Monday, October 18, 2010

AMbulance billing payment calculation - CPT A0425

Ground Mileage Procedure Code A0425

Zip Code Designation       Pricing Period        Quantity           AFSDB Component Calculation

Urban                                7/1/04 and After     Miles 1-50            Urban AFSDB
                                                                            Miles 51+             125% X Urban AFSDB

Rural or Super Rural         7/1/04 to 12-31-06   Miles 1-17               150% X Rural AFSDB
                                                                         Miles 18-50                 Rural AFSDB
                                                                             Miles 51+             125% X Rural AFSDB

“R” or “B” Status zip codes*   1-1-07 and After Miles 1-17                     150% X AFSDB
                                                                   Miles 18 - 50                       AFSDB                    
                                                                   Miles 51+                         125% X Urban AFSDB

*A“B” designation (super rural) indicates that the ZIP code is in a rural county (or Goldsmith area) that is comprised by the lowest quartile by population of all such rural areas arrayed by population density.

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