EMS Law COVID-19 Update


Click Here for COVID-19 EMS Resources


We’re Providing Answers to Your Questions During this Crisis

Please note that our answers to these questions are for general information purposes only and should not be relied on as legal advice or a definitive statement of the law. We are not a government authority.  

Contact Us with Your Specific Issues and Questions

PWW remains in full operational mode.  Please contact any of our professional staff via email or by phone at any time. You may also contact us by sending your question to: info@pwwemslaw.com.  

COVID-19 EMS Legal Questions and Answers (Questions Hyperlinked)


1. Have Medicare’s patient signature rules been relaxed during the COVID-19 crisis?
Revised Date: 4/13/20

2. Does transport of an individual with isolation precautions due to confirmed (or suspected) COVID-19 meet the Medicare medical necessity requirement?
Date added: 3/30/2020


3. Do the new telemedicine options require special documentation practices for EMS?
Date added: 3/30/2020


4. Will CMS reimburse ambulance services for transports to alternative destinations during the COVID-19 pandemic?
Revised Date: 4/9/20

5. Can ambulance services be reimbursed by Medicare for telehealth services?  Can we bill practitioners for telehealth services that we help them provide to our patients?
Date added: 4/1/2020


6. What telehealth waivers are currently in place for the COVID-19 Public Health Emergency?
Date added: 4/1/2020

7. When should I use the “CR” modifier on an ambulance claim?
Revised Date: 05/7/20

8. We were asked to conduct in-home follow-up medical checks on patients who tested positive for COVID-19 but did not require hospital care. Can we charge for these wellness checks?
Date added: 4/9/2020 

9. One of our nursing homes is planning ahead in case there is a need for transferring residents out of the SNF to create a COVID-19 facility and a non-COVID-19 facility. If we transport a patient from one SNF to another would this be billable to Medicare?
Date added: 4/18/2020 

10. Has CMS waived the requirement to obtain Physician Certification Statements (“PCS”) or Non-Physician Certification Statements (also known as Medical Necessity Certification Statement for Non-Emergency Ambulance Services) for nonemergency transports?
Revised Date: 4/29/20

11. Providers are refusing to sign our PCS forms due to risk of COVID exposure with paper. What are our options? 
Date added: 4/29/20

12. When should I use the “CS” modifier on an ambulance claim?
Date added: 05/12/20 

13. When transporting a patient in Novitas or FCSO jurisdictions, do I still need to use the secondary Z Codes, or do the COVID-19 specific codes replace the need for such codes?
Date added: 05/12/20 

14. Regarding a Physician’s office as a covered destination, does the treatment have to be COVID-19 related?
Date added: 05/15/20 


1. Can facilities and other healthcare providers share the COVID-19 status of patients with EMS and other first responders?
Date added: 3/27/2020

2. How can staff members work remotely and still be secure under HIPAA when dealing with health information?
Date added: 3/27/2020

3. How can we share COVID-19 information about patients within our agency?
Date added: 3/27/2020

4. How can we share COVID-19 information about patients with other first responders and health care providers?
Date added: 3/27/2020

5. What about dispatch communications?  What can we share, and can we flag addresses with suspected COVID-19?
Date added: 3/27/2020

6. What if we think someone is in danger because they may have been exposed?  Can we share COVID-19 information about a patient with that person?
Date added: 3/27/2020

7.  Who can – and should -  we report COVID-19 information to?  Can we report to our health department or EMS regional council?
Date added: 3/27/2020


8. What are your recommendations if we have billers that need to work from home that specifically need to handle physical paperwork (run logs, PCS's, face sheets)? Can we deliver paperwork to them at their homes or have them pick up/drop off paperwork? How do we stay HIPAA compliant with physical paperwork at biller's homes?
Date added: 3/30/2020


9. What information regarding COVID-19 calls can be shared with county executive and other county officials?
Date added: 3/31/2020


10. Does an employer have the right to be notified if one of their employees test positive for COVID-19?
Date added: 3/31/2020

