Welcome to the Department of Health Care Services Welcome to Medi-Cal Welcome to the Department of Health Care Services

Medi-Cal Logo
Click to Sign Up for MCSS emails

Reminder: Billing Transportation Services That Include Day and Night Hours

January 31, 2019

This is a reminder to providers when billing transportation services for a round trip that encompasses day and night hours to reflect one unit for each leg of the trip. Manual section, Medi-Cal Transportation – Ground defines night calls as “transportation responses between the hours of 7 p.m. and 7 a.m.”

Proper Billing Example:

Round-trip transportation that includes one night call (modifier UJ)
From Through Service Code Modifier Rate Units
8/14/18 8/14/18 A0130   $ 17.65 001
8/14/18 8/14/18 A0130 UJ $ 23.78 001

The above billing example will decrement the remaining occurrences approved on the Treatment Authorization Request (TAR) by two units.

Improper Billing Example:

Round-trip transportation that includes one night call (modifier UJ)
From Through Service Code Modifier Rate Units
8/14/18 8/14/18 A0130   $ 35.30 002
8/14/18 8/14/18 A0130 UJ $ 6.13 001

The above improper billing example will decrement the remaining occurrences approved on the TAR by three units rather than two units. Billing improper units causes claims to deny with Remittance Advice Details (RAD) code 079: Service billed exceeds remaining occurrences approved on the TAR (Treatment Authorization Request).

All transportation services must document the start and stop times for each leg of the services.

Refer to Medical Transportation – Air: Billing Codes and Reimbursement Rates and Medical Transportation – Ground: Billing Codes and Reimbursement Rates in the Part 2 manual for specific codes, maximum reimbursement amounts and further instructions.