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Prior Approval for Non-Emergency Ambulance Services

Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jul 1, 2013
We identified it
Jun 20, 2026
Days to comply

Summary

Illinois Medicaid now requires prior approval for all non-emergency ambulance services effective July 1, 2013. Healthcare providers must complete and fax a Medical Certification for Non-Emergency Ambulance (MCA) form to First Transit for any patient discharge requiring medically supervised ground ambulance transport.

Action Required

Action needed
For Illinois Medicaid patients: When discharging patients who require non-emergency ambulance transport, authorized providers or designees must complete and fax the Medical Certification for Non-Emergency Ambulance (MCA) form to First Transit prior to transport. Forms and criteria are available on the NETSPAP website. Failure to obtain proper certification may result in overpayment recovery actions.