US · guidance
CMS Pub. 100-04, ch. 15, § 20.5
Documentation Requirements
In all cases, the appropriate documentation must be kept on file and, upon request, presented to
the contractor. It is important to note that the presence (or absence) of a physician’s order for a
transport by ambulance does not necessarily prove (or disprove) whether the transport was
medically necessary. The ambulance service must meet all program coverage criteria in order
for payment to be made.
IOM Pub 100-01, Medicare General Information, Eligibility, and Entitlement Manual, chapter 4
- Physician Certifications and Recertification of Services, contains specific information on
supplier requirements for ambulance certification.
IOM Pub. 100-08, Medicare Program Integrity Manual, chapter 6 - Medicare Contractor Medical
Review Guidelines for Specific Services contains information on medical review instructions of
ambulance services.
History
(Rev. 1696; Issued: 03-06-09; Effective/Implementation Date: 04-06-09)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
a4b4e588abf6aa19da9b80e17aaae86cc3f7b7804190d7fb534292dfbdfed37c
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