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Missouri Medicaid (MO HealthNet)Medicaid · Billing Codes · Provider Notice · MO · Emergency MedicineMedium impact

Ambulance Billing for Procedure Code A0428

Act
immediately
Effective date
Mar 29, 2024
Identified
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).

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What to do

immediately · 4 steps
01Billing team must update system to require modifier HH or HD when billing A0428 for ambulance services.
02Only bill A0428 for hospital-to-hospital transfers (HH) or hospital-to-diagnostic site transport (HD).
03Stop billing A0428 without appropriate modifiers or claims will be denied.
04Review current A0428 claims to ensure compliance.

Codes mentioned

A0428

Original notice

Ambulance Billing for Procedure Code A0428
mydss.mo.gov · Always check the source before changing claims.
View original ↗

Related changes

See all Missouri Medicaid (MO HealthNet) changes →
CMS Approves Ground Ambulance Transport to Behavioral Health Crisis Centers (BHCCs) State Plan Amendment (SPA)MediumEffective Jan 1, 2026 · Provider BulletinNavigating the Miles How to Bill for Ground Ambulance MileageMediumEffective Jun 8, 2026 · Provider NoticeBrowse every Missouri Medicaid (MO HealthNet) change in the policy list

Related policy hubs

Missouri Medicaid (MO HealthNet) policiesMO policy changesEmergency MedicineCode A0428

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