Depending on your circumstances, Medicare may cover scheduled/regular non-emergency ambulance transportation if the ambulance supplier receives a written order from your doctor in advance stating that transport is medically necessary. The order must be dated no earlier than 60 days before the trip.
For unscheduled/irregular non-emergency trips, your doctor must provide a written order no later than 48 hours after the trip.
Keep in mind that Medicare does not require a doctor’s written order for coverage of emergency ambulance transportation.
Prior authorization in certain states
In certain states, ambulance suppliers must receive prior authorization from Medicare before providing scheduled, non-emergency ambulance transportation. These states include:
- Delaware
- District of Columbia
- Maryland
- New Jersey
- North Carolina
- Pennsylvania
- South Carolina
- Virginia
- West Virginia
If the prior authorization request is approved, Medicare should cover your ambulance trips so long as the ambulance supplier also receives a written order from your doctor stating that transport is medically necessary. If Medicare denies your request, the ambulance supplier or you should submit a new prior authorization request. You have the right to appeal denials. Keep in mind that if you choose to receive services after a denial, you may be responsible for the full cost of your ambulance transportation.