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Travel allowance for collection of specimens

The travel allowance is intended to cover the estimated travel costs of collecting a specimen and to reflect the technician’s salary and travel costs. Travel allowance may be made in addition to a medically necessary specimen collection fee when the specimen is collected from a nursing home or homebound patient.

Per mile travel allowance (P9603)

  • Used in situations where the average trip to patients’ homes is longer than 20 miles round trip.
  • For services rendered in calendar year (CY) 2025 the travel allowance is $1.20 per mile:
  • Is to be pro-rated in situations where specimens are drawn or picked up from non-Medicare patients in the same trip.
  • No allowance will be made when a technician is acting as a messenger service to pick-up a specimen drawn by a physician or nursing home personnel.
  • No allowance will be made if the technician arrives for pick-up and no specimen is retrieved (e.g., patient refusal of collection).
  • May not be paid to a physician unless the trip to the home or nursing home was solely for the purpose of drawing or collecting a specimen:
    • Travel costs are not separately reimbursable if services are rendered for patient care at the time of the drawing or collection of a specimen.

Flat rate (P9604)

  • Used in situations where average trips are less than 20 miles round trip.
  • For services rendered in CY 2025, one-way flat rate travel allowance has a minimum reimbursement of $12:
  • One unit is billed per stop:
    • If a single trip is done to and from a Medicare patient's home the units are calculated and billed as two.
  • Specimen collection fee will be paid for each patient encounter.
  • Flat rate travel fee is to be pro-rated for more than one blood drawn at the same address, and for stops at the homes of Medicare and non-Medicare patients:
    • Laboratory does the pro-ration when the claim is submitted based on the number of patients seen on that trip.

Place of service codes

Independent laboratories must submit HCPCS code P9603 (per mile) or P9604 (flat rate) for each patient encounter for places of service:

  • 12 - home
  • 13 - assisted living facility
  • 14 - group home
  • 31 - nursing facility
  • 32 - domiciliary care
  • 33 - custodial care
  • 54 - intermediate care facility

Note: Claims will be denied for travel allowance submitted with place of service 81 - independent lab.

Modifier LR

Laboratories should submit HCPCS modifier LR (informational purposes only) to indicate "round trip" when using HCPCs code P9604 (Travel allowance, prorated trip charge).

Documentation tips

Be sure to include:

  • All available documentation that supports medical necessity of services.
  • Travel log supporting miles billed and how many specimens were received / collected.
  • Verification of miles billed with online mapping programs (e.g., Google Maps, MapQuest, etc.):
    • Include the address of specimen pickup.

Claims correction

If you determine that incorrect information was submitted on your claim or your claim was billed in error, please use one of the following to update your claim:

Please review our Appeals webpage for helpful resources on how to correct or update your claim.

 

References