Resources on Medicare Ambulance Coverage

A. The Statute

• SEC. 1861. [42 U.S.C. 1395x]
              The relevant text of the statute is posted here.
  
  
  B. The Regulation

1. Coverage 42 C.F.R. § 414.40
   
   
2. Fee schedule 42 C.F.R. § 414.601 et. seq.
   
   
3. Definitions 42 C.F.R. § 414.605
   

C. Medicare Carriers Manual (Pub. 14-3) Click here

• The relevant text is posted here.

D. Centers for Medicare and Medicaid Services

1. New Medicare Modernization Act Provisions Boost Payments for Ambulance Services
   Medicare: Today's Issue (June 30, 2004)
   
   
2. Medicare Coverage of Ambulance Services
   Pub 11201, Revised February 1, 2004
   
   
3. Ambulance Coverage Resource for Medicare
   A CMS resource page of ambulance coverage.
   
   
4. Medicare Learning Network (Medlearn)
   Ambulance Services- Quick Reference Guide 

E. Advocacy/Educational Organization Material:

1. Center for Medicare Education
   Issue Brief, Volume 2, Number 6, 2001
   "Medicare Ambulance Services"
   
   
2. Center for Medicare Advocacy:
   FAQ on Ambulance Coverage
   "New Medicare Rules for Ambulance Services" April 2002
   
   
3. Medicare Rights Center
   Summaries of Cases on Ambulance Coverage
   Q & A on Ambulance Coverage

General Information

Medical Necessity Determinations in the Medicare Program:  Are the Interests of Beneficiaries With Chronic Conditions Being Met? Partnership for Solutions: Better Lives for People with Chronic Conditions

A project of the Johns Hopkins University and the Robert Wood Johnson Foundation, January 2003