Code | Allowable Fee | Description of Code |
A0425 | $6.45 | Ground mileage, per statute mile (loaded mileage) |
A0426 | $250.65 | Ambulance service, advanced life support, nonemergency transport, level 1 (ALS 1) |
A0427 | $396.86 | Ambulance service, advanced life support, emergency transport, level 1 (ALS 1 -emergency) |
A0428 | $208.87 | Ambulance service, basic life support, nonemergency transport (BLS) |
A0429 | $334.19 | Ambulance service, basic life support, emergency transport (BLS-emergency) |
A0430 | $4,036.04 | Ambulance service, conventional air services, transport, one way (fixed wing) |
A0431 | $4,036.04 | Ambulance service, conventional air services, transport, one way (rotary wing) |
A0433 | $574.40 | Advanced life support, level 2 (ALS 2) |
A0434 | $678.83 | Specialty care transport (SCT) |
A0170 | I.C. | Transportation ancillary; parking fees, tolls, other (used only for ferry charges) |
A0999 | I.C. | Unlisted ambulance service. (Used for transporting patients who require special resources to be safely transported including, but not limited to, bariatric patients.) |
Code | Allowable Fee | Description of Code |
A0130 | $40.55 | Nonemergency transportation; wheelchair van (each way) |
S0215 | $1.46 | Nonemergency transportation; mileage, per mile (wheelchair van, loaded mileage) |
T2001 | $8.00 | Nonemergency transportation; patient attendant/escort (wheelchair van, each way) |
101 CMR, § 327.03