Overview of the Repetitive, Scheduled Non-emergent Ambulance Prior Authorization Model
The Centers for Medicare & Medicaid Services (CMS) began a 3-year prior authorization model for
repetitive, scheduled non-emergent ambulance transports in the states of New Jersey,
Pennsylvania, and South Carolina on December 1, 2014, for transports on or after December 15,
2014, regardless of the origin or destination of the transport. Six additional areas were included in
the model – Delaware, the District of Columbia, Maryland, North Carolina, Virginia, and West
Virginia – on December 15, 2015, for transports on or after January 1, 2016.
The model was extended three additional years and was previously scheduled to end in all
model states on December 1, 2020. However, the model no longer has an end date and will
continue in effect for the nine model states.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: November 23, 2015
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