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Prior Authorization Process for Repetitive Scheduled Nonemergent Ambulance Transport

The Repetitive, Scheduled Nonemergent Ambulance Transport Prior Authorization Model establishes a process through which a request for provisional affirmation of coverage is submitted for review before the service is rendered to a Medicare beneficiary and before the claim is submitted for payment. Prior authorization helps to ensure applicable coverage, payment and coding rules are met before the transportation service is furnished.

Independent ambulance suppliers that are not institutionally based, providing Part B covered ambulance services under the National Government Services Medicare Contractor are included in this model. Here is the timeline for each NGS Part B Jurisdiction and some helpful resources for your review. 

Jurisdiction 6 (Illinois, Minnesota and Wisconsin)

  • Began submitting requests on 3/18/2022 for transportation services on or after 4/1/2022. 

Jurisdiction K (Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island and Vermont)

  • Will begin submitting requests on 5/18/2022 for transportation services on or after 6/1/2022. 

Learn more about this new model at Prior Authorization of Repetitive Scheduled Nonemergent Ambulance Transport and visit our Events page to register for an upcoming webinar so you can lean how this model can benefit your ambulance company. 

​​​​​​​Posted 4/11/2022