TRICARE covers the following ambulance services:
- Transfers between a beneficiary’s home, accident scene, or other location and a hospital
- Transfers between hospitals
- Transfers from a hospital-based emergency room to a hospital more capable of providing the required care
- Transfers between a hospital or skilled nursing facility (SNF) and another hospital-based or freestanding therapeutic or diagnostic department/facility
Note: Payment of ambulance transfers to and from a SNF may be included in the SNF prospective payment system.
TRICARE does not cover the following ambulance services:
- Use of an ambulance service instead of a taxi service when the patient’s condition would have permitted use of regular private transportation
- Transport or transfer of a patient primarily for the purpose of having the patient nearer to home, family, friends, or personal physician
- Medicabs or ambicabs that function primarily as public passenger conveyances transporting patients to and from their medical appointments
Note: Air or boat ambulance is only covered when the pickup point is inaccessible by a land vehicle, or when great distance or other obstacles are involved in transporting the patient to the nearest hospital with appropriate facilities, and the patient’s medical condition warrants speedy admission or is such that transfer by other means is not advisable.
For additional information about emergency services, refer to the TRICARE Policy Manual, Chapter 2, Section 6.1.
Ancillary Services
TRICARE covers certain diagnostic radiology and ultrasounds, diagnostic nuclear medicine, pathology and laboratory services, and cardiovascular studies. |
