Documentation for Ambulance Services

Home MAC Provider Education Provider Types Part B

All ambulance suppliers (BOTH AIR and GROUND) must include the complete address of the origin and destination for each transport on the run sheet and on the claim submitted to Medicare. The origin is the point where the load mileage begins and the destination is the point where the load mileage ends. Load mileage only includes the miles where the patient is on board the ambulance.

Be sure to include the name and address of any facility or airport involved, i.e.

  • Sunshine Hospital at 111 S Main St, Somewhere, IL 55555 to Somewhere Airport 2001 S Airport Dr, Somewhere, IL 55555
  • Interstate 88 between mile marker 212 and 213 to Daisy Hospital at 2000 Sunflower Lane, Daisy, Kansas 55555

The information is required to process the claim timely and correctly. Remember missing or incomplete information can delay payment, or cause a claim denial.

Page Last Updated: Wednesday, 31-Dec-2008 10:48:34 CST