A0428
The Ambulance Fee Schedule a national fee schedule for ambulance services furnished as a benefit under Medicare Part B. The fee schedule applies to all ambulance services, including volunteer, municipal, private, independent, and institutional providers, hospitals, critical access hospitals (except when it is the only ambulance service within 35 miles), and skilled nursing facilities.
HCPCS code A0428 - Ambulance service, basic life support, non-emergency transport, (bls)
Each year, an update is applied to the payment limits for ambulance transports that is equal to the percentage increase in the Consumer Price Index for All Urban Consumers (CPI-U) for the 12-month period ending with June of the previous year.
See also DME Fee Schedule · Carrier Locality Codes
Carrier | Locality | RVU | GPCI | Base Rate | Urban Base Rate Urban Mileage |
Rural Base Rate Rural Mileage |
Rural Base Rate Lowest Quartile |
Rural Ground Miles (1-7) |
---|---|---|---|---|---|---|---|---|
10112 |
00
ALABAMA
- STATEWIDE
|
1.00 | 0.8690 | 272.44 | 252.41 | 254.88 | 312.48 | n/a |
02102 |
01
ALASKA
- STATEWIDE
|
1.00 | 1.0810 | 272.44 | 293.65 | 296.52 | 363.53 | n/a |
03102 |
00
ARIZONA
- STATEWIDE
|
1.00 | 0.9750 | 272.44 | 273.03 | 275.7 | 338.01 | n/a |
07102 |
13
ARKANSAS
- STATEWIDE
|
1.00 | 0.8600 | 272.44 | 250.66 | 253.11 | 310.31 | n/a |
01112 |
54
CALIFORNIA
- BAKERSFIELD (KERN COUNTY)
|
1.00 | 1.0930 | 272.44 | 295.98 | 298.88 | 366.43 | n/a |
01112 |
55
- CHICO (BUTTE COUNTY)
|
1.00 | 1.0930 | 272.44 | 295.98 | 298.88 | 366.43 | n/a |
01182 |
71
- EL CENTRO (IMPERIAL COUNTY)
|
1.00 | 1.0930 | 272.44 | 295.98 | 298.88 | 366.43 | n/a |
01112 |
56
- FRESNO
|
1.00 | 1.0930 | 272.44 | 295.98 | 298.88 | 366.43 | n/a |
01112 |
57
- HANFORD-CORCORAN (KINGS COUNTY)
|
1.00 | 1.0930 | 272.44 | 295.98 | 298.88 | 366.43 | n/a |
01182 |
18
- LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES COUNTY)
|
1.00 | 1.1940 | 272.44 | 315.63 | 318.72 | 390.75 | n/a |
01112 |
58
- MADERA
|
1.00 | 1.0930 | 272.44 | 295.98 | 298.88 | 366.43 | n/a |
01112 |
59
- MERCED
|
1.00 | 1.0930 | 272.44 | 295.98 | 298.88 | 366.43 | n/a |
01112 |
60
- MODESTO (STANISLAUS COUNTY)
|
1.00 | 1.0930 | 272.44 | 295.98 | 298.88 | 366.43 | n/a |
01112 |
51
- NAPA
|
1.00 | 1.3100 | 272.44 | 338.19 | 341.51 | 418.69 | n/a |
01182 |
17
- OXNARD-THOUSAND OAKS-VENTURA
|
1.00 | 1.1830 | 272.44 | 313.49 | 316.56 | 388.10 | n/a |
01112 |
61
- REDDING (SHASTA COUNTY)
|
1.00 | 1.0930 | 272.44 | 295.98 | 298.88 | 366.43 | n/a |
01112 |
62
