MedicaidReimbursementMedium impact
Encounter Submissions for Medi-Cal Ground Emergency Medical Transportation (GEMT) Services
L.A. Care Health Plan·CA · Emergency Medicine·Coding
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Summary
L.A. Care Health Plan updated enhanced reimbursement rates for Ground Emergency Medical Transportation (GEMT) services under Medi-Cal, with different add-on amounts for private vs public GEMT providers. The policy requires all GEMT encounters to be submitted correctly and promptly to ensure proper Quality Assurance Fee remittance.
Action Required
Immediately: Billing team must ensure all Ground Emergency Medical Transportation encounters using codes A0429, A0427, A0433, A0434, and A0225 are submitted correctly and as quickly as possible. Verify provider designation as 'private' or 'public' GEMT provider to ensure correct add-on reimbursement amounts are applied. Contact assigned L.A. Care Account Manager with any questions.