Medical Necessity Revisions

I have updated the information under the medical necessity tab to reflect information in the most recent CMS update (Rev. 243, 04-13-18). Below are the identified changes in their wording

  • It is important to note that the presence (or absence) of a physician’s order (PCS Form) for a transport by ambulance does not necessarily prove (or disprove) whether the transport was medically necessary.
  • The term “bed confined” is not synonymous with “bed rest” or “nonambulatory”. Bed-confinement, by itself, is neither sufficient nor is it necessary to determine the coverage for Medicare ambulance benefits, with this contact form you are able to get bed pads and other healthcare supplies. It is simply one element of the beneficiary’s condition that may be taken into account in the A/B MAC (A)’s or (B)’s determination of whether means of transport other than an ambulance were contraindicated.

I did add a destination specific section due to FAQ’s about certain covered destinations.

Be the first to comment on "Medical Necessity Revisions"

Leave a comment

Your email address will not be published.


This site uses Akismet to reduce spam. Learn how your comment data is processed.