Last Modified: 11/12/2017 Location: FL, PR, USVI Business: Part A, Part B
Q: When billing Part B ambulance services, how should the number of miles billed be reported?
A: Beginning with dates of service on or after January 1, 2011, mileage billed must be reported as fractional units in the following situations:
• Where billing is by ASC X12 claims transaction (professional or institutional), and
• Where billing is by CMS-1500 paper form.
Electronic billers should see the appropriate Implementation Guide to determine where to report the fractional units. Item 24G of the Form CMS-1500 paper claim is used.
Fractional units are not required on Form CMS-1450
For trips totaling up to 100 covered miles suppliers must round the total miles up to the nearest tenth of a mile and report the resulting number with the appropriate HCPCS code for ambulance mileage. The decimal must be used in the appropriate place (e.g., 99.9).
For trips totaling 100 covered miles and greater, suppliers must report mileage rounded up to the next whole number mile without the use of a decimal (e.g., 998.5 miles should be reported as 999).
For trips totaling less than 1 mile, enter a “0” before the decimal (e.g., 0.9).
For mileage HCPCS billed on the ASC X12 837 professional transaction or the CMS-1500 paper form only, contractors shall automatically default to “0.1” units when the total mileage units are missing.
Source: MLN Matters ® article MM7065
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