— This is provided for non-emergency and inter-facility transports that are considered medically necessary and non-emergent. This includes trips to and from a variety of treatment centers (i.e., dialysis, cancer treatment, physical therapy, and/or outpatient clinics).
There is now a national definition of the term "bed-confined". Please note that is not synonymous with "bed rest" or "non-ambulatory". In addition, "bed confined" status is not the only criteria to be used in determining if the patient must be transported by ambulance. It is one factor to be considered when making coverage determinations.
"BED-CONFINED" is defined as:
The term "EMERGENCY" relates to "services provided after the sudden onset of a medical condition manifesting itself by acute symptoms of such severity (including severe pain) that the absence of immediate medical attention could reasonably be expected to result" in any of the following:
Any ambulance transport that meets the following criteria is considered non-emergent and will require the use of a Physician's Certification Statement (PCS), or more commonly known as a Certificate of Medical Necessity (CMN), at the time of transport:
For scheduled and unscheduled non-emergency ambulance transports, Medicare requires ambulance suppliers to obtain a physician's written order certifying the need for an ambulance prior to the transport. This form is commonly known as a PCS or CMN. These forms can be provided to you at no charge. Simply contact our office @ 678-827-2367, and advise us where we should make the delivery. The form must contain the following information:
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