Type of Service (TOS) Indicator D: Ambulance

HCPCS codes

CodeDescription
A0021  Ambulance service, outside state per mile, transport (medicaid only)  
A0080  Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest  
A0090  Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest  
A0100  Non-emergency transportation; taxi  
A0110  Non-emergency transportation and bus, intra or inter state carrier  
A0120  Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems  
A0130  Non-emergency transportation: wheelchair van  
A0140  Non-emergency transportation and air travel (private or commercial) intra or inter state  
A0160  Non-emergency transportation: per mile - case worker or social worker  
A0170  Transportation ancillary: parking fees, tolls, other  
A0180  Non-emergency transportation: ancillary: lodging-recipient  
A0190  Non-emergency transportation: ancillary: meals-recipient  
A0200  Non-emergency transportation: ancillary: lodging escort  
A0210  Non-emergency transportation: ancillary: meals-escort  
A0225  Ambulance service, neonatal transport, base rate, emergency transport, one way  
A0380  Bls mileage (per mile)  
A0382  Bls routine disposable supplies  
A0384  Bls specialized service disposable supplies; defibrillation (used by als ambulances and bls ambulances in jurisdictions where defibrillation is permitted in bls ambulances)  
A0390  Als mileage (per mile)  
A0392  Als specialized service disposable supplies; defibrillation (to be used only in jurisdictions where defibrillation cannot be performed in bls ambulances)  
A0394  Als specialized service disposable supplies; iv drug therapy  
A0396  Als specialized service disposable supplies; esophageal intubation  
A0398  Als routine disposable supplies  
A0420  Ambulance waiting time (als or bls), one half (1/2) hour increments  
A0422  Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation  
A0424  Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged); (requires medical review)  
A0425  Ground mileage, per statute mile  
A0426  Ambulance service, advanced life support, non-emergency transport, level 1 (als 1)  
A0427  Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)  
A0428  Ambulance service, basic life support, non-emergency transport, (bls)  
A0429  Ambulance service, basic life support, emergency transport (bls-emergency)  
A0430  Ambulance service, conventional air services, transport, one way (fixed wing)  
A0431  Ambulance service, conventional air services, transport, one way (rotary wing)  
A0432  Paramedic intercept (pi), rural area, transport furnished by a volunteer ambulance company which is prohibited by state law from billing third party payers  
A0433  Advanced life support, level 2 (als 2)  
A0434  Specialty care transport (sct)  
A0435  Fixed wing air mileage, per statute mile  
A0436  Rotary wing air mileage, per statute mile  
A0800  AMBULANCE TRANSPORT PROVIDED BETWEEN THE HOURS OF 7PM AND 7AM  
A0888  Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility)  
A0998  Ambulance response and treatment, no transport  
A0999  Unlisted ambulance service  
S0208  Paramedic intercept, hospital-based als service (non-voluntary), non-transport  
S0209  Wheelchair van, mileage, per mile  
S0215  Non-emergency transportation; mileage, per mile  
S9960  Ambulance service, conventional air service, nonemergency transport, one way (fixed wing)  
S9961  Ambulance service, conventional air service, nonemergency transport, one way (rotary wing)  
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