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.

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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.