Medicare Benefit Policy Manual (Pub. 100-02), Ch. 10 § 10.4.5
Special Coverage Rule
10.4.5 - Special Coverage Rule
(Rev. 1, 10-01-03)
A3-3114.C.11.F, B3-2120.4.F
Air ambulance services are not covered for transport to a facility that is not an acute care
hospital, such as a nursing facility, physician’s office, or a beneficiary’s home.