HCPCS procedure codes are used for Ambulance service The HCPCS procedure codes listed in the following table are the only reimbursable procedure codes, per the Ancillary Provider Agreement. Hospital-owned providers are subject to their respective contracts. Submit the most appropriate HCPCS procedure codes when billing for services.
| Procedure Codes | Description |
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| | A0225 | Ambulance service, neonatal transport, base rate, emergency transport, one way | | A0384 | Basic life support, specialized service - defibrillation (where permitted) | | A0392 | Advanced life support, specialized service, defibrillation (where not permitted by basic life support) | | A0394 | Advanced life support disposable supplies - IV drug therapy | | A0396 | Advanced life support disposable supplies - esophageal intubation | | A0422 | Oxygen and oxygen supplies | | A0425 | Ground Mileage-per mile | | A0426 | Advanced Life Support, non-emergency-base rate | | A0427 | Advanced Life Support, Level I - base rate | | A0428 | Basic Life Support, non-emergency-base rate | | A0429 | Basic Life Support, emergency-base rate | | A0433 | Advanced Life Support, Level II -base rate | | A0434 | Specialty Care Transport | | S0208* | Paramedic intercept, hospital-based ALS service (non-voluntary), non-transport | |
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| * Applies to hospital-based ambulance services only. |
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| Note: HCPCS procedure code A0998 (ambulance response and treatment; no transport), if billed, will deny as not covered, member responsibility. |
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