Ground ambulance transportation coverage under Apple Health managed care
Washington State Health Care Authority sent this bulletin at 03/07/2016 03:59 PM PST
Provider Alert!
Clarification
of ground ambulance transportation coverage under Apple Health managed care
Emergency ambulance
transportation is covered under Apple Health managed care, including for
psychotic episodes that require ambulance transportation of a mentally-ill
client to an evaluation and treatment facility.
Nonemergency
ground ambulance services are covered when they are:
Necessary
to transport an enrollee between facilities to receive a contracted service;
Necessary
to transport an enrollee who must be carried on a stretcher, or who may require
medical attention en route to receive a covered service; or
Effective
for claims with dates of service on and after April 1, 2016, medically
necessary to transport an enrollee from home to a facility for a medical
appointment (e.g., ventilator dependent, bed-confined and unable to hold
self-upright or unsafe for wheelchair transport).
