Multiple Patient Transports

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 Medicare 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.

References

• CMS guidance for ambulance suppliers regarding Advance Beneficiary Notice (PDF, 140 KB) 
• CMS Ambulance Services Center
• Medicare Benefit Policy Manual, Chapter 10, Ambulance (PDF, 400 KB) 
• Medicare Claims Processing Manual, Chapter 15, Ambulance (PDF, 410 KB)
• Code of Federal Regulations
  • §410.40 Coverage of Ambulance Services
  • §410.41 Requirements for Ambulance Suppliers