A0428 HCPCS code: Ambulance service, basic life support, non-emergency transport, (bls)
A0428 is the HCPCS Level II code for ambulance service, basic life support, non-emergency transport, (bls). In 2024 Medicare paid an average of $206.38 per service for A0428 across 2,956,154 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 8% from 2022 to 2024 (3,225,722 to 2,956,154 services). In 2024, about 4,223 clinicians billed Medicare for A0428 for 1,283,126 beneficiaries; Texas, New Jersey, Georgia accounted for 25% 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 A0428 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 4,223 |
| Medicare beneficiaries | 1,283,126 |
| States with claims | 54 |
| Share of services in top 3 states (Texas, New Jersey, Georgia) | 25% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A0428, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 3,225,722 | 1,321,409 | $231.50 | $183.07 |
| 2023 | 2,997,474 | 1,288,362 | $253.05 | $200.38 |
| 2024 | 2,956,154 | 1,283,126 | $260.65 | $206.38 |
States with the most A0428 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 272,219 | $195.01 |
| New Jersey | 239,418 | $205.14 |
| Georgia | 220,211 | $176.73 |
| California | 208,727 | $246.35 |
| New York | 188,310 | $238.61 |
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 A0428
- 2001-01-01: A0428 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 A0428?
A0428 is the HCPCS Level II code for ambulance service, basic life support, non-emergency transport, (bls). Short descriptor: "Bls".
How much does Medicare pay for A0428?
In 2024, the average Medicare payment was $206.38 per service (average allowed $260.65).
Does Medicare cover A0428?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of A0428 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
- A0426 — Ambulance service, advanced life support, non-emergency transport, level 1 (als 1)
- A0427 — Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)
- 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)
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Next steps
- Run a reimbursement report for a device billed under A0428
- Watch A0428 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A0428
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.