2025 HCPCS code A0434
Specialty care transport (SCT) by ground ambulance vehicle, one way interfacility transport; critically ill or injured patient.
Medical necessity for A0434 must be substantiated by the patient's critical or unstable condition requiring specialized care or equipment not available at the original facility. The transport must be between facilities.
The ambulance provider ensures the safe transport of the critically ill or injured patient between facilities. They are responsible for providing all necessary medical services and supplies during transport. Specialized medical personnel with the appropriate training and certifications, according to state regulations, accompany the patient to provide care.
- A: Transportation Services, Medical and Surgical Supplies, Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) and Miscellaneous Supplies
- A0021-A0999
In simple words: This code covers the cost of transporting a very sick or injured patient between hospitals or medical facilities using a ground ambulance staffed with specialized medical personnel and equipment to provide necessary care during the transfer.
This code represents the interfacility transportation of a critically ill or injured patient by a ground ambulance, including the delivery of all medically necessary services and supplies.The transport is one way and occurs between facilities.
Example 1: A patient in critical condition following a car accident requires transfer from a rural hospital to a Level 1 trauma center for specialized surgical intervention. A0434 is used for the ground ambulance transport, including continuous medical care during the transfer., A neonate requiring specialized care in a neonatal intensive care unit (NICU) needs to be transferred to another facility with a higher level of NICU services. A0434 covers the transport by a ground ambulance with specialized personnel and equipment for neonatal care., A patient on a ventilator requires interfacility transport for a specialized diagnostic procedure not available at the current facility.A0434 covers the ground ambulance transport with necessary life support equipment and specialized medical personnel to manage the ventilator and patient’s condition during transport.
Documentation should clearly indicate the patient's critical condition, the medical necessity for interfacility transport, the level of service provided during transport (including the qualifications of medical personnel), and the origin and destination facilities.A detailed account of the patient's condition and care during transport is essential.
** Reimbursement for this code involves carrier judgment. The definition of "critically ill or injured" may vary by payer.It is important to contact iFrameAI directly for further insights.
- Payment Status: Active
- Specialties:Emergency Medicine, Critical Care, Neonatology (and potentially other specialties depending on patient’s condition), Ambulance Services
- Place of Service:Ambulance - Land