Critical Care Transport Standard Charges
| HCPCS | DESCRIPTION | CHARGE |
|---|---|---|
| A0225 | Ambulance service, neonatal transport, base rate, emergency transport, one way | $8,135.00 |
| A0425 | Ground mileage, per statute mile | $62.00 |
| A0426 | Ambulance service, advanced life support, nonemergency transport, level 1 (ALS 1) | $3,406.00 |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (ALS 1 - emergency) - GENERAL | $3,756.00 |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (ALS 1 - emergency) - NEONATAL | $3,219.00 |
| A0428 | Ambulance service, basic life support, nonemergency transport, (BLS) | $2,768.00 |
| A0429 | Ambulance service, basic life support, emergency transport (BLS, emergency) | $2,315.00 |
| A0430 | Ambulance service, conventional air services, transport, one way (fixed wing) | $65,000.00 |
| A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | $46,000.00 |
| A0433 | Advanced life support, level 2 (ALS 2) | $3,944.00 |
| A0434 | Specialty care transport (SCT) - GENERAL | $5,368.00 |
| A0434 | Specialty care transport (SCT) - NEONATAL | $7,118.00 |
| A0435 | Fixed wing air mileage, per statute mile | $155.00 |
| A0436 | Rotary wing air mileage, per statute mile | $443.00 |
| A0888 | Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility) - FIXED WING | $155.00 |
| A0888 | Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility) - GROUND | $62.00 |
| A0888 | Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility) - ROTARY WING | $443.00 |
| S9960 | Ambulance service, conventional air services, nonemergency transport, one way (fixed wing) | $65,000.00 |
| S9961 | Ambulance service, conventional air service, nonemergency transport, one way (rotary wing) | $46,000.00 |
Prices are effective July 1, 2025