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April 3, 2023

Requesting RSNAT Trips

Per the Repetitive Scheduled Non-Emergent Ambulance Transport (RSNAT) Operational guide providers can request a certain number of trips within a 60-day period. The maximum number of trips that can be requested is 80 one-way trips (40 round trips). It is up to the ambulance provider to determine the number of trips to request in a 60-day period.

Requesting the maximum number is not a guarantee that an ambulance provider will receive all 80 one-way trips in a 60-day period. Based on the beneficiary’s condition, the MAC can affirm for fewer trips and/or for less than a 60-day period. Per the RSNAT operational guide, an affirm decision can be for all or part of the requested number of trips.

Requested trips are measured in one-way trips:

  • 20 round trips = 40 one-way trips
  • 40 round trips = 80 one-way trips

When submitting a prior authorization request, providers need to include the number of one-way trips up to a maximum of 80 one-way trips. If a provider finds that they will need more trips, they will need to submit another prior authorization request.

Beneficiaries With a Chronic Condition

A MAC may extend an affirmation period for patients with a chronic medical condition. The maximum number providers still need to request remains at 80 one-way trips. However, the MAC at their discretion can affirm up to 240 one-way trips over 180-day period. It is the responsibility of the ambulance provider to always maintain a current PCS on file. The MAC has the option to request a PCS at any time.

Resources:

Repetitive, Scheduled Non-Emergent Ambulance Transport Prior Authorization Model Operational Guide (cms.gov)External PDF.

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