COVID-19 (Coronavirus): Ground ambulance transport services for Medicare Advantage members

April 20, 2020

Independence is committed to providing our members with access to the care they need. As COVID-19 has escalated into a pandemic, we are working to make sure that our members can receive appropriate testing and treatment for the virus causing COVID-19 if needed.

We encourage all Independence members to visit our dedicated COVID-19 webpage regularly for the latest news and updates. We will continue to evaluate member needs as the situation changes.

Temporary expansion of covered destinations

Independence is expanding ground ambulance transport services for Medicare Advantage members in accordance with the Centers for Medicare & Medicaid Services (CMS). The list of covered destinations for medically necessary ground ambulance transportation (emergency and nonemergency) from any point of origin will be expanded to include, but not limited to, any of the following:

  • any location that is an alternative site determined to be part of a hospital, critical access hospital (CAH), or skilled nursing facility (SNF)
  • community mental health centers
  • federally qualified health centers (FQHCs)
  • rural health clinics (RHCs)
  • physician offices
  • urgent care facilities
  • ambulatory surgical centers (ASCs)
  • any location furnishing dialysis services outside of an end stage renal disease (ESRD) facility when an ESRD facility is not available
  • an individual's home

Billing and coding for ground transportation services

The following HCPCS codes are eligible for ground transportation services:

●   A0140         ●   A0427         ●   A0433 
●   A0225         ●   A0428         ●   A0434 
●   A0426         ●   A0429 

The following Revenue codes are eligible for ground transportation services:

●   0540         ●   0543         ●   0549 
●   0542         ●   0546 

The following Origin and Destination modifiers should be used when submitting claims:

Origin and destination locations Modifier

Diagnostic or therapeutic site other than P or H when these are used as origin codes:

  • community mental health center
  • FQHC
  • RHC
  • urgent care facility
  • non-provider-based ASC or freestanding emergency center
  • location furnishing dialysis services and not affiliated with ESRD facility

D

Residential

  • domiciliary, custodial facility (other than 1819 facility)
  • domiciliary, custodial facility (other than 1819 facility) if the facility is the beneficiary’s home

E

Hospital-based ESRD facility

G

  • hospital
  • alternative care site for hospital, including CAH
  • provider-based ASC
  • freestanding emergency center

H

Site of transfer (e.g., airport or helicopter pad) between modes of ambulance transport

I

Freestanding ESRD facility

J

Skilled nursing facility; alternative care site for SNF

N

Physician’s office

P

Residence; beneficiary’s home

R

Scene of accident or acute event

S

Intermediate stop at physician’s office on way to hospital (This is a destination code only.)

X

You can view the complete announcement, Ground Ambulance Transport Services (Emergency and Nonemergency) for Medicare Advantage Members, in the Medicare Advantage News & Announcements section of the Medical Policy Portal.

Learn more

For more information about Independence’s position on COVID-19, please review the following resources: