benefits.

Medicare requires the signature of the beneficiary, or that of his or her representative, for both the purpose of accepting assignment and submitting a claim to Medicare.

This article outlines how and when to use the 'Physician Certification Statement' (PCS), which is the written order certifying the medical necessity of non-emergency ambulance transports.

CMS requirements for obtaining a physician certification statement (PCS) for nonemergency, scheduled, repetitive ambulance services are contained in the Code of Federal Regulations, section 410.40(e)(2).

Do you order or provide repetitive, scheduled non-emergent ambulance transports (RSNAT)?​​​​​​​If the answer is yes, take a look at the We’re All In This Together! flyer to learn about your part in ambulance prior authorization for these transports.

This article is a reminder regarding Medicare requirements for repetitive vs. non-repetitive transports, scheduled vs. unscheduled transports, examples of each and CMS requirements.

Medicare covers air ambulance transport only to the nearest hospital with appropriate facilities for treatment.

There are two categories of air ambulance services: fixed wing (airplane) and rotary wing (helicopter) aircraft.

Medicare covers medically appropriate air ambulance services only if furnished to a beneficiary whose medical condition is such that transportation by either basic or advanced life support ground ambulance is not appropriate.

Medicare provides for limited coverage for medical services furnished outside the United States.

In situations where the beneficiary dies, whether any payment under the Medicare ambulance benefit may be made depends on the time at which the beneficiary is pronounced dead by an individual authorized by the state to make such pronouncements.

This article provides guidance on how to submit modifiers for ambulance services — two trips on the same day of service.

An emergency service is one that is provided after the sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity.

Only one ambulance supplier can submit a claim for mutual aid services.

Do not file a claim for non-covered services or no-transport services unless the patient insists.

The Medicare ambulance benefit is a transportation benefit only. Without a transport, there is no payable service.

Any vehicle used as an ambulance must be designed and equipped to respond to medical emergencies and, in non-emergency situations, be capable of transporting beneficiaries with acute medical conditions.

Medicare Part B considers payment for ambulance services if the patient's transport is not payable under Part A.

Multiple patient transports must be submitted with HCPCS modifier GM on the appropriate ambulance base code and mileage code.

Ambulance providers are reminded to use the applicable origin and destination modifiers correctly when submitting their claims to Palmetto GBA.

Medicare covers ambulance transportation only when transportation by any other means would endanger the patient’s health.