Multi-passenger Ambulance Transports Require GM and 32

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  • October 19, 2009
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Changes the Centers for Medicare & Medicaid Services (CMS) recently made to the Medicare Claims Processing Internet Only Manual may affect the way providers and suppliers report claims for multi-passenger ambulance services in the near future.

CMS issued, Sept. 25, Transmittal 1821, Change Request 6621 to communicate claims processing instructions added to the Ambulance chapter, sections 30.1.2 and 30.2.

Coding Instructions for Paper and Electronic Claims Forms

Effective Oct. 26, ambulance suppliers submitting CMS-1500 or ANSI X12N 837 claim form for an ambulance transport involving more than one Medicare patient on board must use modifier GM Multiple patient on one ambulance trip for each service line item.

Suppliers are also required to submit documentation to specify the particulars of a multiple patient transport. Documentation should include the total number of patients transported in the vehicle at the same time and the health insurance claim (HIC) number for each Medicare patient.

Fiscal Intermediary Shared System (FISS) Guidelines

Also effective Oct. 26, for claims with dates of service on or after April 1, 2002, providers should report value code 32 Multiple patient ambulance transport when an ambulance transports more than one patient at a time to the same destination. Report the number of patients transported in the amount field as a whole number to the left of the delimiter.

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