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Ambulance Services

DMA Clinical Policy and Programs
Phone Number (919) 855-4260
Fax (919) 733-2796

Ambulance services provide medically necessary treatment for Medicaid recipients.  Transport is provided only if the recipient's medical condition is such that the use of any other means of transportation is contraindicated. Ambulance services include emergency and non-emergency ambulance transport via ground and air medical ambulance.  Ambulance providers must be licensed by the state.   The patient must be transported in an appropriate vehicle that has been inspected and issued a permit by the state.

For service requirements, coverage criteria and limitations, refer to the Ambulance Services Provider Manual.

Medicaid Bulletins

For changes and updates to coverage criteria, billing information, and other program requirements refer to the N.C. Medicaid general and special bulletins.

 

• Index of Articles for Ambulance Services Providers
• Index of All Bulletins
• All Bulletins by Date

Ambulance Services Fee Schedules

• Adobe Acrobat Format - effective 07/01/12
• Microsoft Excel Format - effective 07/01/12
• Adobe Acrobat Format - effective 11/01/11
• Microsoft Excel Format - effective 11/01/11
• Adobe Acrobat Format - updated 04/01/07
• Microsoft Excel Format - updated 04/01/07
• Adobe Acrobat Format - updated 06/01/05

Ambulance Services Forms

To see forms that apply to all providers, please visit our Provider Forms page.

• Prior Approval Form for Ambulance Services (372-118)
• State-to-State Ambulance Transportation Addendum