Last Modified: 6/4/2024
Location: FL, PR, USVI
Business: Part A, Part B
Q. What type of documentation is acceptable for ambulance mileage?
A. There are several ways to capture, and document loaded ambulance mileage, including:
• Odometer reading
• Trip odometer readings
• Global Positioning System (GPS)
• Navigation computers
• Mapping programs (e.g., MapQuest)
These are all acceptable forms of documentation and must be kept in the patient’s record and made available to Medicare upon request.
Note: Documentation must include the name and address of the origin and destination in the trip report completed by the ambulance supplier.
Q. Are air ambulance services payable when a patient requires a transfer from one hospital to another hospital?
A. Yes, air ambulance services are payable from hospital to hospital, if it meets medical appropriateness criteria and the transferring hospital does not have adequate facilities to provide the medical services needed by the patient. We, at First Coast, will only reimburse to the nearest available medically appropriate facility.
Reference:
Q. Where can I find information on the physician certification statement?
Q. Can I bill for a round trip ambulance service?
A. Yes, you can bill for a round trip ambulance service as long as it meets all requirements for a medically necessary ambulance service. If the point of pickup (POP) zip code is the same then the round trip can be billed on the same claim, if not two separate claims must be submitted.
Example (same POP zip code; same claim):
If you transport a Medicare patient from their residence (R) to hospital (H), report the appropriate ambulance transport Healthcare Common Procedure Coding System (HCPCS) code (AXXXX) and mileage code A0425 with modifiers RH (residence to hospital) appended to each code. The number of loaded miles is reported with the mileage code.
The return trip is reported with the appropriate HCPCS ambulance code and mileage code A0425 with modifiers HR (hospital to residence) appended to each code. The number of loaded miles is reported with the mileage code.
There will be a total of four lines billed.
Example (different POP zip codes; two separate claims):
If you transport a Medicare patient from their residence to hospital, report the appropriate ambulance transport HCPCS code and mileage code A0425 with modifiers RH appended to each code. The number of loaded miles is reported with the mileage code.
The return trip is billed on the second claim. Report the appropriate HCPCS ambulance code and mileage code A0425 with modifiers HR appended to each code. The number of loaded miles is reported with the mileage code.
Reference:
Note: Part B ambulance suppliers follow instructions in section 30.1; Part A providers billing Part B ambulance services follow instructions in section 30.2.
Q. Where can I locate information on the new ground ambulance date collection system?
Q. Where can I locate ambulance modifiers?
Q. Where can I locate information on the ambulance prior authorization process?
A. The information is located under medical review (JH)(JL) and our Ambulance Specialty page.
Q. Where can I locate information on obtaining beneficiary signature?
A. Beneficiary signature requirements related to ambulance services, can be found in the following:
Q. Are beneficiary lifetime signatures valid for ambulance claims?
A. Yes, as found in the references below:
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.