Ambulance Services - (0555)

Cigna covers ambulance (ground, air, water) transport as medically necessary for emergencies to the nearest appropriate facility, transfers of bed‑confined patients needing specialized services, air/water when ground is infeasible, and urgent time‑critical transplant transports meeting policy criteria, but excludes transports to enable residing outside a transplant program’s driving distance and transports solely for clinical trial participation (coverage varies by benefit plan). Coverage requires documentation of medical necessity (emergency, nearest appropriate facility, bed‑confined status, need for specialized care or air/water criteria), use of the correct and current procedure/diagnosis codes (A0424 requires medical review), and compliance with plan terms, licensing, and billing rules.

"Ambulance transport is considered medically necessary when EITHER of the following conditions is met: In connection with a medical emergency AND EITHER of the following criteria are met: Transport ..."