Is Paramedic Intercept A Covered Service?

Published 01/18/2018

Paramedic intercept is advanced life support (ALS) services provided by a paramedic, or other similar entity, to a beneficiary being transported by another separate ambulance service. In this situation, the ambulance transport crew requests the ALS services from an independent, outside source; the additional paramedic, who meets the ambulance, provides the needed services such as CPR, EKG monitoring or IV skills.

Medicare will pay for the paramedic intercept only if all three of the following criteria are met:

  1. The ambulance transport, the BLS entity, is furnished in a rural area and so designated a rural area by state law(s) or regulation
  2. The ambulance entity must be a volunteer ambulance service only able to furnish a BLS level of service
  3. Be prohibited by state law from billing third party payers for any service

Additionally, the paramedic providing the ALS services must meet all state and local certification standards, and bill all recipients receiving ALS paramedic services regardless whether or not those recipients are Medicare beneficiaries.

In those situations where both the ambulance service and the ALS submit claims to Medicare, Medicare can only consider the ambulance transport because Medicare only covers the transport of the patient. In these situations, any claims submitted to Medicare by the additional paramedic will be denied as non-covered; you will be responsible for paying for that additional service.

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