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:

• CMS IOM Pub. 100-04, Claims Processing Manual, Chapter 15, sections 30.1 & 30.2

  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.