# EMS ambulance billing software that keeps the run report, the certification and the claim on one call

> EMS ambulance billing is the work of turning a completed run into a paid claim. Medicare pays a base rate plus mileage for each covered transport, and the paperwork behind it is specific. A repetitive scheduled nonemergency transport needs a physician certification statement dated no earlier than 60 days before the service, a vehicle must be staffed by at least two people, and the claim itself must be filed within one calendar year of the date of service. Neurobird holds the run, the signature and the claim on one record.

- URL: https://neurobird.com/emsambulance/
- Product: Neurobird EMS Ambulance Billing Operations Platform
- Niche: EMS ambulance billing
- Buyer: ambulance services and EMS agencies
- Status: in development, open for early access
- Updated: 2026-08-22

## What Neurobird EMS Ambulance Billing does

- Hold the physician certification statement against the run it authorises, with its own 60 day window watched
- Chase a missing certification for 21 calendar days and record the attempts that let you bill without it
- Apply the rural mileage adjustment to the first 17 miles instead of leaving it on the table
- Watch the one calendar year filing clock per date of service rather than per batch

## How it works

1. **Close the run** Level of service, loaded miles, origin and destination modifiers and crew certification captured against the call while the crew still remembers it.
2. **Complete the file** The certification statement, the signature and any supporting record from the beneficiary's chart attach to the same call, with the dates that decide whether the claim survives.
3. **Build the claim** Base rate, mileage and adjustments assembled from the record under 42 CFR 414.610, with the filing clock visible per date of service rather than per submission batch.

## From the source material

> The beneficiary's condition must require both the ambulance transportation itself and the level of service provided in order for the billed service to be considered medically necessary.

Source: 42 CFR 410.40, coverage of ambulance services, https://www.law.cornell.edu/cfr/text/42/410.40

## Industry context

- **60 days** Maximum age of a physician certification statement for a medically necessary nonemergency, scheduled, repetitive ambulance service. The statement must be obtained before the service is furnished and dated no earlier than 60 days before it. (source: 42 CFR 410.40, https://www.law.cornell.edu/cfr/text/42/410.40)
- **48 hours** Window to obtain a physician certification statement after an unscheduled or nonrepetitive transport for a facility resident who is under the care of a physician. A beneficiary at home and not under direct physician care needs no certification. (source: 42 CFR 410.40, https://www.law.cornell.edu/cfr/text/42/410.40)
- **21 calendar days** Period after the date of service in which a provider must try to obtain the required certification. If it cannot, it must document the attempts, including a signed return receipt, and may then submit the claim. (source: 42 CFR 410.40, https://www.law.cornell.edu/cfr/text/42/410.40)
- **1 calendar year** Filing limit for a Medicare claim, running from the date of service for services furnished on or after January 1, 2010. A handful of narrow exceptions extend it, but the default is the one that governs almost every transport. (source: 42 CFR 424.44, https://www.law.cornell.edu/cfr/text/42/424.44)
- **2 staff** Minimum crew on a vehicle furnishing ambulance services, with at least one member certified at minimum as an emergency medical technician basic for a BLS vehicle, and as a paramedic or emergency medical technician for an ALS vehicle. (source: 42 CFR 410.41, https://www.law.cornell.edu/cfr/text/42/410.41)
- **50 percent** Increase to the ground mileage rate for each of the first 17 miles where the point of pickup is in a rural area. The practice expense portion of the geographic adjustment factor is applied to 70 percent of the ground ambulance base rate. (source: 42 CFR 414.610, https://www.law.cornell.edu/cfr/text/42/414.610)

## Pricing

- Single service: $199 per month
- Agency: $599 per month
- Regional: $1,500 per month

## Questions

### What is EMS ambulance billing?

EMS ambulance billing is the process of converting a completed transport into a claim a payer will pay. It combines the clinical run report, the level of service, the loaded mileage, the origin and destination modifiers, a physician certification statement where one is required, and the beneficiary signature, all filed inside the deadline.

### What are the physician certification statement rules?

42 CFR 410.40 sets three windows. For a nonemergency, scheduled, repetitive transport the statement must be obtained before the service and dated no earlier than 60 days before it. For an unscheduled or nonrepetitive transport of a facility resident under physician care the statement is obtained within 48 hours. If the signature cannot be obtained within 21 calendar days, the attempts must be documented and the claim may then be submitted.

### How long do we have to file a Medicare ambulance claim?

One calendar year from the date of service under 42 CFR 424.44. That clock runs per date of service, which is why a batch that looks safe can still contain a run that is three weeks from being unbillable.

### Does this replace our electronic patient care report?

No. It sits beside it. The patient care report is the clinical record and stays where the crew writes it. This holds the billing record: level of service, mileage, modifiers, certification dates, signatures and the filing clock.

### How does it handle rural mileage?

Under 42 CFR 414.610 the point of pickup drives it. Where the pickup is in a rural area the mileage rate rises by 50 percent for each of the first 17 miles, so the adjustment is applied from the run record instead of being remembered by whoever codes the claim.

## Sources

- [42 CFR 410.40, coverage of ambulance services](https://www.law.cornell.edu/cfr/text/42/410.40)
- [42 CFR 410.41, requirements for ambulance providers and suppliers](https://www.law.cornell.edu/cfr/text/42/410.41)
- [42 CFR 414.610, basis of payment](https://www.law.cornell.edu/cfr/text/42/414.610)
- [42 CFR 424.44, time limits for filing claims](https://www.law.cornell.edu/cfr/text/42/424.44)
- [42 CFR 424.36, signature requirements](https://www.law.cornell.edu/cfr/text/42/424.36)
- [CMS, Medicare provider compliance tips for ambulance services](https://www.cms.gov/training-education/medicare-learning-networkr-mln/compliance/medicare-provider-compliance-tips/ambulance-services)

## Contact

- office@neurobird.com
- https://neurobird.com/