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MedicaidReimbursementMedium impact

Fee-for-service air ambulance rates, codes and modifier effective July 1, 2024

Oregon Health Plan·OR · Emergency Medicine, Critical Care·Provider
Effective date
Jul 1, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Oregon Health Authority has updated fee-for-service air ambulance reimbursement rates effective July 1, 2024, adding separate codes for rotary-wing and fixed-wing mileage, introducing the TN modifier for higher rural pickup rates, and increasing rates to 80% of 2024 Medicare rates. The new system includes specific urban and rural rates for both fixed-wing and rotary-wing air ambulance services.

Action Required

Action needed
Immediately: Billing team must update system to use new air ambulance codes A0435 (fixed-wing mileage), A0436 (rotary-wing mileage), A0430 (fixed-wing transport), and A0431 (rotary-wing transport) for all Oregon Medicaid claims with dates of service on or after July 1, 2024. Add TN modifier for rural pickup locations to receive higher reimbursement rates. Resubmit or adjust any previously denied claims with service dates after July 1, 2024 using the updated rates and codes.

Affected Billing Codes

A0435
A0436
A0430
A0431