CMS Adds COVID-19 Ambulance Treatment in Place Waiver

On May 5, 2021, CMS announced that, effective March 1, 2020, where the following criteria are satisfied, Medicare will pay for ground ambulance services without a transport during the COVID-19 Public Health Emergency (PHE):

• The ground ambulance service was furnished in response to a 911 call (or the equivalent in areas without a 911 call system); and
• The patient would have been transported to a destination permitted under Medicare regulations, but the transport did not occur as a result of community-wide emergency medical service protocols due to the COVID-19 PHE; and
• The patient’s condition required the level of service provided and would normally require transport by ambulance, absent the community-wide EMS protocols (in other words, any other means of transportation would have been contraindicated).

CMS further elaborates on this waiver in two CMS documents: a) CMS’ COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing, Section J. Ambulances, FAQ Nos. 5, 6, 16-25; and b) CMS Fact Sheet: Waiver for Ground Ambulance Services: Treatment in Place.  CMS also added a summary of this waiver is its document on CMS COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers under the heading “Ambulances Services” and subheading “Ambulance Treatment in Place” (page 34).