Hospital-based dialysis facility (hospital or hospital related).


  • Submit this modifier to indicate the origin or destination of an ambulance transport, when the location is a hospital-based dialysis facility
  • Additional documentation may be required to support the need for this ambulance trip 

Contact Palmetto GBA JJ Part B Medicare

Provider Contact Center: 877-567-7271

Email JJ Part B

Contact a specific JJ Part B department

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