Ambulance PCS Rules Change in 2020

Ambulance Billing Forms - PCS Updated for 2020
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The ambulance PCS rules have changed for the year 2020.  Ambulance & EMS billing often requires providers to obtain an Ambulance Physician Certification Statement (PCS).  For the year 2020, we have seen some important changes to the PCS rules over at CMS and Medicare.  The Ambulance PCS “certifies” that Medicare’s medical necessity criteria for ambulance transport is met by the patient.  If the patient is repetitive in frequency, (3 transports in 10 days) only a physician signature is acceptable on the certification statement.  However, if the transport being scheduled is not repetitive, other healthcare providers can sign the PCS, and this is where a significant change shows up for providers.  Beginning with service dates of January 1st, 2020, a one time, non-repetitive patient PCS can be signed by one of the following: Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist, Registered Nurse, Licensed Practical Nurse, Social Worker, Case Manager or Discharge Planner…

as long as they have personal knowledge of the patient’s condition at the time the service is ordered or the time of transport.  They must be employed by the attending physician or the hospital / facility where the patient is being treated and from which the patient is being transported from.

We have found the sample Physician Certification Statement form offered by the premier EMS law firm, Page Wolfberg & Wirth to be an exceptional document for ambulance provider use.  The form is a result of their work, provided to the EMS community for free.  Since we can not recommend anything that will serve your needs better on this front, we will only link to their website from here.  Be sure to download the version that can be edited so you can put your ambulance company’s name on it and grab the downloadable documents that come with it.  You will need it to train your staff and rewrite any policies you have in place already.  In closing, we are here to help EMS agencies find their way in a difficult business environment. If you require assistance with your ambulance or EMS billing, call our office today at 1-800-635-7577.  All calls are confidential and free from obligation.  Find the form link below…

https://www.pwwemslaw.com/resources

Priority Medical Claims is a medical billing agency who specializes in EMS and Ambulance Billing.  We are located in Beckley, West Virginia at the intersection of Interstate 64 and Interstate 77.  We currently operate in numerous states and territories through the use of ultra modern billing and claim management technology.

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