<html> <head> <title>Rule 67:16:25:02 Ambulance services covered.</title> <META NAME="Keywords" Content="Administrative Rules 67:16:25:02"> <META NAME="Description" Content="Administrative Rules 67:16:25:02 Ambulance services covered."> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=Generator content="Microsoft Word 15 (filtered)"> <style> <!-- /* Font Definitions */ @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4;} @font-face {font-family:Times; panose-1:2 2 6 3 5 4 5 2 3 4;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {margin:0in; margin-bottom:.0001pt; font-size:10.0pt; font-family:"Times",serif; color:black;} a:link, span.MsoHyperlink {color:blue; text-decoration:underline;} a:visited, span.MsoHyperlinkFollowed {color:purple; text-decoration:underline;} .MsoChpDefault {font-size:10.0pt; color:black;} @page WordSection1 {size:8.5in 11.0in; margin:1.0in 1.25in 1.0in 1.25in;} div.WordSection1 {page:WordSection1;} --> </style> </head> <body lang=EN-US link=blue vlink=purple> <div class=WordSection1> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>67:16:25:02.&nbsp;&nbsp;Ambulance services covered.</b> </span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>A</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>mbulance services are limited to </span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>medically necessary ground ambulance services at the pick-up point and ground or air ambulances services </span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>transporting the recipient locally or to the nearest medical provider that is equipped or trained to provide the necessary service. The following services are eligible for payment </span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>if</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> provided by a participating ambulance provider:</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (1)&nbsp;&nbsp;Ground ambulance service to or from a medical provider or between medical facilities </span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>if</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> other means of transportation would endanger the life or health of the patient;</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (2)&nbsp;&nbsp;Air ambulance service </span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>if</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> the requirements of &#167;&nbsp;67:16:25:02.01 have been met;</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (3)&nbsp;&nbsp;Services of additional attendants </span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>if</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> medically necessary;</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (4)&nbsp;&nbsp;Oxygen provided during transit;</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (5)&nbsp;&nbsp;Loaded mileage. Mileage may not be billed for more than one patient per trip;</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> and</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (6)&nbsp;&nbsp;The ground and air ambulance services payable under the provisions of &#167;&nbsp;67:16:25:03.</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Ground ambulances may provide secure medical transportation as defined in &#167;</span><span style='font-size: 12.0pt;font-family:"Times New Roman",serif'>&nbsp;</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>67:16:25:01. These services are payable under the provisions of &#167;&#167;</span><span style='font-size: 12.0pt;font-family:"Times New Roman",serif'>&nbsp;</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>67:16:25:05 and</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> </span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>67:16:25:08.01.</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span style='font-size: 12.0pt;font-family:"Times New Roman",serif'>T</span><span style='font-size: 12.0pt;font-family:"Times New Roman",serif'>he department may pay for transportation services not meeting the</span><span style='font-size:12.0pt; font-family:"Times New Roman",serif'> </span><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>conditions of this section</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>,</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> if paying for the services results in an overall cost savings for the</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> </span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>department.</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Source:</b> 7 SDR 23, effective September 18, 1980; 7 SDR 66, 7 SDR 89, effective July 1, 1981; 16 SDR 234, effective July 1, 1990; 17 SDR 201, effective July 1, 1991; 35 SDR 253, effective May 12, 2009; 44 SDR 94, effective December 4, 2017; 46 SDR 50, effective October 10, 2019.</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>General Authority:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-1">28-6-1.</A></span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Law Implemented:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-1">28-6-1</A></span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>(1)(2)(4)</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>.</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;</span></p> </div> </body> </html>