Ambulance Services: Multiple Beneficiary Transport

The most common occurrence of this is at the scene of an accident. It doesn't matter whether all injured parties transported are Medicare patients or not.

  • Append a special modifier when transporting more than one patient at a time.
  • In addition to origin/destination modifier, must bill each line of service with a GM modifier (in second position)
  • Include number of patients in comment/narrative line 19 of the CMS-1500 Claim Form or electronic equivalent.
  • Bill full trip charge amount and Noridian will calculate correct amounts, with deductible and coinsurance amounts pro-rated

Two Patient Transport

  • Medicare will allow 75% of payment allowance of base rate billed for level of service plus 50% of total mileage allowance for trip

Three Patient Transport

  • Medicare will allow 60% of payment allowance of base rate billed for level of service plus 50% of total mileage allowance for trip. Mileage is divided by number of patients onboard.

 

Last Updated Mon, 21 Nov 2022 18:28:35 +0000