CAC Medical Billing and Reimbursement for Ambulance Services

Question 1

Which of the following is a primary payer for ambulance services in the United States?

Accepted Answer

Medicare

Answer

Private donations

Answer

State police funds

Answer

Housing and Urban Development grants

Question 2

What is the primary requirement for Medicare to reimburse non-emergency ambulance transport?

Accepted Answer

The transport must be medically necessary

Answer

The patient must sign a waiver

Answer

The ambulance must be operated by a private company

Answer

The patient must have private insurance

Question 3

Which billing code set is primarily used for ambulance services?

Accepted Answer

HCPCS Level II

Answer

CPT

Answer

ICD-10-CM

Answer

SNOMED CT

Question 4

Which of the following must be documented to justify ambulance transport reimbursement?

Accepted Answer

The medical necessity of the transport

Answer

The patient’s home address

Answer

The patient’s ability to pay

Answer

The number of emergency calls received that day

Question 5

Which modifier is typically used for emergency ambulance transport?

Accepted Answer

EM

Answer

NE

Answer

TX

Answer

NC

Question 6

Why is prior authorization required for some non-emergency ambulance transports?

Accepted Answer

To confirm medical necessity before reimbursement

Answer

To verify patient identity

Answer

To document mileage

Answer

To record dispatch times