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:
- Transfer from one hospital to another (modifier HH)
- Transportation from hospital to diagnostic or therapeutic site (modifier HD)
Mileage for transportation to non-covered MO HealthNet services should not be billed. Refer to the Non-Emergency Medical Transportation (NEMT) Provider Manual for more information regarding NEMT.
Please join MO HealthNet’s Ambulance Webinar on April 3, 2024, to hear more about billing, how to navigate MO HealthNet provider resources, eMOMED, the Spend Down Program and more.
Reference the Ambulance Provider Manual, Section 2, for Benefits and Limitations. For additional questions regarding billing, contact Provider Communications via eMOMED or by calling (573) 751-2896. Visit the MHD Education and Training page or contact Education and Training at MHD.Education@dss.mo.gov for training information.