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Official Description

Non-emergency transportation: per mile - case worker or social worker
Short Descr Noner transport case worker
Coverage Not payable by Medicare
Pricing Indicator(s) 00 – Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
MPI 9 – Not applicable, as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
BETOS O1A – Ambulance
TOS Code(s) D – Ambulance
Added Date 1/1/1984
Status Code Not Valid for Medicare Purposes
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 9 - Not Applicable
Multiple Procedures (51) 9 - Concept does not apply.
Bilateral Surgery (50) 9 - Concept does not apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 9 - Concept does not apply.
Co-Surgeons (62) 9 - Concept does not apply.
Team Surgery (66) 9 - Concept does not apply.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Non-Covered Service, not paid under OPPS
MUE 0
MUE Not applicable/unspecified.
OTS Orthotic No
CCS Clinical Classification 239 - Transportation - patient, provider, equipment
HN Bachelors degree level
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
HH Integrated mental health/substance abuse program
HR Family/couple with client present
HE Mental health program
EP Service provided as part of medicaid early periodic screening diagnosis and treatment (epsdt) program
GW Service not related to the hospice patient's terminal condition
HJ Employee assistance program
HP Doctoral level
NR New when rented (use the 'nr' modifier when dme which was new at the time of rental is subsequently purchased)
PN Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital
RD Drug provided to beneficiary, but not administered "incident-to"
RP Replacement and repair -rp may be used to indicate replacement of dme, orthotic and prosthetic devices which have been in use for sometime. the claim shows the code for the part, followed by the 'rp' modifier and the charge for the part.
TN Rural/outside providers' customary service area
U2 Medicaid level of care 2, as defined by each state
U3 Medicaid level of care 3, as defined by each state
U8 Medicaid level of care 8, as defined by each state
Date
Action
Notes
1984-01-01 Added Code added 1/1/1984
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