The HCPCS procedure codes listed in the following table are the only reimbursable procedure codes, per the Ancillary Provider Agreement. Hospital-owned providers are subject to their respective contracts. Submit the most appropriate HCPCS procedure codes when billing for services.
|* Applies to hospital-based ambulance services only.|
|Note: HCPCS procedure code A0998 (ambulance response and treatment; no transport), if billed, will deny as not covered, member responsibility.|