A0433 HCPCS code: Advanced life support, level 2 (als 2)
A0433 is the HCPCS Level II code for advanced life support, level 2 (als 2). In 2024 Medicare paid an average of $594.95 per service for A0433 across 85,086 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 1 per day on outpatient hospital claims. Medicare volume fell 5% from 2022 to 2024 (89,954 to 85,086 services). In 2024, about 5,585 clinicians billed Medicare for A0433 for 82,577 beneficiaries; Texas, Florida, California accounted for 29% 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 A0433 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 5,585 |
| Medicare beneficiaries | 82,577 |
| States with claims | 51 |
| Share of services in top 3 states (Texas, Florida, California) | 29% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A0433, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 89,954 | 87,644 | $676.49 | $532.99 |
| 2023 | 84,324 | 82,109 | $731.55 | $577.46 |
| 2024 | 85,086 | 82,577 | $753.58 | $594.95 |
States with the most A0433 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 8,977 | $588.61 |
| Florida | 8,642 | $574.28 |
| California | 6,787 | $687.85 |
| North Carolina | 3,924 | $563.07 |
| New York | 3,085 | $633.25 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Clinical: Data |
| practitioner claims | 1 | Clinical: Data |
What changed for A0433
- 2001-01-01: A0433 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 A0433?
A0433 is the HCPCS Level II code for advanced life support, level 2 (als 2). Short descriptor: "Als 2".
How much does Medicare pay for A0433?
In 2024, the average Medicare payment was $594.95 per service (average allowed $753.58).
Does Medicare cover A0433?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of A0433 can be billed per day?
1 on outpatient hospital claims; 1 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)
- 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
- A0434 — Specialty care transport (sct)
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Next steps
- Run a reimbursement report for a device billed under A0433
- Watch A0433 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A0433
Sources: CMS HCPCS Level II release October 2026; 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.