- RIVERSIDE-SAN BERNARDINO-ONTARIO (SAN BERNARDINO AND RIVERSIDE COUNTY)
|
1.00 | 1.0930 | 272.44 | 295.98 | 298.88 | 366.43 | n/a |
01112 |
63
- SACRAMENTO-ROSEVILLE-ARDEN-ARCADE (SACRAMENTO, PLACER, YOLO, EL DORADO)
|
1.00 | 1.1560 | 272.44 | 308.23 | 311.26 | 381.60 | n/a |
01112 |
64
- SALINAS (MONTEREY COUNTY)
|
1.00 | 1.1650 | 272.44 | 309.98 | 313.02 | 383.76 | n/a |
01182 |
72
- SAN DIEGO-CARLSBAD
|
1.00 | 1.1910 | 272.44 | 315.04 | 318.13 | 390.03 | n/a |
01112 |
05
- SAN FRANCISCO (SAN FRANCISCO COUNTY)
|
1.00 | 1.4190 | 272.44 | 359.39 | 362.92 | 444.94 | n/a |
01112 |
52
- SAN FRANCISCO-OAKLAND-HAYWARD (MARIN COUNTY)
|
1.00 | 1.4190 | 272.44 | 359.39 | 362.92 | 444.94 | n/a |
01112 |
65
- SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO COUNTY)
|
1.00 | 1.4350 | 272.44 | 362.51 | 366.06 | 448.79 | n/a |
01182 |
73
- SAN LUIS OBISPO-PASO ROBLES-ARROYO GRANDE
|
1.00 | 1.1320 | 272.44 | 303.57 | 306.54 | 375.82 | n/a |
01112 |
09
- SANTA CLARA (SANTA CLARA COUNTY)
|
1.00 | 1.4350 | 272.44 | 362.51 | 366.06 | 448.79 | n/a |
01112 |
66
- SANTA CRUZ-WATSONVILLE
|
1.00 | 1.2090 | 272.44 | 318.54 | 321.67 | 394.37 | n/a |
01182 |
74
- SANTA MARIA-SANTA BARBARA
|
1.00 | 1.1750 | 272.44 | 311.93 | 314.99 | 386.18 | n/a |
01112 |
67
- SANTA ROSA (SONOMA COUNTY)
|
1.00 | 1.2320 | 272.44 | 323.02 | 326.18 | 399.90 | n/a |
01112 |
68
- STOCKTON-LODI (SAN JOAQUIN COUNTY)
|
1.00 | 1.0930 | 272.44 | 295.98 | 298.88 | 366.43 | n/a |
01112 |
53
- VALLEJO-FAIRFIELD (SOLANO COUNTY)
|
1.00 | 1.3100 | 272.44 | 338.19 | 341.51 | 418.69 | n/a |
01112 |
69
- VISALIA-PORTERVILLE (TULARE COUNTY)
|
1.00 | 1.0930 | 272.44 | 295.98 | 298.88 | 366.43 | n/a |
01112 |
70
- YUBA CITY (SUTTER, YUBA)
|
1.00 | 1.0930 | 272.44 | 295.98 | 298.88 | 366.43 | n/a |
01112 |
75
- CALIFORNIA (ALL OTHER COUNTIES)
|
1.00 | 1.0930 | 272.44 | 295.98 | 298.88 | 366.43 | n/a |
04112 |
01
COLORADO
- STATEWIDE
|
1.00 | 1.0530 | 272.44 | 288.2 | 291.02 | 356.79 | n/a |
13102 |
00
CONNECTICUT
- STATEWIDE
|
1.00 | 1.0910 | 272.44 | 295.59 | 298.49 | 365.95 | n/a |
12102 |
01
DELAWARE
- STATEWIDE
|
1.00 | 0.9920 | 272.44 | 276.33 | 279.04 | 342.10 | n/a |
09102 |
03
FLORIDA
- FORT LAUDERDALE (BROWARD, COLLIER, INDIAN RIVER, LEE, MARTIN, PALM BEACH, AND ST. LUCIE)
|
1.00 | 0.9980 | 272.44 | 277.5 | 280.22 | 343.55 | n/a |
09102 |
04
- MIAMI (DADE AND MONROE COUNTY)
|
1.00 | 1.0270 | 272.44 | 283.14 | 285.92 | 350.54 | n/a |
09102 |
99
- REST OF STATE
|
1.00 | 0.9400 | 272.44 | 266.22 | 268.83 | 329.59 | n/a |
01212 |
01
HAWAII
