This is a reminder that
Medicare pays for limited ambulance transport services for Medicare Advantage
HMO members receiving custodial and skilled nursing care.
For members in custodial care
Ambulance transport services are not a covered benefit for Medicare Advantage HMO
members in custodial care when they are being transported to a provider?s
office.
For members receiving skilled
nursing care
If a Medicare Advantage HMO member who
is receiving covered inpatient skilled nursing care is being transported to a
provider?s office, ambulance transport services are covered only if
transportation in any other vehicle could endanger the member?s health.
Please refer to Claim Payment Policy #12.04.02b:
Nonemergency Ambulance Transport Services on our Medical Policy website for
further information on Medicare requirements for ambulance transport
services.