A0434 HCPCS code: Specialty care transport (sct)
A0434 is the HCPCS Level II code for specialty care transport (sct). In 2024 Medicare paid an average of $729.40 per service for A0434 across 71,279 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. In 2024, about 1,181 clinicians billed Medicare for A0434 for 57,909 beneficiaries; California, Illinois, New Jersey accounted for 32% 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 A0434 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 1,181 |
| Medicare beneficiaries | 57,909 |
| States with claims | 47 |
| Share of services in top 3 states (California, Illinois, New Jersey) | 32% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A0434, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 70,676 | 54,807 | $828.79 | $659.01 |
| 2023 | 70,958 | 56,770 | $895.49 | $711.53 |
| 2024 | 71,279 | 57,909 | $918.36 | $729.40 |
States with the most A0434 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 11,361 | $814.00 |
| Illinois | 6,938 | $699.98 |
| New Jersey | 4,717 | $775.67 |
| New York | 4,613 | $781.13 |
| Florida | 3,771 | $684.06 |
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 A0434
- 2001-01-01: A0434 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 A0434?
A0434 is the HCPCS Level II code for specialty care transport (sct). Short descriptor: "Specialty care transport".
How much does Medicare pay for A0434?
In 2024, the average Medicare payment was $729.40 per service (average allowed $918.36).
Does Medicare cover A0434?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of A0434 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)
- 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)
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Next steps
- Run a reimbursement report for a device billed under A0434
- Watch A0434 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A0434
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.