MedicaidBilling CodesMedium impact
Ambulance Billing for Procedure Code A0428
Missouri Medicaid (MO HealthNet)·MO · Emergency Medicine·Provider Notice
Effective date
Mar 29, 2024
We identified it
Jun 20, 2026
Summary
MO HealthNet Division requires ambulance providers to use specific modifiers when billing procedure code A0428 (BLS non-emergency transport). Code A0428 can only be billed with modifier HH (hospital-to-hospital transfer) or HD (hospital to diagnostic/therapeutic site).
Action Required
Immediately: Billing team must update system to require modifier HH or HD when billing A0428 for ambulance services. Only bill A0428 for hospital-to-hospital transfers (HH) or hospital-to-diagnostic site transport (HD). Stop billing A0428 without appropriate modifiers or claims will be denied. Review current A0428 claims to ensure compliance.