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2025 HCPCS code A0426

Non-emergency transport by advanced life support ambulance, level 1 (ALS 1), including ALS assessment and/or at least one ALS intervention.

Use origin and destination modifiers to specify the pick-up and drop-off locations.

Applicable, two-digit origin and destination modifiers.

Medical necessity for non-emergency ALS ambulance transport must be clearly documented. The patient's condition must require the level of service provided and transport must be medically necessary.Transport for services that could be safely provided at the patient's location is typically not covered.

The ambulance staff, consisting of qualified emergency medical professionals, are responsible for providing ALS assessment, interventions, and monitoring during the non-emergency transport.

In simple words: Non-emergency ambulance transportation for a patient who needs advanced life support (ALS) care, such as cardiac monitoring, during transport.The ambulance is staffed with trained emergency medical personnel and equipped with specialized life-support equipment.

This code represents the non-emergency transport of a patient in an advanced life support (ALS) ambulance and provision of level one prehospital services, such as an ALS assessment and/or at least one ALS intervention by the ambulance staff, including all necessary supplies and services.An ALS assessment and/or at least one ALS intervention is performed. Minimal to moderate supplies are used.

Example 1: A bed-confined patient requires transport to a dialysis center for treatment., A patient on a ventilator needs transport from one hospital to another for specialized care., A patient with a chronic respiratory condition requires transport to a doctor's appointment and needs continuous monitoring of oxygen saturation levels.

Documentation should justify the medical necessity of ALS-level transport and specify the ALS interventions provided during transport.

** Medicare coverage for non-emergency ambulance transport is limited to situations where transport is medically necessary due to the patient's condition. Transport is not covered if the services could be safely provided at the patient's location.

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