HCPCS A0425: Ground Mileage, Per Statute Mile
HCPCS Level II code A0425 represents ground ambulance mileage billed on a per statute mile basis and is a core component of ambulance transport reimbursement nationally. Mileage codes like A0425 matter because they separate distance-related charges from base transport services, affecting billing accuracy, claim adjudication, and overall emergency medical services (EMS) revenue. This summary addresses how mileage billing integrates with common ambulance service lines and clinical transports.
Key payers covered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what A0425 denotes, how it functions alongside ambulance level-of-care codes, and which payers typically process mileage charges. The publication outlines common clinical contexts where mileage is billed (for example, chest pain, syncope, respiratory failure, myocardial infarction, and concussion) and lists related ambulance service codes that are billed in combination with mileage.
The analysis provides practical benchmarks and policy-relevant notes for revenue cycle and compliance teams: how mileage is reported, typical sites of service, interplay with other ambulance HCPCS codes, and payer-specific considerations. Where input data is incomplete, the report flags missing elements as “Data not available in the input.”
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Billing Code Overview
HCPCS Level II code A0425 identifies ground mileage billed per statute mile for ambulance services. The service type is ambulance ground transportation mileage, and the typical site of service is ground ambulance transport performed during patient conveyance between locations. This code is used to report the distance component of ambulance trips separate from the base transport service.
National Reimbursement Benchmarks
National commercial pricing for HCPCS A0425 clusters around the BUCA average commercial rate of $12.5, with notable variation by insurer. Blue Cross Blue Shield (BCBS) shows an extreme upper outlier at $99770 but its central tendency is modest, while Aetna and UnitedHealth Group exhibit higher maximums ($540.6 and $22.1 respectively) that reflect occasional high-priced claims rather than typical reimbursements. Cigna’s distribution is compact with a mean of $6.6, and BUCA’s mean of $12.5 sits between the lower and higher payer averages.
Measuring dispersion as P75 minus P25 highlights tightest and widest spreads: Cigna’s spread is $4.3 (P75 $8.7 minus P25 $4.4), indicating the tightest band, while Blue Cross Blue Shield has the widest interquartile range of $5.5 (P75 $12.1 minus P25 $6.5). UnitedHealth Group’s spread is $2.1, Aetna’s is $2.0, and BUCA’s interquartile spread is $4. - these values show most payers have modest IQRs but BCBS includes extreme volatility in its extremes.