Per Mile Travel Allowance P9603

In addition to a specimen collection fee Medicare, under Part B, covers a  travel allowance for a laboratory technician to draw a specimen from either a nursing home patient or homebound patient. The travel allowance is intended to cover the estimated travel costs of collecting a specimen and to reflect the technician’s salary and travel costs.

The travel allowance is not distributed by CMS. Instead, the carrier must calculate the travel allowance for each claim using the following rules for the particular Code. The following HCPCS codes are used for travel allowances:

Per Mile Travel Allowance (P9603)

The minimum “per mile travel allowance” is $1.00. The per mile travel allowance is to be used in situations where the average trip to patients’ homes is longer than 20 miles round trip, and is to be pro-rated in situations where specimens are drawn or picked up from non Medicare patients in the same trip. – one way, in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually traveled (carrier allowance on per mile basis);


P9603 – The per mile allowance was computed using the Federal mileage rate plus an additional 45 cents a mile to cover the technician’s time and travel costs. Contractors have the option of establishing a higher per mile rate in excess of the minimum ($1.00 a mile in CY 2018) if local conditions warrant it. The minimum mileage rate will be reviewed and updated in conjunction with the clinical lab fee schedule as needed. At no time will the laboratory be allowed to bill for more miles than are reasonable or for miles not actually traveled by the laboratory technician.

See Examples..

Similar Posts

Leave a Reply

Your email address will not be published.