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.
The table below shows the correct modifiers to use for the ground mileage procedure code A0425 when billing the base procedure codes and modifier combinations listed.
Base Procedure Code | Modifier | Description | How to bill A0425 (Ground Mileage) |
|---|---|---|---|
| A0426 | HH | Non-emergency, ALS1, hospital to hospital transfer, Limitation-Supplies | A0425 No Modifier |
| A0427 | N/A | ALS1, emergency transport | A0425 No Modifier |
| A0427 | EP | ALS1, emergency transport, Healthy Children and Youth (HCY) Limitation-Supplies | A0425 with EP Modifier |
| A0427 | HH | ALS1, emergency transport, hospital to hospital transfer | A0425 No Modifier |
| A0428 | HD | BLS, non-emergency, Specialized testing/treatment, round trip, Limitation-Supplies | A0425 No Modifier |
| A0428 | HH | BLS, non-emergency, hospital to hospital transfer, Limitation-Supplies | A0425 No Modifier |
| A0428 | SD | BLS non-emergency BHCC, Limitation Supplies | A0425 No Modifier |
| A0429 | BLS, emergency transport | A0425 No Modifier | |
| A0429 | EP | BLS, emergency transport, HCY Limitation Supplies | A0425 with EP Modifier |
| A0429 | HH | BLS, emergency transport, hospital to hospital transfer, Limitation-Supplies | A0425 No Modifier |
| A0433 | ALS2 | A0425 No Modifier | |
| A0433 | EP | ALS2, emergency transport, HCY Limitation Supplies | A0425 with EP Modifier |
| A0433 | HH | ALS2, hospital to hospital transfer, Limitation-Supplies | A0425 No Modifier |
Refer to Section 1.4 (Mileage) and Section 5 (Procedure Codes) of the Ambulance Provider Manual for further information regarding appropriate mileage billing and procedure codes.
For additional resources, refer to the Education and Training Resources page and/or sign up for a live webinar by accessing our Provider Training Calendar.
Email MHD.Education@dss.mo.gov for more information.