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Issue Number - Name
0054 - Ambulance Billed During Inpatient Stay
Review Type
Automated
Claim Type
Ambulance Providers
Region and State
RAC 1-4
All States
Date Approved
2017-05-19

Description

Ambulance services during an inpatient stay are included in the facility’s PPS payment and are not separately payable under Part B, excluding the date of admission, date of discharge and any leave of absence days. Ambulance providers are expected to seek reimbursement from the inpatient facility.

Affected Code(s)

  • HCPCS codes A0021-A0999

Applicable Policy References

  • Title XVIII of the Social Security Act, Section 1833(e)
  • Title XVIII of the Social Security Act, Section 1862(a)(1)(A)
  • CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 3, Section 10.5
  • CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 15, Section 30.1.4