62J.48 Criteria For Reimbursement

Published: 2015

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All ambulance services licensed under section 144E.10 are eligible for reimbursement under health plan companies. The commissioner shall require health plan companies to adopt the following reimbursement policies.
(1) All scheduled or prearranged air and ground ambulance transports must be reimbursed if requested by an attending physician or nurse, and, if the person is an enrollee in a health plan company, if approved by a designated representative of a health plan company who is immediately available on a 24-hour basis. The designated representative must be a registered nurse or a physician assistant with at least three years of critical care or trauma experience, or a licensed physician.
(2) Reimbursement must be provided for all emergency ambulance calls in which a patient is transported or medical treatment rendered.
(3) Special transportation services must not be billed or reimbursed if the patient needs medical attention immediately before transportation.