Insurance & Billing

Generally no. Medicare Part B covers ambulance transport to or from a hospital, skilled nursing facility, dialysis center, or the patient's home — not to a physician's office or outpatient clinic for a routine appointment, unless the patient is bed-confined and the destination is a covered facility type.

A CMN is a written statement signed by the ordering physician documenting that the patient's condition requires ambulance transport — that transport by car, taxi, or wheelchair van would be medically contraindicated. Medicare and most insurers require this document before they will pay a claim. Your hospital case manager or attending physician typically completes this at discharge.

Contact your Medicaid managed care organization (MCO) — the number is on the back of your Medicaid card. You will need the patient's Medicaid ID, the physician's order, the origin and destination, and the requested date. Allow 24–48 hours for processing. Preferred EMS can assist with this process — call us at (713) 791-9000.

Denials are common but not always final. Request the denial reason in writing, gather supporting documentation (physician's order, medical records, authorization numbers), and file an internal appeal. If the internal appeal is denied, you have the right to an independent external review. For Medicare denials, use the Medicare appeals process. For private insurance, external review is available under the ACA. We can help you understand what documentation is needed.

Preferred EMS participates with Medicare, Texas Medicaid, and many major commercial insurance networks in the Houston area. Call us at (713) 791-9000 and provide your insurance information — we will verify network status and benefits before your transport is scheduled.

Yes. For self-pay transports, we provide flat-rate pricing for common routes before you commit. For insured transports, we can verify your benefits and give you an estimate of your expected cost share. Call (713) 791-9000 or email [email protected].

Medicare covers long-distance transport when it is medically necessary and to the nearest appropriate facility. Transport to a facility in another state may not be covered if an equivalent facility exists closer to the patient. Texas Medicaid covers medically necessary in-state transport; out-of-state requires prior authorization. Private insurance varies — always verify before scheduling.

Ambulance transport is for patients who require medical monitoring, a stretcher, or clinical intervention during transport. Non-Emergency Medical Transportation (NEMT) — coordinated through ModivCare in Texas — is for patients who can be safely transported in a standard vehicle or wheelchair van without clinical oversight. Medicaid authorizes these separately. If your loved one needs oxygen, IV therapy, or a stretcher, they likely need ambulance transport, not NEMT.