US · guidance
CMS Pub. 100-02, ch. 10, § 10.4.2
Medical Reasonableness
Medical reasonableness is only established when the beneficiary’s condition is such that
the time needed to transport a beneficiary by ground, or the instability of transportation
by ground, poses a threat to the beneficiary’s survival or seriously endangers the
beneficiary’s health. Following is an advisory list of examples of cases for which air
ambulance could be justified. The list is not inclusive of all situations that justify air
transportation, nor is it intended to justify air transportation in all locales in the
circumstances listed.
• Intracranial bleeding - requiring neurosurgical intervention;
• Cardiogenic shock;
• Burns requiring treatment in a burn center;
• Conditions requiring treatment in a Hyperbaric Oxygen Unit;
• Multiple severe injuries; or
• Life-threatening trauma.
History
(Rev. 103; Issued: 02-20-09; Effective Date: 01-05-09; Implementation Date: 03- 20-09)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
e2500608ca99542a2187d7fcff7a4b8f3577c9e29d9629db6ef5477193773d84
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