42 CFR §410.41

1. (a)Vehicle. A vehicle used as an ambulance must meet the following requirements:
   1. (1)Be specially designed to respond to medical emergencies or provide acute medical care to transport the sick and injured and comply with all State and local laws governing an emergency transportation vehicle.
   2. (2)Be equipped with emergency warning lights and sirens, as required by State or local laws.
   3. (3)Be equipped with telecommunications equipment as required by State or local law to include, at a minimum, one two-way voice radio or wireless telephone.
   4. (4)Be equipped with a stretcher, linens, emergency medical supplies, oxygen equipment, and other lifesaving emergency medical equipment as required by State or local laws.
2. (b)Vehicle staff. A vehicle furnishing ambulance services must be staffed by at least two people who meet the requirements of state and local laws where the services are being furnished, and at least one of the staff members must, for:
   1. (1)BLS vehicles.
      1. (i)Be certified at a minimum as an emergency medical technician-basic by the State or local authority where the services are furnished; and
      2. (ii)Be legally authorized to operate all lifesaving and life-sustaining equipment on board the vehicle;
   2. (2)ALS vehicles.
      1. (i)Meet the requirements of paragraph (b)(1) of this section; and
      2. (ii)Be certified as a paramedic or an emergency medical technician, by the State or local authority where the services are being furnished, to perform one or more ALS services.
3. (c)Billing and reporting requirements. An ambulance supplier must comply with the following requirements:
   1. (1)Bill for ambulance services using CMS-designated procedure codes to describe origin and destination and indicate on claims form that the physician certification statement or non-physician certification statement is on file, if required.
   2. (2)Upon a carrier's request, complete and return the ambulance supplier form designated by CMS and provide the Medicare carrier with documentation of compliance with emergency vehicle and staff licensure and certification requirements in accordance with State and local laws.
   3. (3)Upon a carrier's request, provide additional information and documentation as required.