Multiple patient transports must be submitted with HCPCS modifier GM on the appropriate ambulance base code and mileage code.
- Submit the appropriate origin and destination modifiers in the first modifier position and HCPCS modifier GM in the second modifier position
Documentation required with claims for multiple patient transports:
- The number of patients transported
- The health insurance claim numbers for each Medicare beneficiary in the vehicle at the same time. If there was no other Medicare beneficiary in the vehicle, this must be clearly documented.
- The total mileage traveled for that individual Medicare beneficiary
- This information must be in the appropriate documentation record for EDI claims and as an attachment to the CMS-1500 claim form
- Claims submitted without this information will be rejected as unprocessable and must be resubmitted as new claims
Palmetto GBA will not change a code submitted or add any modifier that may be required for payment when processing your claim.
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