- HAWAII, GUAM, AMERICAN SAMOA, MARSHALL ISLANDS, PALAU, NORTHERN MARIANA ISLANDS, FEDERATED STATES OF MICRONESIA
|
1.00 | 1.1490 | 272.44 | 306.87 | 309.88 | 379.91 | n/a |
02202 |
00
IDAHO
- STATEWIDE
|
1.00 | 0.9080 | 272.44 | 259.99 | 262.54 | 321.87 | n/a |
06102 |
16
ILLINOIS
- CHICAGO (COOK COUNTY)
|
1.00 | 1.0230 | 272.44 | 282.36 | 285.13 | 349.57 | n/a |
06102 |
12
- EAST ST. LOUIS (BOND, CALHOUN, CLINTON, JERSEY, MACOUPIN, MADISON, MONROE, MONTGOMERY, RANDOLPH, ST. CLAIR AND WASHINGTON)
|
1.00 | 0.9180 | 272.44 | 261.94 | 264.51 | 324.29 | n/a |
06102 |
15
- SUBURBAN CHICAGO (DUPAGE, KANE, LAKE AND WILL)
|
1.00 | 1.0480 | 272.44 | 287.23 | 290.04 | 355.59 | n/a |
06102 |
99
- REST OF STATE
|
1.00 | 0.9120 | 272.44 | 260.77 | 263.33 | 322.84 | n/a |
08102 |
00
INDIANA
- STATEWIDE
|
1.00 | 0.9220 | 272.44 | 262.72 | 265.29 | 325.25 | n/a |
05102 |
00
IOWA
- STATEWIDE
|
1.00 | 0.9130 | 272.44 | 260.97 | 263.52 | 323.08 | n/a |
05202 |
00
KANSAS
- STATEWIDE
|
1.00 | 0.9060 | 272.44 | 259.6 | 262.15 | 321.40 | n/a |
15102 |
00
KENTUCKY
- STATEWIDE
|
1.00 | 0.8770 | 272.44 | 253.96 | 256.45 | 314.41 | n/a |
07202 |
01
LOUISIANA
- NEW ORLEANS (JEFFERSON, ORLEANS, PLAQUEMINES AND ST. BERNARD)
|
1.00 | 0.9350 | 272.44 | 265.24 | 267.85 | 328.38 | n/a |
07202 |
99
- REST OF STATE
|
1.00 | 0.8810 | 272.44 | 254.74 | 257.24 | 315.38 | n/a |
14112 |
03
MAINE
- SOUTHERN MAINE (CUMBERLAND AND YORK COUNTY)
|
1.00 | 1.0120 | 272.44 | 280.22 | 282.97 | 346.92 | n/a |
14112 |
99
- REST OF STATE
|
1.00 | 0.9130 | 272.44 | 260.97 | 263.52 | 323.08 | n/a |
12302 |
01
MARYLAND
- BALTIMORE/SURROUNDING COUNTIES
|
1.00 | 1.0780 | 272.44 | 293.06 | 295.93 | 362.81 | n/a |
12302 |
99
- REST OF STATE
|
1.00 | 1.0160 | 272.44 | 281 | 283.76 | 347.89 | n/a |
14212 |
01
MASSACHUSETTS
- METROPOLITAN BOSTON (MIDDLESEX, NORFOLK AND SUFFOLK)
|
1.00 | 1.1970 | 272.44 | 316.21 | 319.31 | 391.47 | n/a |
14212 |
99
- REST OF STATE
|
1.00 | 1.0610 | 272.44 | 289.75 | 292.6 | 358.73 | n/a |
08202 |
01
MICHIGAN
- DETROIT (MACOMB, OAKLAND, WASHTENAW AND WAYNE)
|
1.00 | 0.9860 | 272.44 | 275.17 | 277.86 | 340.66 | n/a |
08202 |
99
- REST OF STATE
|
1.00 | 0.9110 | 272.44 | 260.58 | 263.13 | 322.60 | n/a |
06202 |
00
MINNESOTA
- STATEWIDE
|
1.00 | 1.0250 | 272.44 | 282.75 | 285.52 | 350.05 | n/a |
07302 |
00
MISSISSIPPI
- STATEWIDE
|
1.00 | 0.8520 | 272.44 | 249.1 | 251.54 | 308.39 | n/a |
05302 |
02
MISSOURI
- METROPOLITAN KANSAS CITY (CLAY, JACKSON AND PLATTE)
|
1.00 | 0.9480 | 272.44 | 267.77 | 270.4 | 331.51 | n/a |
05302 |
