2025 HCPCS code A0160
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Transportation - Non-emergency transportation Ambulance and Other Transport Services and Supplies Feed
Non-emergency transportation per mile for case workers or social workers.
No modifiers are typically applied to this code; however, payer-specific requirements should be consulted.
The medical necessity for A0160 is established when the transportation is integral to the delivery of medically necessary case management, home health, or other clinical services that the case worker or social worker provides.
The clinical responsibility lies with the case worker or social worker who provides non-emergency transportation to facilitate patient care, whether it be home healthcare, case management, or other supportive services.
In simple words: This code is for the miles traveled by a social worker or case manager when they visit patients or clients for non-emergency medical reasons, such as going to their home or a facility.Medicare doesn't pay for this.
This HCPCS code represents the non-emergency travel, billed per mile, incurred by a case worker or social worker traveling to and from the nearest appropriate facility or to a patient's or client's home.The transportation is for a non-emergency medical purpose, supporting services such as home healthcare, case management, or transporting clients for medical/therapeutic services.It may also include non-medical transportation to assist clients in finding housing or employment. Medicare does not cover this service; verify coverage with the payer.
Example 1: A social worker travels 10 miles to a patient's home to conduct a home health assessment.A0160 would be reported for those 10 miles., A case manager drives 15 miles to a residential facility to meet with a client and discuss their discharge planning needs. The 15 miles would be billed using A0160., A social worker travels 5 miles to a client's home to assist with securing housing resources and employment leads. The 5 miles of transportation are reported using A0160.
Documentation should include the date of service, the number of miles traveled, the patient's name and address, the origin and destination of the trip, the reason for the visit (linking it to a medical necessity), and the provider's signature.
** This code should only be used when the transportation is directly related to providing medically necessary services. The miles must be accurately documented.It's crucial to verify coverage with the patient's insurance provider before submitting claims using A0160.
- Payment Status: Not covered by Medicare
- Modifier TC rule: Not applicable.
- Specialties:Social Work, Case Management, Home Health
- Place of Service:Office, Home, Other Place of Service