HCPCS A0430 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Ambulance and Other Transport Services and Supplies |
| Complexity Level | High |
National average reimbursement for HCPCS A0430 by major payers:
$5,915.49
$3,177.54
$4,298.71
$7,268.40
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS A0430 | ||||||
United | A0430 | $2046.83 | 1922023035 - UTTAM BODANAPALLY | 464217508 - (MD) MEDSTAR GOOD SAMARITAN PHYSICIANS LLC | PA | Diagnostic Radiology Physician (2085R0202X) |
United | A0430 | $2439.32 | 1164782454 - MICHAEL CASEY | 205292168 - (NY) LABORATORY OF DERMATOPATHOLOGY ADX LLC | WA | Anatomic Pathology & Clinical Pathology Physician (207ZP0102X) |
United | A0430 | $3048.75 | 1497015028 - JACQUELINE HUNTZICKER | 861057582 - (PA) PINNACLE HEALTH EMERGENCY DEPARTMENT SERVICES LLC | PA | Emergency Medicine Physician (207P00000X) |
United | A0430 | $3048.75 | 1912982984 - MARCO CANTINI | 250965570 - (PA) UPMC | PA | Anesthesiology Physician (207L00000X) |
United | A0430 | $3104.89 | 1942254388 - NOAM GILBOA | 251490707 - DUBOIS REGIONAL MEDICAL CENTER | PA | Emergency Medicine Physician (207P00000X) |
United | A0430 | $3048.75 | 1588613285 - MATTHEW PEGHER | 240802108 - UPMC | PA | Emergency Medicine Physician (207P00000X) |
United | A0430 | $1308.90 | 1871646703 - ASHLIE BURKART | 231714249 - (PA) BRYN MAWR MEDICAL SPECIALISTS ASSOCIATION | PA | Anatomic Pathology & Clinical Pathology Physician (207ZP0102X) |
United | A0430 | $3072.84 | 1295026151 - COLIN NABB | 251838458 - HIGHMARK HEALTH | PA | Anesthesiology Physician (207L00000X) |
United | A0430 | $4947.85 | 1720372758 - JAMIE ROPER | 261378489 - (TX) FRISCO EMERGENCY MEDICINE ASSOCIATES PA | TX | Emergency Medicine Physician (207P00000X) |
United | A0430 | $3272.25 | 1255301883 - JONATHAN WOLKO | 232743545 | PA | Diagnostic Radiology Physician (2085R0202X) |
United | A0430 | $3149.36 | 1578505459 - RICHARD COOK | 232919472 - UPMC | PA | Emergency Medicine Physician (207P00000X) |
United | A0430 | $2993.57 | 1972958692 - CAMERON JERNIGAN | 464186362 - (NY) GREAT LAKES PHYSICIAN PRACTICE PC | NY | Emergency Medicine Physician (207P00000X) |
United | A0430 | $6518.85 | 1922298652 - MELISSA ORNER | 236291113 - GEISINGER CLINIC | PA | Anesthesiology Physician (207L00000X) |
United | A0430 | $2160.71 | 1962445569 - GAUTAM KHANDELWAL | 202265068 - INTERNAL MEDICINE ASSOCIATES OF RESTON | PA | Emergency Medicine Physician (207P00000X) |
United | A0430 | $3272.25 | 1578534533 - SEAN REITER | 460779942 - (PA) ARIA HEALTH ORTHOPAEDICS | PA | Diagnostic Radiology Physician (2085R0202X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS A0430 vs. Other Ambulance and Other Transport Services and Supplies Codes
The HCPCS A0430 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 A0430 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 |
|---|---|---|
| A0429-HCPCS | Moderate | Ambulance service, basic life support, emergency transport (BLS-emergency) |
| A0430-HCPCS | High | Ambulance service, conventional air services, transport, one way (fixed wing) |
| A0431-HCPCS | High | Ambulance service, conventional air services, transport, one way (rotary wing) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A0430. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A0430 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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