A0426 HCPCS code: Ambulance service, advanced life support, non-emergency transport, level 1 (als 1)
A0426 is the HCPCS Level II code for ambulance service, advanced life support, non-emergency transport, level 1 (als 1). In 2024 Medicare paid an average of $259.34 per service for A0426 across 218,943 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 2 per day on outpatient hospital claims. Medicare volume fell 2% from 2022 to 2024 (224,411 to 218,943 services). In 2024, about 2,559 clinicians billed Medicare for A0426 for 196,454 beneficiaries; Florida, Ohio, Texas accounted for 21% of services.
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 52 |
| BETOS category | O1A — Ambulance |
| Added | 2001-01-01 |
| Last action effective | 2001-01-01 |
Who bills A0426 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 2,559 |
| Medicare beneficiaries | 196,454 |
| States with claims | 51 |
| Share of services in top 3 states (Florida, Ohio, Texas) | 21% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A0426, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 224,411 | 199,913 | $295.54 | $233.16 |
| 2023 | 216,580 | 194,846 | $319.04 | $252.48 |
| 2024 | 218,943 | 196,454 | $327.72 | $259.34 |
States with the most A0426 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 15,469 | $253.04 |
| Ohio | 15,307 | $244.11 |
| Texas | 14,831 | $258.34 |
| California | 12,024 | $299.69 |
| Illinois | 11,259 | $256.61 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 2 | Clinical: Data |
| practitioner claims | 2 | Clinical: Data |
What changed for A0426
- 2001-01-01: A0426 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code A0426?
A0426 is the HCPCS Level II code for ambulance service, advanced life support, non-emergency transport, level 1 (als 1). Short descriptor: "Als 1".
How much does Medicare pay for A0426?
In 2024, the average Medicare payment was $259.34 per service (average allowed $327.72).
Does Medicare cover A0426?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of A0426 can be billed per day?
2 on outpatient hospital claims; 2 on practitioner claims (NCCI medically unlikely edits).
Related A04 codes
- A0420 — Ambulance waiting time (als or bls), one half (1/2) hour increments
- A0422 — Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation
- A0424 — Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged); (requires medical review)
- A0425 — Ground mileage, per statute mile
- A0427 — Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)
- A0428 — Ambulance service, basic life support, non-emergency transport, (bls)
- A0429 — Ambulance service, basic life support, emergency transport (bls-emergency)
- A0430 — Ambulance service, conventional air services, transport, one way (fixed wing)
- A0431 — Ambulance service, conventional air services, transport, one way (rotary wing)
- A0432 — Paramedic intercept (pi), rural area, transport furnished by a volunteer ambulance company which is prohibited by state law from billing third party payers
- A0433 — Advanced life support, level 2 (als 2)
- A0434 — Specialty care transport (sct)
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under A0426
- Watch A0426 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A0426
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.