Avoid Common Errors in Ambulance Transportation Billing


An ambulance is a part of Emergency Medical Services (EMS), which is a billable event and most of the insurance companies such as Medicaid and Medicare compensate for it. Billing and coding for ambulance services may be complex owing to different modes of transportation like air, water, and ground. Apart from this, reimbursement of ambulance […]

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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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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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