01
- METROPOLITAN ST. LOUIS (JEFFERSON, ST. CHARLES, ST. LOUIS AND ST. LOUIS CITY)
|
1.00 | 0.9520 | 272.44 | 268.55 | 271.18 | 332.47 | n/a |
05302 |
99
- REST OF STATE
|
1.00 | 0.8590 | 272.44 | 250.46 | 252.92 | 310.08 | n/a |
03202 |
01
MONTANA
- STATEWIDE
|
1.00 | 1.0000 | 272.44 | 277.89 | 280.61 | 344.03 | n/a |
05402 |
00
NEBRASKA
- STATEWIDE
|
1.00 | 0.9170 | 272.44 | 261.74 | 264.31 | 324.04 | n/a |
01312 |
00
NEVADA
- STATEWIDE
|
1.00 | 1.0000 | 272.44 | 277.89 | 280.61 | 344.03 | n/a |
14312 |
40
NEW HAMPSHIRE
- STATEWIDE
|
1.00 | 1.0340 | 272.44 | 284.5 | 287.29 | 352.22 | n/a |
12402 |
01
NEW JERSEY
- NORTHERN NEW JERSEY (BERGEN, ESSEX, HUDSON, HUNTERDON, MIDDLESEX, MORRIS, PASSAIC, SOMERSET, SUSSEX, UNION AND WARREN)
|
1.00 | 1.1720 | 272.44 | 311.35 | 314.4 | 385.45 | n/a |
12402 |
99
- REST OF STATE
|
1.00 | 1.1060 | 272.44 | 298.51 | 301.43 | 369.55 | n/a |
04212 |
05
NEW MEXICO
- STATEWIDE
|
1.00 | 0.9080 | 272.44 | 259.99 | 262.54 | 321.87 | n/a |
13202 |
01
NEW YORK
- MANHATTAN
|
1.00 | 1.1660 | 272.44 | 310.18 | 313.22 | 384.01 | n/a |
13202 |
02
- NYC SUBURBS/LONG ISLAND (BRONX, KINGS, NASSAU, RICHMOND, ROCKLAND, SUFFOLK AND WESTCHESTER)
|
1.00 | 1.2000 | 272.44 | 316.79 | 319.9 | 392.20 | n/a |
13202 |
03
- POUGHKPSIE/N NYC SUBURBS (COLUMBIA, DELAWARE, DUTCHESS, GREENE, ORANGE, PUTNAM, SULLIVAN AND ULSTER)
|
1.00 | 1.1060 | 272.44 | 298.51 | 301.43 | 369.55 | n/a |
13292 |
04
- QUEENS
|
1.00 | 1.1950 | 272.44 | 315.82 | 318.92 | 391.00 | n/a |
13282 |
99
- REST OF STATE
|
1.00 | 0.9490 | 272.44 | 267.97 | 270.6 | 331.76 | n/a |
11502 |
00
NORTH CAROLINA
- STATEWIDE
|
1.00 | 0.9260 | 272.44 | 263.49 | 266.08 | 326.21 | n/a |
03302 |
01
NORTH DAKOTA
- STATEWIDE
|
1.00 | 1.0000 | 272.44 | 277.89 | 280.61 | 344.03 | n/a |
15202 |
00
OHIO
- STATEWIDE
|
1.00 | 0.9110 | 272.44 | 260.58 | 263.13 | 322.60 | n/a |
04312 |
00
OKLAHOMA
- STATEWIDE
|
1.00 | 0.8910 | 272.44 | 256.69 | 259.2 | 317.78 | n/a |
02302 |
01
OREGON
- PORTLAND (CLACKAMAS, MULTNOMAH AND WASHINGTON)
|
1.00 | 1.1030 | 272.44 | 297.92 | 300.85 | 368.84 | n/a |
02302 |
99
- REST OF STATE
|
1.00 | 0.9860 | 272.44 | 275.17 | 277.86 | 340.66 | n/a |
12502 |
01
PENNSYLVANIA
- METROPOLITAN PHILADELPHIA (BUCKS, CHESTER, DELAWARE, MONTGOMERY AND PHILADELPHIA)
|
1.00 | 1.0530 | 272.44 | 288.2 | 291.02 | 356.79 | n/a |
12502 |
99
- REST OF STATE
|
1.00 | 0.9270 | 272.44 | 263.69 | 266.27 | 326.45 | n/a |
09202 |
20
PUERTO RICO
- PUERTO RICO
|
1.00 | 1.0070 | 272.44 | 279.25 | 281.99 | 345.72 | n/a |
14412 |
01
