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US · guidance

CMS Pub. 100-04, ch. 19, § 100.12.1.1

A/B MAC (A) - Outpatient Hospital-Based Ambulance

activein force · 2026-08-25 – presentas-observed

Services - Medicare Part B - Claims Processing

(Rev. 1040, Issued: 08-25-06, Effective: 09-11-06, Implementation: 09-11-06)

Outpatient ambulance bills from hospital-based ambulance providers are submitted with

revenue code 054X (ambulance) with charges for ambulance, as well as the appropriate

ambulance HCPCS codes on TOB 12X or 13X.

If an outpatient encounter occurs at the same time a covered ambulance service is

provided, the hospital-based ambulance providers may bill for a clinic visit (revenue code

051X) as well as the ambulance charges (revenue code 054X) and will be paid separately

for each service.

The MSN is suppressed.

History

(Rev. 1040, Issued: 08-25-06, Effective: 09-11-06, Implementation: 09-11-06)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
7fab84c6cdcd1515719bc532b5d177201840a31d82d35336dd434cff160e3749
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