Nonemergency ambulance transportation expedited prior authorization update

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Apple Health (Medicaid) Provider Alert

Currently, ambulance providers use the expedited prior authorization (EPA) process for nonemergency ambulance transportation services under certain circumstances or conditions (EPA# 870001404).

Effective for dates of service on and after April 1, 2018, the Health Care Authority expanded the list of circumstances and conditions under which an ambulance provider may use EPA# 870001404. The list now includes:

  • Hospital to hospital transfer (i.e. services are not available at sending facility, or there are no beds available at sending facility, and the client requires admission and the ambulance transportation is medically necessary)
  • Intravenous (IV) infusion monitoring

This update, along with the complete list of when it is appropriate to use EPA# 870001404, is located in the April 1 publication of the Ambulance and ITA Transportation Billing Guide.

For more information, contact Abigail Cole at