105 CMR 170.200
Licensure of Ambulance and EFR Services
(A) No person shall establish, operate or maintain an ambulance or EFR service without a valid
license or in violation of the terms of a valid license. All services shall be licensed as provided
in 105 CMR 170.000. Any person who proposes to establish or operate a service shall apply for
and obtain from the Department a license before initiating service.
(B) Ambulance services may be licensed at the BLS, ALS, or critical care service level, and
EFR services may be licensed at the EMS first response, BLS or ALS level. Licensure as an
ambulance service at a particular level of service includes licensure to provide ambulance or EFR
service at the same or lower level of service.
(C) Ambulance and EFR service licenses shall identify and reflect the number of EMS vehicles
to be operated, the classification of each certified EMS vehicle to be operated and maintained,
and the level of service at each place of business. No service shall operate at a level of service
above that for which it is licensed.
(D) To be eligible for licensure at the critical care services level, the applicant must document
the following:
(1) Current licensure from the Department as an ambulance service at the ALS-Paramedic
level;
(2) Current written affiliation agreement between a hospital and the applicant, meeting the
requirements of 105 CMR 170.300, under which the hospital shall provide oversight of the
delivery of critical care services and designate a medical director to have authority over the
clinical and patient care aspects of critical care services; and
(3) Current accreditation, in good standing, from the CAMTS, its successor(s), or an
accreditation program the Department approves as substantially equivalent to CAMTS.