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MedicaidReimbursementHigh impact

MAB2024041801

Pennsylvania Medicaid (DHS)·PA · Emergency Medicine·Provider Bulletin
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Pennsylvania Medical Assistance (Medicaid) significantly increased ambulance service fees and now pays for all loaded miles instead of only miles beyond 20. Ground mileage increased from $4.00 to $13.20 per mile, and service fees increased substantially (e.g., BLS emergency from $325 to $562.05).

Action Required

Action needed
Immediately: Billing team must update fee schedules in billing system to reflect new Pennsylvania Medicaid ambulance rates effective January 1, 2024. Update A0425 ground mileage to $13.20 per loaded mile (now all miles, not just beyond 20 miles). Update all ambulance service codes (A0426-A0434, A0436) with new fee amounts. Resubmit any claims for dates of service January 1, 2024 or later that were processed with old rates - these will be automatically reprocessed by the state.

Affected Billing Codes

A0425
A0426
A0427
A0428
A0429
A0430
A0431
A0432
A0433
A0434
A0436