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Advising the Congress on Medicare issues
MedPAC > Recommendations > Medicare payment for ambulance services (2)

Medicare payment for ambulance services (2)

June 14, 2013

The Congress should direct the Secretary to:

  • promulgate national guidelines to more precisely define medical necessity requirements for both emergency and nonemergency (recurring and nonrecurring) ground ambulance transport services;
  • develop a set of national edits based on those guidelines to be used by all claims processors; and
  • identify geographic areas and/or ambulance suppliers and providers that display aberrant patterns of use, and use statutory authority to address clinically inappropriate use of basic life support nonemergency ground ambulance transports.

Topics: Ambulatory care settings.