How To Use HCPCS Code A0090

HCPCS code A0090 describes non-emergency transportation services provided by an individual with a vested interest, such as a family member, self, or neighbor. This code is used to identify the per mile transportation costs for patients who require assistance in reaching their healthcare appointments or facilities but do not have an urgent medical condition. It is important for medical coders to understand the specific usage and guidelines for HCPCS code A0090 to ensure accurate billing and reimbursement.

1. What is HCPCS A0090?

HCPCS code A0090 is a specific code used to identify non-emergency transportation services provided by an individual with a vested interest. This can include family members, the patient themselves, or neighbors who assist in transporting the patient to their healthcare appointments or facilities. It is important to note that this code is not applicable for emergency situations where immediate medical attention is required. Instead, it is used for patients who need assistance in reaching their healthcare appointments but do not have an urgent medical condition.

2. Official Description

The official description of HCPCS code A0090 is “Non-emergency transportation, per mile – vehicle provided by individual (family member, self, neighbor) with vested interest.” The short description for this code is “Interest escort in non-ER.”

3. Procedure

1. When providing non-emergency transportation services using HCPCS code A0090, the individual providing the transportation should ensure that the vehicle used is safe and appropriate for the patient’s needs.
2. The transportation should be provided on a per mile basis, with the total number of miles traveled documented for billing purposes.
3. It is important to accurately record the start and end locations of the transportation service, as well as any additional stops made during the journey.
4. The individual providing the transportation should maintain appropriate documentation, including the date of service, the patient’s name and identification, and any relevant medical information that may impact the transportation needs.

4. When to use HCPCS code A0090

HCPCS code A0090 should be used when a patient requires non-emergency transportation services and the vehicle used is provided by an individual with a vested interest, such as a family member, self, or neighbor. This code is not applicable for emergency situations where immediate medical attention is required. It is important to ensure that the patient does not have an urgent medical condition before using this code.

5. Billing Guidelines and Documentation Requirements

When billing for non-emergency transportation services using HCPCS code A0090, healthcare providers should ensure that the following documentation requirements are met:

• Date of service
• Patient’s name and identification
• Start and end locations of the transportation service
• Total number of miles traveled
• Any additional stops made during the journey
• Relevant medical information that may impact the transportation needs

6. Historical Information and Code Maintenance

HCPCS code A0090 was added to the Healthcare Common Procedure Coding System on January 01, 1982. There have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. It is important for medical coders to stay updated on any changes or revisions to the code, as well as its historical context.

7. Medicare and Insurance Coverage

HCPCS code A0090 is classified as I, which means it is not payable by Medicare. The pricing indicator code for this code is 00, indicating that the service is not separately priced by Part B. This means that the service is not covered, bundled, or used by Part A only. The multiple pricing indicator code is 9, which means it is not applicable as HCPCS is not priced separately by Part B or the value is not established.

8. Examples

Here are five examples of when HCPCS code A0090 should be billed:

1. A patient requires non-emergency transportation to a routine doctor’s appointment, and their family member provides the transportation using their personal vehicle.
2. An elderly patient needs assistance in reaching a physical therapy session, and their neighbor offers to drive them to the facility.
3. A patient with limited mobility requires transportation to a medical imaging center for a scheduled MRI, and they arrange for a friend to drive them.
4. A patient who is unable to drive due to a recent surgery needs transportation to a follow-up appointment, and they hire a family member as a driver.
5. A patient with a chronic illness requires regular visits to a specialist, and they utilize a self-driving service to reach their appointments.