Non-emergent medical transportation (ambulance) updates

As identified in the article titled “New prior authorizations for 2025,” which is also included in this issue of Provider Update, CarePartners of Connecticut is making updates to our prior authorization requirements for non-emergent medical transportation (ambulance) effective Jan. 1, 2025. 

We will require prior authorization for the following codes and will follow Medicare Benefit Policy Manual Chapter 10 for criteria:

• A0426
• A0428
• A0430
• A0435

Please keep in mind that this change does not apply to emergent medical transportation using an ambulance, or to non-emergent medical transportation using another other type of vehicle, such as a wheelchair van or chair car. The intention of the change is to encourage the use of the least intensive means of transportation whenever possible, which helps manage costs for members and helps ensure that prompt ambulance transportation is accessible for those who need it most.