Non-Covered Emergency Ambulance Services

Non-Covered Emergency Ambulance Services The Division of Medicaid does not cover the following including, but not limited to: A. Emergency ambulance transportation of a beneficiary: 1. To anywhere other than the nearest appropriate facility that is able to care for the beneficiary, 2. Pronounced dead prior to the dispatch of the ambulance by an individual who is licensed or otherwise authorized under state law to pronounce death in the state where such pronouncement is made, 3. To a funeral home, 4. Due to a lack of alternative means, 5. For the convenience of the beneficiary and/or beneficiary’s family, and/or 6. For which medical necessity criteria has not been satisfied. B. Services that are not directly related to medically necessary emergency treatment of an illness or injury including, but not limited to: 1. Time spent waiting for the beneficiary, 2. Refusal of the beneficiary to be transported after the ambulance arrives in response to an emergency, and/or 3. First-aid or other medical type treatment provided by ambulance staff to a beneficiary who is not subsequently transported to the closest appropriate facility, C. Services provided to an individual not eligible for Medicaid, D. Mileage beyond the nearest appropriate facility, or E. Services not specifically listed as covered services.