Navigating the Miles How to Bill for Ground Ambulance Mileage

Navigating the Miles: How to Bill for Ground Ambulance Mileage


When billing for ambulance ground mileage, bill the total ground mileage one-way from the point of pickup to the destination.

Sometimes you need to use the EP modifier, which means the trip is for a Healthy Children and Youth (HCY) transport. If the base procedure code is billed with an EP modifier, then the ground mileage procedure code (A0425) must also be billed with an EP modifier. Do not use any modifiers with the ground mileage procedure code A0425 for any other type of trip.

Look Who is Paying for Treatment Without Transport!

Look Who is Paying for Treatment Without Transport!

Certain emergency services are covered by the MO HealthNet Division (MHD) when the participant is not transported to an emergency department. This is referred to as Treat No Transport. A Treat No Transport call can include first responders providing patient care and dispensing medical supplies, but ultimately not transporting the participant to the hospital. 

PACE Benefit Table

Program of All-Inclusive Care for the Elderly (PACE) Benefit Table

The Program of All-Inclusive Care for the Elderly (PACE) is administered by MO HealthNet and Medicare to provide comprehensive health care, social, recreational, and wellness services to its participants. One of the main goals of PACE is to allow older adults to live safely in their homes instead of nursing facilities. As of May 3, 2024, PACE organizations are active in St. Louis and Kansas City, with a new PACE organization coming to the Springfield area later this year.

Ambulance Billing for Procedure Code A0428

Ambulance Billing for Procedure Code A0428

The MO HealthNet Division (MHD) requires all MHD enrolled Ambulance providers to use appropriate modifiers when billing. Recently, we noticed some providers have been billing procedure code A0428 (Ambulance service, Basic Life Support (BLS) non-emergency transport) without the appropriate modifiers. A0428 should only be billed in the following circumstances: 

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