CMS Extends Prior Authorization for One Year

Ambulance Prior Authorization Extended

CMS just announced that the Medicare Prior Authorization Model for Repetitive, Scheduled Non Emergent Ambulance Transport is being extended for an additional year. 

This affects ambulance suppliers in the current model States of:

  • Delaware
  • District of Columbia
  • Maryland
  • New Jersey
  • North Carolina
  • Pennsylvania
  • South Carolina
  • Virginia
  • West Virginia 

CMS says the model will now end in all states on December 1, 2018

Dates of Service December 2 – December 4, 2017:  CMS says that repetitive, scheduled non-emergent ambulance transport claims with dates of service 12/2/17 through 12/4/17 will not be stopped for prepayment review if prior authorization is not requested before the fourth round trip in a 30-day period. 

Dates of Services on or After December 5, 2017: All repetitive, scheduled non-emergent ambulance transports in the model States with a date of service on or after 12/5/17 must have completed the prior authorization process.
Join us for the upcoming abc360 Update Webinar on December 12, 2017, where we’ll discuss what this extension means and whether prior authorization will ever go nationwide.  

Register Today!