ARSD 67:16:25:08. Billing requirements -- Ground ambulance

A claim for ground ambulance transportation service must be submitted at the provider's usual and customary charge. A provider may bill for services only if a recipient was actually transported or medically necessary services were provided at the pick-up point. Return trips or other nonemergency trips by ground ambulance must be justified by a physician or other licensed pracitioner's order. Documentation of the order must exist in the provider's files but need not be submitted with the claim for payment. A claim for ground ambulance service must contain the procedure codes established in § 67:16:25:03. Charges for transporting the patient from the airport to the hospital or from the hospital to the airport must be billed by the ground ambulance provider and may not be included in the air ambulance charge.