Billing reminders for ambulance providers

As we continue to transition to our next generation platform, we want to remind our Ambulance providers to follow CMS billing guidelines to ensure proper claims processing.

Ambulance reporting

Ambulance services should be reported according to CMS guidelines. Some examples of these reporting requirements are outlined below.

  • Ambulance services must be reported with an origin and destination modifier for each ambulance trip.
  • Ambulance services are typically billed with two lines of coding: one line for the service and one line for the mileage.
  • Follow these guidelines to report mileage:
    • Mileage reported should be the number of loaded statute miles (the number of miles traveled when the beneficiary was in the ambulance).
    • For ambulance trips totaling up to 100 covered miles, mileage must be reported as fractional units and should be rounded to nearest tenth of a mile with the decimal in the appropriate place:

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    • For ambulance trips 100 miles or more, mileage must be reported rounded up to the nearest whole number mile and not use a decimal:24-0034_AH_img_02.png

For more information, please refer to Chapter 15 of the CMS Medicare Claims Processing Manual​.