Medicare News
Medicare Learning Network (MLN) Articles from CMS
New:
- MM8983 – Implement Operating Rules - Phase III ERA EFT: CORE 360 Uniform Use of Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC) Rule - Update from CAQH CORE
- MM8908 - Quarterly Update to the Correct Coding Initiative (CCI) Edits, Version 21.1, Effective April 1, 2015
Specialty Care Transport (SCT) under the Fee Schedule for Ambulance Services is defined in 42 CFR §414.605 as an interfacility transportation of a critically injured or ill beneficiary by a ground ambulance vehicle, including medically necessary supplies and services, at a level of service beyond the scope of the Emergency Medical Technician (EMT)–Paramedic. SCT is necessary when a beneficiary’s condition requires ongoing care that must be furnished by one or more health professionals in an appropriate specialty area, for example, nursing, emergency medicine, respiratory care, cardiovascular care, or a paramedic with additional training.
In the December 1, 2006 Final Rule (71 FR 69716), CMS expanded the definition of “interfacility” to include both hospitals and skilled nursing facilities (SNFs). CMS considers a “facility” to include only a SNF or a hospital that participates in the Medicare program, or a hospital-based facility that meets our requirements for provider-based status as specified at 42 CFR §413.65. Medicare hospitals include, but are not limited to, rehabilitation hospitals, cancer hospitals, children’s hospitals, psychiatric hospitals, Critical Access Hospitals (CAHs), inpatient acute care hospitals, and Sole Community Hospitals (SCHs).
