Medicare Policy Concerning Bed-Confinement

10.2.3 - Medicare Policy Concerning Bed-Confinement (Rev. 1, 10-01-03) As stated above, medical necessity is established when the patient’s condition is such that the use of any other method of transportation is contraindicated. A/B MACs (A) and (B) may presume this requirement is met under certain circumstances, including when the beneficiary was bed-confined before and after the ambulance trip (see §20 for the complete list of circumstances). A beneficiary is bed-confined if he/she is: • Unable to get up from bed without assistance; • Unable to ambulate; and • Unable to sit in a chair or wheelchair. The term "bed confined" is not synonymous with "bed rest" or "nonambulatory". Bed- confinement, by itself, is neither sufficient nor is it necessary to determine the coverage for Medicare ambulance benefits. It is simply one element of the beneficiary's condition that may be taken into account in the A/B MAC (A)’s or (B)’s determination of whether means of transport other than an ambulance were contraindicated.