Medicare Air ambulance coverage requirements

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.