2020 Ambulance Fee Schedule

Effective January 1, 2020.

North Carolina

HCPCS
Contractor
Locality
RVU
GPCI(PE)
Base Rate
Urban Rate
Rural Rate
A0425
11502
0
1.00
0.930
7.47
$7.62
$7.69
A0426
11502
0
1.20
0.930
231.98
$270.03
$272.68
A0427
11502
0
1.90
0.930
231.98
$427.55
$431.74
A0428
11502
0
1.00
0.930
231.98
$225.03
$227.23
A0429
11502
0
1.60
0.930
231.98
$360.04
$363.57
A0430
11502
0
1.00
0.930
3147.91
$3,037.73
$4,556.60
A0431
11502
0
1.00
0.930
3659.92
$3,531.82
$5,297.73
A0432
11502
0
1.75
0.930
231.98
$393.79
$397.65
A0433
11502
0
2.75
0.930
231.98
$618.82
$624.89
A0434
11502
0
3.25
0.930
231.98
$731.33
$738.50
A0435
11502
0
1.00
0.930
8.93
$8.93
$13.40
A0436
11502
0
1.00
0.930
23.83
$23.83
$35.75

South Carolina

HCPCS
Contractor
Locality
RVU
GPCI(PE)
Base Rate
Urban Rate
Rural Rate
A0425
11202
1
1.00
0.907
7.47
$7.62
$7.69
A0426
11202
1
1.20
0.907
231.98
$265.46
$268.06
A0427
11202
1
1.90
0.907
231.98
$420.31
$424.43
A0428
11202
1
1.00
0.907
231.98
$221.22
$223.38
A0429
11202
1
1.60
0.907
231.98
$353.95
$357.42
A0430
11202
1
1.00
0.907
3147.91
$3,001.53
$4,502.30
A0431
11202
1
1.00
0.907
3659.92
$3,489.73
$5,234.60
A0432
11202
1
1.75
0.907
231.98
$387.13
$390.92
A0433
11202
1
2.75
0.907
231.98
$608.34
$614.31
A0434
11202
1
3.25
0.907
231.98
$718.95
$726.00
A0435
11202
1
1.00
0.907
8.93
$8.93
$13.40
A0436
11202
1
1.00
0.907
23.83
$23.83
$35.75

Virginia

HCPCS
Contractor
Locality
RVU
GPCI(PE)
Base Rate
Urban Rate
Rural Rate
A0425
11302
0
1.00
0.991
7.47
$7.62
$7.69
A0426
11302
0
1.20
0.991
231.98
$282.15
$284.92
A0427
11302
0
1.90
0.991
231.98
$446.74
$451.12
A0428
11302
0
1.00
0.991
231.98
$235.13
$237.43
A0429
11302
0
1.60
0.991
231.98
$376.21
$379.89
A0430
11302
0
1.00
0.991
3147.91
$3,133.74
$4,700.62
A0431
11302
0
1.00
0.991
3659.92
$3,643.45
$5,465.18
A0432
11302
0
1.75
0.991
231.98
$411.48
$415.51
A0433
11302
0
2.75
0.991
231.98
$646.60
$652.94
A0434
11302
0
3.25
0.991
231.98
$764.17
$771.66
A0435
11302
0
1.00
0.991
8.93
$8.93
$13.40
A0436
11302
0
1.00
0.991
23.83
$23.83
$35.75

West Virginia

HCPCS
Contractor
Locality
RVU
GPCI(PE)
Base Rate
Urban Rate
Rural Rate
A0425
11402
16
1.00
0.857
7.47
$7.62
$7.69
A0426
11402
16
1.20
0.857
231.98
$255.52
$258.03
A0427
11402
16
1.90
0.857
231.98
$404.57
$408.54
A0428
11402
16
1.00
0.857
231.98
$212.93
$215.02
A0429
11402
16
1.60
0.857
231.98
$340.69
$344.03
A0430
11402
16
1.00
0.857
3147.91
$2,922.83
$4,384.25
A0431
11402
16
1.00
0.857
3659.92
$3,398.24
$5,097.35
A0432
11402
16
1.75
0.857
231.98
$372.63
$376.29
A0433
11402
16
2.75
0.857
231.98
$585.57
$591.31
A0434
11402
16
3.25
0.857
231.98
$692.04
$698.82
A0435
11402
16
1.00
0.857
8.93
$8.93
$13.40
A0436
11402
16
1.00
0.857
23.83
$23.83
$35.75

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