Understanding Ambulance Services: Specialty Care Transport

Specialty Care Transport - SCT Transportation

Like BLS and ALS, Specialty Care Transport (SCT) is a category of the Levels of Service provided by ground ambulances. SCT-level transports are typically the interfacility transportation of a critically injured or ill patient. 

When is SCT needed?

The most common reason a patient needs SCT is for transportation from one hospital to another medical facility. Standard factors for an SCT run are: the patient’s condition requires care that must be provided in an appropriate specialty area, and the patient needs ALS and specialized medical monitoring or intervention during transport.

Some conditions requiring a Specialty Care Transport include trauma, cardiovascular care, respiratory failure, hemorrhaging, and threat to maternal/fetal life.

In Texas, the call must meet the following criteria to qualify as a Specialty Care Transport:

  • Interventions: vasopressors, vasoactive compounds, antiarrhythmics, fibrinolytics, tocolytics, blood or blood products and/or any other parenteral pharmaceutical. 
  • Special Monitoring/Procedures: mechanical ventilation, multiple monitors, cardiac balloon pump, external cardiac support, any other specialized device, vehicle, or procedure.

Requirements for Specialty Care Transport

The Centers for Medicare & Medicaid Services (CMS) declares that each State sets the EMT-Paramedic level of care. In compliance with the Texas Administrative Code, the minimum required staffing for a Specialty Care Transport ambulance is:

  • One certified EMT-Basic and one certified/licensed Paramedic with the required additional training*;
  • Or, a certified EMT-Basic and a certified Paramedic accompanied by at least one of the following: a Registered Nurse with knowledge of the patient’s care needs; a certified Respiratory Therapist; a licensed physician; or any licensed health care professional designated by the transferring physician.

*Additional Training refers to paramedic training and skills verification in managing critical care monitoring devices, medications, or other specialized procedures.

Texas also requires that SCT ambulances have all specialized equipment and supplies appropriate to the necessary interventions during the transport.

Reimbursement for SCT Transportation Claims

SCT transportation claims must indicate that the patient needed attention at a level of service above what standard paramedics can provide. To achieve that, it’s essential that the EMS agency supply detailed documentation about the SCT call in their electronic health record, which the billing company will use in the reimbursement process. 

The EMS provider documentation can state, “EMT-Paramedic with additional training.” This phrase identifies that the paramedic on the call qualifies to provide the specialty care required during the SCT.

According to CMS, if Paramedics – without specialty care qualification – are permitted to provide a service, it doesn’t qualify for SCT reimbursement.

EMERGICON’s teams are experts in processing SCT claims efficiently. If you have questions about Specialty Care Transport, contact our EMS & Client Hotline: 866-839-3671 |

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