Rule 23-201-1.3 - Covered ServicesA. The Division of Medicaid covers medically necessary emergency ground ambulance services which meet the requirements of the Mississippi Bureau of Emergency Medical Services (BEMS) including, but not limited to: 1. Basic Life Support (BLS) Ground Ambulance Services which must include, but are not limited to: a) A BLS ambulance vehicle with a BEMS permit, staffed with at least one (1) individual certified by BEMS to provide services at or above the level of Emergency Medical Technician (EMT),b) A driver with a valid Emergency Medical Services Driver Certificate from the state of Mississippi,c) Equipment and supplies as required by BEMS,d) Services provided by an EMT within the scope of their practice as determined by BEMS, ande) Transportation from the pick-up site to the nearest appropriate facility.2. Advanced Life Support (ALS) Ground Ambulance Services which must include, but are not limited to: a) An ALS ambulance vehicle, with a BEMS permit, staffed with at least one (1) individual certified by BEMS to provide services at or above the level of Advanced EMT (AEMT),b) A driver with a valid Emergency Medical Services Driver Certificate from the state of Mississippi,c) Equipment and supplies as required by BEMS,d) Services provided by an AEMT and/or higher-level medical professional within the scope of their practice(s) as determined by BEMS or the appropriate licensing and/or governing board, ande) Transportation from the pick-up site to the nearest appropriate facility.B. The Division of Medicaid covers medically necessary emergency air ambulance services in a rotary-wing aircraft that meet the requirements of BEMS which must include, but are not limited to: 1. An air ambulance aircraft, with a BEMS permit, staffed commensurate with the mission statement and scope of care of the medical transport service, as required and/or specified by BEMS.2. A pilot who is certified in accordance with current Federal Aviation Regulations (FARs) and meets the appropriate BEMS requirements,3. Equipment and supplies as required by BEMS,4. Services provided by an air medical paramedic, registered nurse, and/or licensed physician, or other air medical personnel as defined by BEMS, and5. Transportation from the pick-up site to the nearest appropriate facility.C. The Division of Medicaid covers emergency or urgent air ambulance services in a fixed-wing aircraft which are medically necessary and meet the requirements of BEMS including, but not limited to: 1. An air ambulance aircraft, with a BEMS permit, staffed commensurate with the mission statement and scope of care of the medical transport service, as required and/or specified by BEMS.2. A pilot who is certified in accordance with current FARs and meets the appropriate BEMS requirements,3. Equipment and supplies as required by BEMS,4. Services provided by an air medical paramedic, registered nurse, and/or licensed physician, or other air medical personnel as defined by BEMS, and5. Transportation from the pick-up site to the nearest appropriate facility.D. The Division of Medicaid covers medically necessary neonatal emergency ambulance services that meet the requirements of BEMS.E. The Division of Medicaid covers the following in addition to the emergency ambulance service base rate: 1. Ground ambulance mileage to the closest appropriate facility when appropriate documentation is provided.2. Air ambulance mileage to the closest appropriate facility when appropriate documentation is provided.3. Injectable drugs administered by licensed or certified personnel acting within their scope of practice under the direction of medical control, and/or4. Discarded injectable drugs up to the dosage amount indicated on the single-use vial or package label minus the administered dose(s) if:a) The drug or biological is supplied in a single use vial or single-use package,b) The drug or biological is actually administered to the beneficiary to appropriately address his/her condition and any unused portion is discarded,c) The amount wasted is recorded in the beneficiary's medical record,d) The provider has written policies and procedures regarding single-use drugs and biologicals and bills all payers in the same manner, ande) The amount billed to the Division of Medicaid as a discarded drug is not administered to another beneficiary or patient.23 Miss. Code. R. 201-1.3
42 C.F.R. §§ 410.40, 414.605; Miss. Code Ann §§ 41-59-29, 41-59-101, 43-13-117, 43-13-121; Miss. Admin. Code Title 15, Part 12.