Ambulance Services

20.1 – Ambulance Services (Rev. 121, Issued: 04-22-16, Effective: 04-22-16, Implementation: 04-22-16) MAOs are financially responsible for ambulance services, including ambulance services dispatched through 911 or its local equivalent, when either an emergency situation exists as defined in section 20.2 below or other means of transportation would endanger the beneficiary’s health. The enrollee is financially responsible for plan-allowed cost-sharing. Medicare rules on coverage for ambulance services are set forth at 42 CFR 410.40. For original Medicare coverage rules for ambulance services, refer to chapter 10 of the Medicare Benefit Policy Manual, publication 100-02, located at http://www.cms.hhs.gov/manuals/Downloads/bp102c10.pdf.