What services does Medicare not cover?

Medicare does not cover the following services:

  • To or from the doctor’s office or a physician-directed clinic. (Exception: If in the course of transporting a patient to a hospital, the ambulance stops at a physician’s office because of the patient’s dire need for professional attention and immediately thereafter the ambulance takes the patient to the hospital, payment can be made for the entire trip)
  • Transfer from one residence to another. (A nursing home is considered to be a place of residence)
  • Transfer from a hospital which has appropriate facilities for treatment to another hospital
  • Transportation of a deceased patient to a funeral home
  • Transportation to a non approved dialysis facility for routine maintenance dialysis
  • Waiting time charges – the charge an ambulance company makes for time spent while waiting for the patient
  • The patient refuses to be transported. If, after responding to a call from a patient, no transportation service is rendered, the supplier should not bill Medicare for the unloaded mileage to the patient’s location and the ambulance crew’s assessment of the patient as an ambulance transportation service, since no ambulance service was rendered
  • Oral or self administered drugs
  • Assessing the patient’s condition or taking vital signs
  • Charges made for services not rendered, or bills submitted for the express purpose of obtaining payment from Medicare for known non-covered services constitutes fraudulent billing practices. Claims submitted for denial purposes used for billing a supplemental insurer would not be considered fraudulent billing

Show All Answers

1. How much does ambulance transport cost?
2. Will I receive a bill for ambulance transport?
3. What services does Medicare usually cover?
4. What services does Medicare not cover?
5. In what cases are ambulance services not covered?