HCPCS Modifier GM
Published 04/07/2023
Description
Multiple patients on one ambulance trip.
Guidelines and Instructions
Multiple patients on one ambulance trip.
Guidelines and Instructions
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This modifier may be submitted only with claims for ambulance transport
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Submit this modifier second, and the origin/destination modifier first
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Submit this modifier even if only one of the patients involved in the single trip was a Medicare patient
Documentation Required with the Claim
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Number of patients transported (including Medicare and non-Medicare patients)
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Medicare number of each Medicare patient being transported
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Number of miles traveled for each Medicare beneficiary
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For electronic claims, submit this documentation in the electronic documentation field
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For paper claims, submit this documentation as an attachment
References
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CMS Pub. 100-02, Chapter 10, Section 10.3.8 (PDF, 208 KB)