Ambulances: CMS Flexibilities to Fight COVID-19

The Trump Administration is issuing an unprecedented array of temporary regulatory waivers and new rules to equip the American healthcare system with maximum flexibility to respond to the 2019 Novel Coronavirus (COVID-19) pandemic. Made possible by President Trump’s recent Ambulance emergency declaration and emergency rulemaking, these temporary changes will apply immediately across the entire U.S. […]

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Medicare Coverage for DSMT Benefit

The Centers for Medicare & Medicaid Services (CMS) provides reimbursement for Medicare beneficiaries for diabetes self-management training (DSMT), under certain conditions. Becoming familiar with the Medicare DSMT reimbursement guidelines can help increase a DSMES service’s financial sustainability. Medicare Part B (medical insurance for outpatient care, preventive services, Ambulance Billing Services, and durable medical equipment) covers […]

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New Payment Model for Ambulance Services: ET3

The Department of Health and Human Services had launched a new payment model for ambulance services that federal officials believe could lower out-of-pocket costs for Medicare fee-for-service beneficiaries. The Emergency Triage, Treat, and Transport Model—ET3—allows ambulance companies to deliver on-the-scene or telehealth services to Medicare FFS patients, and transport them to alternative care venues, such […]

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Ground Ambulance Transports Coverage Requirements

All of these coverage requirements apply to ground ambulance transports: The Transport Is Medically Reasonable and Necessary A medically reasonable and necessary ground ambulance transport must meet these requirements: Medical necessity is established when the patient’s condition is such that the use of any other method of transportation is contraindicated. In any case in which […]

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Ambulatory Blood Pressure Monitoring (ABPM) Coverage Expanded by CMS

Centers for Medicare & Medicaid Services (CMS) finalized its national coverage policy for Ambulatory Blood Pressure Monitoring (ABPM) on 02nd July 2019.  ABPM is a non-invasive diagnostic test that uses a device to track blood pressure over 24-hour cycles, allowing a doctor to assess a patient’s blood pressure during routine daily living, instead of when […]

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Top 5 Compliance Issues for Ambulance Biller

Ambulance service billing involves a host of unique compliance challenges. The ambulance industry has seen a significant number of false claim cases, fraud investigations, Medicare audit activity, and other types of billing-related cases. It is imperative that billers fully understand the nuances of ambulance reimbursement to be able to successfully sidestep these landmines. The following […]

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Air ambulance balance billing is banned in Florida

Ambulance billing has been under the flak of both insurance companies and patients due to the high overhead cost for transportation. Many US states through a patient survey after an accident or under medical emergency think before calling an ambulance service.  Either the patient prefers a taxi or other people help to drive in the […]

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What Makes Ambulance Transportation Facility Limit to Provide Care?

An ambulance can be termed as “Intensive Care Unit” offering immediate medical care to the ailing patient till he/she reaches the hospital. Ambulance transportation plays a crucial role however, as per Medicare Part B – Medical insurance only covers emergency and non-emergency ambulance transportation but it’s important to understand the exceptions and the costs. While […]

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