South Dakota Administrative Rules
Title 67 - Department of Social Services
Article 67:16 - Covered medical services
Chapter 67:16:25 - Transportation services
Section 67:16:25:08 - Billing requirements - Ground ambulance

A claim for ground ambulance transportation service must be submitted at the provider's usual and customary charge. A provider may bill for services only if a recipient was actually transported or medically necessary services were provided at the pick-up point. A provider may not bill for any portion of ambulance service during which the recipient was not physically present in the ambulance.

Return trips or other nonemergency trips by ground ambulance must be justified by a physician or other licensed practitioners order. Documentation of the order must exist in the provider's files but need not be submitted with the claim for payment.

A claim for ground ambulance service must contain the procedure codes established in § 67:16:25:03.

Charges for transporting the patient from the airport to the hospital or from the hospital to the airport must be billed by the ground ambulance provider and may not be included in the air ambulance charge.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1(1)(2)(4).

Third-party liability, ch 67:16:26.