PCS Forms in Roundtrip – Roundtrip

What Is a PCS Form?

A Physician Certification Statement (PCS) is a signed statement confirming that ambulance transport is medically necessary for the rider's condition at the time of transport. It can be signed by a Physician, Physician's Assistant, Nurse Practitioner, Clinical Nurse Specialist, Discharge Planner, or Registered Nurse.

Why It's Needed

Medicare requires a signed PCS for all non-emergency ambulance transports, to confirm the transport is reasonable and medically necessary. See the federal regulation for details (42 CFR §410.40).

Does My Organization Require One?

If yes, you'll be asked to create or upload a PCS on Step 3 of booking — but only for stretcher and ambulance rides. If your organization doesn't require this in Roundtrip, no action is needed here.

Your organization may still require a physical copy separately. Always follow your organization's own workflow.

Creating a PCS Form

If you're a credentialed party, you can fill one out directly in Roundtrip:

Click Create PCS.

Fill in the requested fields.

Click Save Information.

Once the ride is booked, the form is automatically generated as a PDF.

Only use Create PCS if you're personally credentialed to attest to medical necessity. If you're not, use Upload PCS instead.

Uploading a PCS Form

Use this option if you're not a credentialed party, or if your organization requires its own specific PCS form.

Click Upload PCS.

Select the completed, signed form from your device and click Open.

Enter the clinical details explaining why ambulance transport is medically necessary.

Click Continue.

Once booked, the form is available on the ride's Trip Details page.

Finding a PCS Form on a Booked Ride

Open the ride's Trip Details page.

Expand the Payer tab.

Click Download next to the PCS Form field.

Transportation Providers can access this the same way.

Editing a Ride With a PCS Form

Electronically-created PCS forms update their signature to whoever edits the ride — which is a problem if that person isn't a credentialed party. Here's how to avoid that:

Just changing the ride or will-call time? Use Change Ride Time or Set Ride Time at the top of the page. This does not affect the PCS signature — no extra steps needed.

Making any other edit through the full Edit Trip flow? If you're not a credentialed party:

On the Trip Details page, expand Payer and click Download next to PCS Form.

Save that PDF to your device.

Click Edit Trip and make your changes as usual.

On Step 3, click Upload PCS and upload the form you just downloaded, instead of using the electronic version.

Continue through the flow and click Book Trip on Step 5 to save.

See Editing and Canceling Transports for more on the edit flow in general.