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    OpenPayerBilling CodesAmbulance and Other Transport Services and SuppliesHCPCS hcpcs-a0436-rotary-wing-air-mileage
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    HCPCS Level II A0436: Rotary Wing Air Mileage, Per Statute Mile

    HCPCS Level II code A0436 describes rotary wing air ambulance mileage billed per statute mile, representing charges for air transport distance when a helicopter is used; the service type is air ambulance transport (rotary wing) and the typical site of service is in-transit air transport via helicopter.

    For related coverage guidance, see recent payer policy updates: Percutaneous Arteriovenous Fistula Creation, Dialysis Services (ESRD) Coverage and Provider Requirements, Intradialytic Parenteral Nutrition - Medical Policy.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient scenario involves an acutely ill or traumatically injured patient located in a remote or difficult-to-access area (e.g., rural highway, mountainous terrain, offshore platform) requiring rapid aeromedical transport to a higher level of care. Emergency Medical Services (ground and local EMS) request a rotary-wing air ambulance for time-sensitive conditions such as major trauma, intracranial hemorrhage, acute myocardial infarction with hemodynamic instability, severe stroke requiring thrombectomy, or multisystem injuries exceeding local hospital capability. The rotorcraft crew (pilot, flight paramedic, flight nurse, and occasionally a flight physician) stabilizes the patient on scene, performs advanced airway management and critical interventions as indicated, and transports the patient directly to the receiving facility.

    Typical clinical workflow:

    • Emergency call triage and on-scene assessment by local EMS.

    • Decision to request rotary-wing transport based on physiologic criteria, mechanism of injury, distance/time to definitive care, or need for specialized services.

    • Flight dispatch and patient packaging; documentation of pickup and statute miles flown.

    • In-flight critical care interventions (airway, ventilatory support, circulatory support, sedation, analgesia, hemorrhage control).

    • Handoff to receiving emergency department or specialty team with transfer of medical record and billing-critical documentation (origin/destination, departure/arrival times, medical necessity justification).

    • Billing uses A0436 to report rotary wing air mileage billed per statute mile for the transport portion of the aeromedical service; mileage is documented in the flight record and must align with payer-specific policies.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99285Emergency department visit for high severity problemOften represents initial ED evaluation that precipitated rotary-wing A0436 transport to higher level of care.
    31500Intubation, endotracheal, emergency procedurePerformed pre-flight or in-flight for airway protection; commonly precedes aeromedical transport.
    36415Collection of venous blood by venipunctureRoutine diagnostic sampling before or during transport to guide urgent care decisions.
    93010Electrocardiogram, interpretation and reportPerformed for chest pain or suspected acute coronary syndrome prior to or during transport.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    246QH0600X
    111NX0800X
    229N00000X
    261QA0005X
    363LP1700X
    364SP0812X
    2472V0600X
    373H00000X

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    I21.09ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall
    I46.9Cardiac arrest, cause unspecified
    R07.9Chest pain, unspecified
    R41.82Altered mental status, unspecified
    S06.0X0AConcussion without loss of consciousness, initial encounter
    S06.0X1AConcussion with loss of consciousness of 30 minutes or less, initial encounter
    S06.2X0ADiffuse traumatic brain injury without loss of consciousness, initial encounter
    S06.2X1ADiffuse traumatic brain injury with loss of consciousness of 30 minutes or less, initial encounter
    S06.5X0ATraumatic subdural hemorrhage without loss of consciousness, initial encounter
    S06.5X1ATraumatic subdural hemorrhage with loss of consciousness of 30 minutes or less, initial encounter

    Showing 1–10 of 25

    Related Payer Policy Updates

    Specialty: Dialysis/Renal Replacement1 / 3

    10 rows

    PolicyPayerEffective Date
    Percutaneous Arteriovenous Fistula CreationAmeriHealth Caritas2026-08-01
    Dialysis Services (ESRD) Coverage and Provider RequirementsMississippi Division of Medicaid2026-08-01
    Intradialytic Parenteral Nutrition - Medical PolicyHealth-New-England2026-07-01
    Total Parenteral Nutrition and Intradialytic Parenteral NutritionCentene2026-05-01
    End Stage Renal Disease (ESRD): Renal Dialysispriority health2026-02-01
    Home Hemodialysis (HHD) Coverage Criteriasierra health and life2026-01-01
    Home Hemodialysis (HHD) — Coverage CriteriaUnitedHealthcare2026-01-01
    Dialysis services (acute and chronic hemodialysis and peritoneal dialysis)UnitedHealthcare2026-01-01
    Staff-Assisted Home HemodialysisCigna2025-11-15
    Parsabiv (etelcalcetide) Coverage for Secondary HyperparathyroidismMolina Healthcare2025-10-09

    Related Codes

    HCPCS-A0021-AMBULANCE-SERVICE-OUTSIDE-STATE-PER-MILE-TRANSPORT

    HCPCS A0021: Ambulance Service Outside State Per Mile, Transport (Medicaid Only)

    HCPCS-A0080-VOLUNTEER-NON-EMERGENCY-TRANSPORTATION-MILEAGE

    HCPCS Level II A0080: Non-Emergency Volunteer Vehicle Transport, Per Mile

    HCPCS-A0090-NON-EMERGENCY-TRANSPORTATION-MILE-PRIVATE-VEHICLE

    HCPCS A0090: Non-Emergency Transportation, Per Mile

    HCPCS-A0100-NON-EMERGENCY-TAXI-TRANSPORTATION

    HCPCS A0100: Non-Emergency Transportation, Taxi

    HCPCS-A0110-NON-EMERGENCY-BUS-TRANSPORTATION

    HCPCS Level II A0110: Non-Emergency Bus or Carrier Transportation

    HCPCS-A0120-NON-EMERGENCY-MINI-BUS-TRANSPORTATION

    HCPCS Level II A0120: Non‑Emergency Transportation by Mini‑Bus or Mountain Transport

    HCPCS-A0130-WHEELCHAIR-VAN-NON-EMERGENCY-TRANSPORTATION

    HCPCS Level II A0130: Non-Emergency Transportation, Wheelchair Van

    HCPCS-A0140-NON-EMERGENCY-AIR-TRANSPORTATION

    HCPCS Level II A0140: Non-Emergency Transportation and Air Travel

    HCPCS-A0160-NON-EMERGENCY-TRANSPORTATION-CASE-WORKER-SOCIAL-WORKER-PER-MILE

    HCPCS Level II A0160: Non-Emergency Transportation by Case Worker

    HCPCS-A0180-ANCILLARY-LODGING-NON-EMERGENCY-TRANSPORTATION

    HCPCS Level II A0180: Non-Emergency Transportation Lodging-Recipient

    Showing 1–10 of 40

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    95806
    Electroencephalogram, 31–60 minutes; awake and drowsy
    Occasionally performed at sending/receiving facility for neurologic monitoring in severe stroke or head injury cases; part of overall care pathway.
    94640Pressurized or nonpressurized inhalation treatment for acute airway obstructionAdministered in-flight for bronchospasm or reactive airway conditions requiring rapid transport.