Physician Certification Statement (PCS)
Download and complete the necessary documentation for medical transport services.
Important Information
The Physician Certification Statement (PCS) is required for non-emergency medical transportation. This form must be completed by a qualified healthcare professional to certify medical necessity.
- Must be signed by a physician or qualified healthcare professional
- Valid for 60 days from the date of signature
- Required for each non-emergency medical transport
Ambulance Transport Qualifications
To qualify for ambulance transport, patients must meet specific medical criteria that necessitate specialized medical transportation.
Medical Necessity Criteria
- Bed-confined patients unable to get up from bed without assistance
- Patients requiring continuous oxygen monitoring or administration
- Patients needing specialized medical monitoring during transport
- Patients requiring positioning that only a stretcher can provide
Additional Qualifying Conditions
- Patients with severe mobility limitations requiring specialized handling
- Patients with medical conditions requiring immediate medical attention
- Patients requiring medical equipment that must be monitored during transport
Non-Qualifying Transportation
Not all medical transportation needs qualify for ambulance services. The following situations typically do not meet medical necessity criteria:
Note: If you're unsure whether your transportation needs qualify for ambulance service, please consult with your healthcare provider or contact our team for guidance.
Need Assistance?
If you need help completing the PCS form or have any questions, our team is here to assist you.
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