RHODE ISLAND
- STATEWIDE
|
1.00 | 1.0390 | 272.44 | 285.48 | 288.27 | 353.42 | n/a |
11202 |
01
SOUTH CAROLINA
- STATEWIDE
|
1.00 | 0.9130 | 272.44 | 260.97 | 263.52 | 323.08 | n/a |
03402 |
02
SOUTH DAKOTA
- STATEWIDE
|
1.00 | 1.0000 | 272.44 | 277.89 | 280.61 | 344.03 | n/a |
10312 |
35
TENNESSEE
- STATEWIDE
|
1.00 | 0.8960 | 272.44 | 257.66 | 260.18 | 318.98 | n/a |
04412 |
31
TEXAS
- AUSTIN (TRAVIS COUNTY)
|
1.00 | 1.0460 | 272.44 | 286.84 | 289.65 | 355.11 | n/a |
04412 |
20
- BEAUMONT (JEFFERSON COUNTY)
|
1.00 | 0.9030 | 272.44 | 259.02 | 261.56 | 320.67 | n/a |
04412 |
09
- BRAZORIA
|
1.00 | 1.0060 | 272.44 | 279.06 | 281.79 | 345.47 | n/a |
04412 |
11
- DALLAS
|
1.00 | 1.0070 | 272.44 | 279.25 | 281.99 | 345.72 | n/a |
04412 |
28
- FORT WORTH (TARRANT COUNTY)
|
1.00 | 0.9980 | 272.44 | 277.5 | 280.22 | 343.55 | n/a |
04412 |
15
- GALVESTON (TARRANT COUNTY)
|
1.00 | 1.0000 | 272.44 | 277.89 | 280.61 | 344.03 | n/a |
04412 |
18
- HOUSTON
|
1.00 | 1.0030 | 272.44 | 278.47 | 281.2 | 344.75 | n/a |
04412 |
99
- REST OF STATE
|
1.00 | 0.9450 | 272.44 | 267.19 | 269.81 | 330.79 | n/a |
03502 |
09
UTAH
- STATEWIDE
|
1.00 | 0.9330 | 272.44 | 264.86 | 267.45 | 327.89 | n/a |
14512 |
50
VERMONT
- STATEWIDE
|
1.00 | 0.9930 | 272.44 | 276.53 | 279.24 | 342.35 | n/a |
09202 |
50
VIRGIN ISLANDS
- VIRGIN ISLANDS
|
1.00 | 1.0070 | 272.44 | 279.25 | 281.99 | 345.72 | n/a |
11302 |
00
VIRGINIA
- STATEWIDE
|
1.00 | 0.9840 | 272.44 | 274.78 | 277.47 | 340.18 | n/a |
02402 |
02
WASHINGTON
- WASHINGTON SEATTLE (KING COUNTY)
|
1.00 | 1.2200 | 272.44 | 320.68 | 323.83 | 397.02 | n/a |
02402 |
99
- REST OF STATE
|
1.00 | 1.0400 | 272.44 | 285.67 | 288.47 | 353.66 | n/a |
12202 |
01
WASHINGTON, DC
- DC + MD/VA SUBURBS (DISTRICT OF COLUMBIA; ALEXANDRIA CITY, ARLINGTON, FAIRFAX, FAIRFAX CITY, FALLS CHURCH CITY IN VIRGINIA; MONTGOMERY AND PRINCE GEORGE'S IN MARYLAND)
|
1.00 | 1.1920 | 272.44 | 315.24 | 318.33 | 390.27 | n/a |
11402 |
16
WEST VIRGINIA
- STATEWIDE
|
1.00 | 0.8620 | 272.44 | 251.04 | 253.51 | 310.80 | n/a |
06302 |
00
WISCONSIN
- STATEWIDE
|
1.00 | 0.9570 | 272.44 | 269.52 | 272.17 | 333.68 | n/a |
03602 |
21
WYOMING
- STATEWIDE
|
1.00 | 1.0000 | 272.44 | 277.89 | 280.61 | 344.03 | n/a |
The fee schedule on this page is for informational purposes only. All official fee schedule files that are used to process Medicare claims are maintained by Medicare Administrative Contractors (MACs) and could vary slightly from the amounts referenced here. Contact your local MAC for official pricing information.
