Physician’s Certification Statement (PCS)
Physician certification statements (PCS) are required for patients who are under the direct care of a physician and are required for:
- Scheduled non-emergency ambulance transports.
- Unscheduled non-emergency ambulance transports.
Ambulance suppliers must obtain certification from the patient’s attending physician verifying the medical necessity of ambulance transportation in certain circumstances. The physician certification must be accurate and timely as it enables billing Medicare to receive payment for ambulance services.
The attending physician is responsible for supervising the medical care of the patient by:
- Reviewing the patient’s program of care.
- Ordering medications.
- Monitoring changes in the patient’s medical status.
- Signing and dating all orders.
Note: The signed PCS does not, by itself, demonstrate that the transport was medically necessary and does not absolve the ambulance provider from meeting all other coverage and documentation criteria.
Scheduled repetitive transports (dialysis, wound care, etc.)
PCS requirements for non-emergency scheduled repetitive ambulance transportation include the following:
The PCS for repetitive transports must be signed and dated by the attending physician before furnishing the services to the patient.
The PCS must be dated no earlier than 60 days in advance of the transport for those patients who require repetitive ambulance services and whose transportation is scheduled in advance.
The PCS may include the expected length of time ambulance transport would be required but may not exceed 60 days.
Definition of repetitive ambulance service:
A repetitive ambulance service is defined as medically necessary ambulance transportation that is furnished in three or more round trips during a ten-day period; or at least one round trip per week for at least three weeks.
Repetitive ambulance services are often needed by beneficiaries receiving dialysis or cancer treatment.
Non-repetitive transports
PCS requirements for non-emergency unscheduled or scheduled on a non-repetitive basis ambulance transportation include the following:
The PCS must be obtained from the attending physician within 48 hours after transport.
If the ambulance provider is unable to obtain the PCS from the attending physician within 48 hours of transport, the provider may submit a claim if a certification has been obtained from one of the following who is knowledgeable about the patient’s condition and who is employed by either the attending physician or the facility to which the patient is admitted:
- Physician assistant
- Nurse practitioner
- Clinical nurse specialist
- Registered nurse
- Discharge planner
- Licensed practical nurse (LPN) or licensed vocational nurse (LVN)
- Social workers; and
- Case managers
As with the other non-physician staff currently permitted to sign non-repetitive, unscheduled PCS forms, LPNs, LVNs, social workers, and case managers need to be employed by the beneficiary’s attending physician or the hospital or facility where the beneficiary is being treated and from which the beneficiary is transported and have personal knowledge of the beneficiary’s condition at the time the ambulance transport is ordered, or the service is furnished.
Acadian Identification Numbers
Acadian Ambulance Service of Texas, LLC.
4100 Ed Bluestein Blvd #100
Austin, TX 78721
NPI #: 1750676870
Texas Provider Identifier (TPI) #318533201
Tax ID #:30-0688582
Acadian Transport Assistance Center (ATAC)
Phone (737)-209-6665
Fax # (337)-291-2271
Dispatch: 800-259-1111
