Ambulance Prior Authorization Dates Finalized

Ambulance Image

The Centers for Medicare & Medicaid Service (CMS) has announced the implementation dates creating a national expansion of the Prior Authorization Model for Repetitive, Schedule Non-Emergent Ambulance Transports.  The first group of states will begin on December 1, 2021, followed by 4 other phases for remaining states and territories.

If an ambulance provider does not submit a prior authorization request by the fourth round trip in a 30-day period, subsequent transport claims will be stopped for prepayment review.  CMS will be issuing outreach and education including FAQs.

The phased in implementation dates and grouping of states are as follows:

Effective December 1, 2021
Arkansas
Colorado
Louisiana
Mississippi
New Mexico
Oklahoma
Texas
Effective no Earlier than February 1, 2022
Alabama
American Samoa
California
Georgia
Guam
Hawaii
Nevada
Northern Mariana Islands
Tennessee
Effective no Earlier than April 1, 2022
Florida
Illinois
Iowa
Kansas
Minnesota
Missouri
Nebraska
Puerto Rico
Wisconsin
U.S. Virgin Islands
Effective no Earlier than June 1, 2022
Connecticut
Indiana
Maine
Massachusetts
Michigan
New Hampshire
New York
Rhode Island
Vermont
Effective no Earlier than August 1, 2022
Alaska
Arizona
Idaho
Kentucky
Montana
North Dakota
Ohio
Oregon
South Dakota
Utah
Washington
Wyoming

The Federal Register announcing the implemtation dates can be found here.