Medical Reasonableness

10.4.2 - Medical Reasonableness (Rev. 103; Issued: 02-20-09; Effective Date: 01-05-09; Implementation Date: 03- 20-09) Medical reasonableness is only established when the beneficiary’s condition is such that the time needed to transport a beneficiary by ground, or the instability of transportation by ground, poses a threat to the beneficiary’s survival or seriously endangers the beneficiary’s health. Following is an advisory list of examples of cases for which air ambulance could be justified. The list is not inclusive of all situations that justify air transportation, nor is it intended to justify air transportation in all locales in the circumstances listed. • Intracranial bleeding - requiring neurosurgical intervention; • Cardiogenic shock; • Burns requiring treatment in a burn center; • Conditions requiring treatment in a Hyperbaric Oxygen Unit; • Multiple severe injuries; or • Life-threatening trauma.