2025 HCPCS code A0998
(Valid as of 2024-12-01) Effective Date: N/A Revision Date: N/A Ambulance and Other Transport Services and Supplies - Ambulance response and treatment, no transport A Codes: Transportation Services, Medical and Surgical Supplies, Durable Medical Equipment, Prosthetics, Orthotics, and DME Information Technology Feed
Ambulance response and treatment, but no transport provided.
Modifiers may apply based on specific payer rules and the circumstances of the non-transport.
While the service itself isn't covered by Medicare, the documentation should still justify the medical necessity of the ambulance response.The initial complaint should warrant an ambulance response due to the potential for a serious or life-threatening condition.
The ambulance crew responds to the emergency call, assesses the patient's condition, and administers necessary prehospital treatment.This can include basic life support, first aid, and certain tests or minor procedures. The crew also determines whether transport is necessary and ensures the patient's well-being, even if transport is refused.
- A Codes: Transportation Services, Medical and Surgical Supplies, Durable Medical Equipment, Prosthetics, Orthotics, and DME Information Technology
- A0021-A0999
In simple words: An ambulance came to a medical emergency and treated someone, but that person didn't need or want to be taken to the hospital in the ambulance.
This code reports an ambulance response to a call where the crew treats the patient, but the patient either refuses transport or ultimately doesn't require it. This may be due to the patient's condition improving after initial treatment or the patient choosing to seek alternative means of transportation.
Example 1: A patient experiences chest pain and calls 911.The ambulance arrives, performs an ECG, and administers medication. The patient's pain subsides, and they decide to go to the hospital with a family member later, refusing ambulance transport., An individual sustains a minor injury at a public event.The ambulance crew cleans and bandages the wound. The patient declines transport, preferring to continue their activities. , An elderly person falls at home. The paramedics assess the patient and find no serious injuries. They advise the patient's family on appropriate care, and the patient chooses not to be transported to a hospital.
Documentation should include details of the emergency call, the patient's initial condition, the assessment and treatment provided by the ambulance crew, the reason for not transporting the patient (refusal or not medically necessary), and the patient's condition at the time the ambulance left the scene.
** Although Medicare does not cover this specific code, other payers may have different coverage policies. Always verify coverage with the individual payer. Thorough documentation is essential for justifying the ambulance response and any subsequent claims.
- Payment Status: Not payable by Medicare
- Specialties:Emergency Medical Services
- Place of Service:Ambulance - Land, Patient's Home, Other Place of Service (depending on the location of the incident)