Ambulance Transport Refusal

Although the HCPCS A0998 definition states "Ambulance response and treatment, no transport," this code has a Medicare Physician Fee Schedule (MPFS) status indicator of "I." Status "I" codes are not valid for Medicare reimbursement.

To receive a proper denial from Medicare to bill the patient when treatment nor a transport was provided, ambulance suppliers may:

  • Submit claim with unlisted HCPCS A0999; append GY modifier, and
  • Include comment "Patient refused transport" or "No transport" in Item 19 on CMS-1500 paper claim form or its electronic equivalent
  • Claim will deny "Patient Responsibility" (PR)

No Advance Beneficiary Notice of Noncoverage (ABN) is necessary

  • May use voluntarily ABN for non-emergent transports

Last Updated Fri, 25 Aug 2017 15:10:35 +0000