Listed below are the definitions for the various levels of service provided by Lake-Sumter EMS. These levels of service are defined by the Centers for Medicare and Medicaid Services (CMS). Please note that the definitions for emergency and non-emergency are listed separately.

Basic Life Support (BLS): When medically necessary, the provision of BLS services as defined in the National EMS Education and Practice Blueprint for the EMT-Basic, including the establishment of a peripheral intravenous line.

Advanced Life Support, Level 1 (ALS1): When medically necessary, the provision of an assessment by an ALS provider or supplier or the provision of one or more ALS interventions. An ALS provider/supplier is defined as a provider trained to the level of EMT-Intermediate or Paramedic as defined in the National EMS Education and Practice Blueprint. An ALS intervention is defined as any procedure beyond the scope of an EMT-Basic.

Advanced Life Support, Level 2 (ALS2): When medically necessary, the administration of three or more different medications and the provision of at least one of the following ALS procedures:

• Manual defribrillation/cardioversion
• Endotracheal intubation
• Central Venous Line
• Cardiac Pacing
• Chest Decompression
• Surgical Airway
• Intraosseous Line

Specialty Care Transport: When medically necessary, for a critically injured or ill beneficiary, a level of inter-facility service provided beyond the scope of the paramedic as defined in the National EMS Education and Practice Blueprint. This is necessary when a beneficiary’s condition requires ongoing care that must be provided by one or more health professionals in an appropriate specialty area, e.g. nursing, medicine respiratory care, cardiovascular care, or a paramedic with additional training.

Emergency: An emergency response in one that is provided after the sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity such that absence of immediate medical attention could reasonably be expected to result in:

1. Placing the beneficiary’s health in serious jeopardy;
2. Impairment to bodily functions; or
3. Serious dysfunction to any bodily organ or part.

Non-Emergency: Ambulance transportation is covered when it meets medical necessity requirements. One of the primary, but not the sole, determining factors of medical necessity for non-emergency transport is the status of whether the patient is “bed confined." For bed confinement, the following criteria must be met:

1. The beneficiary is unable to get up from bed without assistance;
2. The beneficiary is unable to ambulance; and
3. The beneficiary is unable to sit in a chair or wheelchair.

This term applies to patient’s who are unable to tolerate activity out of bed. Please note that bed confinement is not the sole criteria for medical necessity of a non-emergent transport.