Ambulance Prior Authorization


The Prior Authorization Demonstration for South Carolina began on December 1, 2014 and is expanding to North Carolina, Virginia and West Virginia on January 1, 2016. Ambulance suppliers that are not institutionally (hospital) based that provide Part B Medicare covered ambulance services and are enrolled as an independent ambulance suppliers will be participants. Prior authorization is a process through which a request for affirmation of coverage is submitted for review before a service is rendered to a beneficiary and before a claim is submitted for payment. Prior authorization helps ensure that applicable coverage, payment and coding rules are met before services are rendered.

View our Prior Authorization website for more information about the program.





Ambulance Prior Authorization Articles


Ambulance Suppliers of Repetitive Scheduled Non-Emergent TransportsAdministrative Relief in Response to the 2019-Novel Coronavirus (COVID-19) Pandemic: Pausing Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) Prior Authorization ModelAmbulance Prior Authorization RemindersUpdate: Prior Authorization of Repetitive, Scheduled Non-Emergent Ambulance TransportPrior Authorization of Repetitive Scheduled Non-Emergent Ambulance TransportsFrequently Asked Questions: Prior Authorization (PA) Repetitive Scheduled Non-Emergent Ambulance TransportsLetter for Patients with a Legal Representative for Repetitive Scheduled Non-Emergent Ambulance Transport Prior AuthorizationPhysician Compliance: Ambulance Prior Authorization DocumentationAmbulance Prior Authorization Request FormEnhanced eServices Ambulance Prior Authorization FormPhysician/Practitioner LetterBeneficiary Non-Affirmation Letter for Ambulance Prior AuthorizationAmbulance MileageAmbulance Prior Authorization eServices Form (HCPCS A0427, A0429) ModuleNon-Affirmed Code Crosswalk: Prior Authorization RequestAmbulance Prior Authorization Documentation Decision ToolJurisdiction M Part B Prior Authorization Extended Affirmation Teleconference Questions and Answers: August 14, 2019Important Lessons Learned About the Repetitive Scheduled Non-emergent Ambulance Prior Authorization ModelIf Your Medicare Patient Requires Scheduled Repetitive Non-Emergent Ambulance Transport, This Is Information You Need to KnowRelease of Beneficiary Information to Ambulance Providers of Repetitive Scheduled Non-Emergent TransportsWe're All In This Together Flyer - Wound Care Facilities (WCF)We're All In This Together Flyer - Dialysis FacilitiesAmbulance Fee Schedule and Medicare Transports CMS Booklet