2025 HCPCS code QL

Modifier QL is used to indicate that a patient was pronounced dead after an ambulance was called, but before transport.

Follow guidelines from Medicare and other payers when using modifier QL. Note that base rates for life support may be reimbursed, but mileage and rural adjustments may not be covered under Medicare.

Modifier QL can be used with ambulance service HCPCS codes (e.g., A0427).

The medical necessity for the ambulance dispatch is based on the initial emergency call. Although transport did not occur due to the patient's prior death, the response itself is medically necessary.

Ambulance services personnel and the qualified provider declaring death are responsible.

In simple words: If a doctor declares a patient dead at the scene after an ambulance is called but before the patient is transported, the ambulance service uses modifier QL on their bill. This tells the insurance company that the patient was deceased upon arrival.

Modifier QL applies to ambulance services where the ambulance arrives at the scene (accident site, home, etc.), and a qualified provider declares the patient legally dead before transport in the ambulance. This modifier ensures proper payment adjustments, reflecting the basic life support base rate but not mileage or rural service adjustments for Medicare. Other payers may have different policies.

Example 1: A car accident occurs, and an ambulance is dispatched. Upon arrival, paramedics find the patient has already passed away. A physician or other authorized provider at the scene confirms the death. Modifier QL is appended to the ambulance service code., A 911 call is made for an elderly patient who collapsed at home. The ambulance arrives, and paramedics determine the patient is deceased. A physician contacted by phone confirms the death. The ambulance service bills using modifier QL., An individual experiences a sudden cardiac arrest in a public place. An ambulance is called, but bystanders initiate CPR. Upon arrival, paramedics and a physician at the scene pronounce the patient dead. Modifier QL is applied to the ambulance service claim.

Documentation should include the time of ambulance arrival, the time of death declaration, and the identity of the provider pronouncing death. A clear statement confirming that the patient was deceased prior to any transport is essential.

** Always verify payer-specific guidelines for using modifier QL and related reimbursement policies.

  • Payment Status: Active
  • Specialties:Emergency Medical Services
  • Place of Service:Ambulance - Land, Ambulance - Air or Water
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