Ambulance Transport When Beneficiary Dies

When determining reimbursement for an ambulance transport when a beneficiary dies depends on the time at which the beneficiary is pronounced dead.

View reimbursement information for air and ground ambulance transports when the beneficiary dies.

Air Ambulance

Time of Death Pronouncement Medicare Reimbursement Determination
Before beneficiary is loaded on ambulance:
  • Dispatcher receives pronouncement of death and has reasonable opportunity to notify pilot to abort flight
  • Aircraft has taxied but has not taken off, or, at a controlled airport, has been cleared for takeoff but has not yet taken off
 None
After takeoff to POP (at point-of-pickup) and before beneficiary is loaded on ambulance Air base rate, no mileage or rural adjustment; use QL modifier
After pickup, prior to/ upon arrival at receiving facility Appropriate air base rate, mileage, and rural adjustment, if applicable

Ground Ambulance

Time of Death Pronouncement Medicare Reimbursement Determination
Before dispatch None
After dispatch, before patient is loaded on ambulance, before/ after arrival at point-of-pickup (POP) BLS base rate, no mileage or rural adjustment; use QL modifier
After pickup, prior to/ upon arrival at receiving facility Level of service furnished (base rate/mileage)

Beneficiary Pronounced Dead After Ambulance Called But Prior to Pick-up

  • Bill appropriate HCPCS base rate
    • A0428 (BLS; non-emergency transport)
    • Append QL modifier after origin/destination modifiers
    • Bill without mileage or rural adjustments
  • Date of service (DOS) is the vehicle dispatch date, and mileage is measured from the dispatch point to the point of pickup (POP)
  • Trip report/run sheet/medical documentation must include the time the call came in, and time the patient passed away

Resource

Last Updated Sep 29 , 2026