Monday, November 15, 2010

ambulance billing - Ground to air - payment limitations

Billing for Ground to Air Ambulance Transports

For situations in which a beneficiary is transported by ground ambulance to or from an air ambulance, the ground and air ambulance suppliers providing the transports must bill Medicare independently. Under these circumstances, Medicare pays each supplier individually for its respective services and mileage.

Special Payment Limitations

If a determination is made that transport by ambulance was necessary, but ground ambulance service would have sufficed, payment for the air ambulance service is based on the amount payable for ground transportation.

If the air transport was medically appropriate (that is, ground transportation was contraindicated, and the beneficiary required air transport to a hospital), but the beneficiary could have been treated at a nearer hospital than the one to which they were transported, the air transport payment is limited to the rate for the distance from the point of pickup to that nearer hospital.

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