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See a sample rate comparisonHCPCS A0425 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Ground mileage, per statute mile
| Key Fact | Detail |
|---|---|
| Service Type | Ambulance and Other Transport Services and Supplies |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for A0425 |
National average reimbursement for HCPCS A0425 by major payers:
$11.38
$7.64
$5.64
$7.78
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HCPCS A0425
5 of 25 sample ratesHigher to lower in this preview
Scottish Rite Childrens Medical Ctr, Children'S Healthcare Of Atlanta At Scottish Rite
Childrens Healthcare Of Atlanta Inc
$27.65Published rateHouston Hospitals Inc, Houston Medical Center
Houston Hospitals Inc
$9.06Published rateScottish Rite Childrens Medical Ctr, Children'S Healthcare Of Atlanta At Scottish Rite
Childrens Healthcare Of Atlanta Inc
$7.76Published rateNorthside Hospital, Inc., Northside Hospital Duluth
$6.55Published rateRescue Medical Transport, LLC
Rescue Medical Transport LLC
$5.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A0425 vs. Other Ambulance and Other Transport Services and Supplies Codes
The HCPCS A0425 code is part of the Ambulance and Other Transport Services and Supplies services . It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS A0425 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| A0424-HCPCS | Low | Extra ambulance attendant, ground (ALS or BLS) or air (fixed or rotary winged); (requires medical review) |
| A0425-HCPCS | Low | Ground mileage, per statute mile |
| A0426-HCPCS | Moderate | Ambulance service, advanced life support, non-emergency transport, level 1 (ALS 1) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A0425. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A0425 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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