CMS Pub. 100-04, ch. 15, § 30.1

B3-5116

Payment under the fee schedule for ambulance services:

• Includes a base rate payment plus a payment for mileage;

• Covers both the transport of the beneficiary to the nearest appropriate facility and all

items and services associated with such transport; and

• Precludes a separate payment for items and services furnished under the ambulance

benefit.

Payment for items and services is included in the fee schedule payment. Such items and services

include but are not limited to oxygen, drugs, extra attendants, and EKG testing - but only when

such items and services are both medically necessary and covered by Medicare under the

ambulance benefit.