11. Can our EMS agency notify other first responders – such as fire and PD about the COVID-19 status of a patient AFTER a transport if we know that status?  
Date added: 3/31/2020

Workplace Staffing, Safety & Screening

1. Are hospitals required to let EMS personnel know if they had come into contact or possibly been exposed by a patient that was later diagnosed with COVID-19?
Date added: 3/30/2020


2. Can an EMS agency require employees to shave? 
Date added: 3/30/2020


3. Can an EMS agency refuse to respond to a call because the patient is suspected of having COVID-19?
Date added: 3/30/2020


4. Is it acceptable for a first response agency to delay arriving on scene until dispatch has completed EMD to determine if the patient has COVID-19 like symptoms?
Date added: 3/30/2020


5. Our EMS personnel are requesting to wear their body armor, as well as lawful firearms, while serving through this National Emergency. Should we relax our protocols to make these reasonable accommodations?
Date added? 3/30/2020


6. Does the Ryan White Act apply to COVID-19?
Date added: 3/30/2020


7. Can an employee refuse to work due to concerns over COVID-19?
Date added: 3/30/2020


Workers' Compensation

1. Are volunteer EMS personnel covered under state workers' compensation laws?
Date added: 3/30/2020


2. If an employee refuses to use Personal Protective Equipment ("PPE"), and contracts COVID-19, would it be covered by workers' compensation?
Date added: 3/30/2020

Patient Care

1. Can an EMS provider refuse to transport a patient if that patient is suspected of having COVID-19 and refuses to wear a mask?
Date added: 3/30/2020

EMS Operations

1. Can hospital emergency departments go on diversion or refuse to accept patients?
Date added: 3/31/2020

COVID-19 EMS Resources

PDF icon PWW Secure Remote Working SAMPLE Policy
PDF icon PWW Statement on Sharing COVID-19 Information and HIPAA
PDF icon OCR Guidance on COVID-19 Patient Information With First Responders
PDF icon OCR BULLETIN: HIPAA Privacy and Novel Coronavirus
PDF icon OCR Notification of Enforcement Discretion for Telehealth
PDF icon CDC COVID-19 Official ICD10 Coding Guidance COVID 19 - Updated 3.18.20

EMS1 Article:  Finally! Feds tell hospitals they may share information about COVID-19 patients with first responders

JEMS EMS Lawline Article:  Make Time for Family

EMS World Article: Will Telehealth Redefine Whether Ambulance Services Are Reasonable?

PDF icon PWW Signature Guidance for EMS Billing Personnel
PDF icon PWW Signature Guidance for EMS Practitioners
File PWW Model Ambulance Signature Form COVID-19 Version 2.2-CV (Word)
PDF icon PWW Model Ambulance Signature Form COVID-19 Version 2.2-CV (PDF)
PDF icon PCS Form Compliance During the COVID-19 Public Health Emergency
JEMS EMS Lawline Article: The Hidden Pandemic

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COVID-19 RESOURCES: Any individual or entity who downloads or uses these documents or any modified version of any of these documents in any way is referred to as the "User." Some of the documents are sample forms and policies only, designed by Page, Wolfberg & Wirth, LLC (PWW).  PWW created documents are not legal advice, and no attorney-client relationship is formed by their use. User bears all responsibility for compliance with all applicable laws and regulations, and the User agrees that neither PWW nor the individual designers of PWW created documents are responsible for their use, non-use or modification by any User.  PWW created documents are licensed only for use by individual ambulance services, and may not be sold or distributed by any other individual or entity. Any other use or distribution of PWW created documents requires our express written permission. Please also note that we cannot be responsible to distribute new or updated documents to users. In addition, we do not guarantee that any of these documents will be updated to reflect new laws, regulations or other applicable authority. PWW created documents are Copyrighted by PWW and any use, reproduction or distribution that is not in accordance with these Terms of Use is strictly prohibited unless permitted in writing by PWW. PWW makes no copyright claim to any official government works.