Land Ambulance: Vehicle and Staffing

Vehicle Requirements
Any vehicle used as an ambulance must be designed and equipped to respond to medical emergencies; in non-emergency situations, it must be capable of transporting beneficiaries with acute medical conditions.

• The vehicle must comply with state or local laws governing the licensing and certification of an emergency medical transportation vehicle
• At a minimum, the ambulance must have customary patient care equipment and first aid supplies and must contain a stretcher, linens, emergency medical supplies, oxygen equipment and other lifesaving emergency medical equipment, and be equipped with emergency warning lights, sirens and telecommunications equipment as required by state or local law. This should include, at a minimum, one two-way voice radio or wireless telephone. Equipment and supplies may also include backboards, neckboards, and inflatable leg and arm splints. These supplies, equipment and devices are all considered part of the general ambulance service and payment for them is included in the payment rate for the transport.

Staffing Requirements

• Basic life support (BLS) ambulances must be staffed by at least two people, at least one of whom must be certified as an emergency medical technician (EMT) by the state or local authority where the services are being furnished and be legally authorized to operate all lifesaving and life-sustaining equipment on board the vehicle
• Advanced life support (ALS) vehicles must be staffed by at least two people, at least one of whom must be certified by the state or local authority as an EMT-Intermediate or an EMT-Paramedic

Documentation of Compliance with CMS Vehicle and Staffing Requirements May Include:

• A description of the first aid, safety and other patient care items with which the vehicles are equipped
• Documentation of the extent of first aid training acquired by the personnel assigned to those vehicles
• The supplier’s agreement to notify the carrier of any change in operation which could affect the coverage of ambulance services
• Evidence that the ambulance has the equipment required by state and local authorities. Documentary evidence could include a letter from such authorities, a copy of a license, permit, certificate, etc., issued by the authorities

References

• Beneficiary Notice 
• CMS Ambulance Services Center
• Medicare Benefit Policy Manual, Chapter 10, Ambulance (PDF) 
• Medicare Claims Processing Manual, Chapter 15, Ambulance (PDF)
• Code of Federal Regulations
  • §410.40 Coverage of Ambulance Services
  • §410.41 Requirements