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The term “non-emergency” refers to all
scheduled transportation that does not meet the criteria for
emergency, regardless of origin and destination. By
definition, hospital discharge trips, trips to and from ESRD
facilities for maintenance dialysis, to and from other
outpatient facilities for chemotherapy, radiation therapy,
and other diagnostic and therapeutic services are scheduled
runs, and therefore, are considered non-emergency services.
The following are conditions that could establish medical
necessity for non-emergency ambulance transportation:
-
Patient has a major
fracture (hip, vertebrae) which results in markedly impaired
mobility: or
-
Patient is in a body
cast: or
-
Patient has signs and
symptoms of severe pain or distress or a medical condition or
conditions that would be exacerbated by transport other than
ambulance; or
-
Patient must be
transported by ambulance because of a specific physical
condition or limitation that contraindicates transfer by
wheelchair or other means.
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