Coverage Requirements
Air ambulance transportation services, either by means of a helicopter or fixed wing aircraft, may be determined to be covered only if:
• The vehicle and crew requirements are met;
• The beneficiary’s medical condition required immediate and rapid ambulance transportation that could not have been provided by ground ambulance; and either
o The point of pick-up is inaccessible by ground vehicle, or
o Great distances or other obstacles (for example, heavy traffic) are involved in getting the patient to the nearest hospital with appropriate facilities.
As a general guideline, when it would take a ground ambulance 30-60 minutes or more to transport a beneficiary whose medical condition at the time of pick-up required immediate and rapid transport due to the nature and/or severity of the beneficiary’s illness/injury, carriers should consider air transportation to be appropriate.
Medicare Ambulance billing. Ambulance billing codes, Air ambulance billing guide and reimbursement. How and what code to use for correct payment.
Tuesday, November 2, 2010
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