This is the identifier used by the Centers for Medicare and Medicaid Services to identify the entity which has the responsibility for adjudicating and paying claims within a defined geographical location.
This field represents subsets of locations within a defined jurisdiction with different GPCI's.
RVUs set a numeric value for ambulance services relative to the value of a base level ambulance service. Since there are marked differences in resources necessary to furnish the various levels of ground ambulance services, different levels of payment are appropriate for the various levels of service. The different payment amounts are based on level of service. An RVU expresses the constant multiplier for a particular type of service (including, where appropriate, an emergency response). An RVU of 1.00 is assigned to the Basic Life Support (BLS) level of ground service, i.e., BLS has an RVU of 1; higher RVU values are assigned to the other types of ground ambulance services, which require a higher level of service than BLS.
Service Level | RVU |
---|---|
A0428 BLS | 1.00 |
A0429 BLS - Emergency | 1.60 |
A0426 ALS1 | 1.20 |
A0427 ALS1 - Emergency | 1.90 |
A0433 ALS2 | 2.75 |
A0434 SCT | 3.25 |
A0432 PI | 1.75 |
The GPCI for the practice expense portion of the Medicare physician fee schedule is used to adjust payment to account for regional differences. The geographic areas applicable to the ambulance fee schedule are the same as those used for the physician fee schedule.
The location where the beneficiary was put into the ambulance (“point of pickup”) establishes which GPCI applies. For multiple vehicle transports, i.e., where ground ambulance transports to an air ambulance, each leg of the transport is separately evaluated for the applicable GPCI.
Thus, for the second (or any subsequent) leg of a transport, the point of pickup establishes the applicable GPCI for that portion of the ambulance transport.
The Base Rate is a nationally uniform “base” amount used to calculate each HCPCS payment amount.
This field displays one of four rates calculated as such*:
This field displays one of four rates calculated as such*:
The “super-rural bonus” payment rate applies only to ground ambulance transports originating in a rural area determined by the Secretary to be in the lowest 25th percentile of all rural populations arrayed by population density. Medicare contractors will apply this amount to the base rate when the point of pickup (POP) is in one of a group of designated rural ZIP codes. In order to calculate the “super-rural bonus“ payment rate of 22.6%, multiply any rural ground ambulance transport service payment rate by .226.
For example, for HCPCS A0428 (BLS), for Carrier 01112, Locality 05, use the rural rate of $286.18 and multiply by 0.226 for a bonus payment rate (286.18 * 0.226 = 64.68) and then add that bonus rate to the rural rate (286.18 + 64.68 = 350.86).
This field displays the amounts for rural ground miles 1-17.
For ground rural miles 1-17, the mileage rate for ground transports provided in a rural area is 1.5 times the rural mileage rate per mile.
(The urban ground mileage rate applies to all miles of an ambulance transport originating in an urban area.)
This field displays a rural amount for the air base rate and air mileage. The amount payable for the base rate and all air miles for all air transportation originating in a rural area is 1.5 times the urban air base and mileage rates.