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February 2021

Blue Cross offers additional mileage reimbursement for ground ambulance providers in 2021

During the first quarter of 2021, Blue Cross Blue Shield of Michigan and Blue Care Network are offering ground ambulance providers an opportunity to become eligible for additional reimbursement for mileage.

Ground ambulance providers who participate under the BCBSM and BCN Ambulance Provider Participation Agreement will be eligible for additional reimbursement associated with HCPCS code A0425. Reimbursement will depend on the number of providers who sign the agreement. This additional reimbursement is in addition to the 2.25% overall ambulance fee schedule increase for 2021.

The program will be reassessed every 12 months.

To receive this additional reimbursement, follow these steps:

  • Sign the joint BCBSM and BCN Ambulance Provider Participation Agreement if you haven’t already done so.
    • The signing period runs from Jan. 1 to March 31, 2021, for initial qualification.
  • Receive an additional percentage reimbursement for mileage.
    • The percentage will depend on the number of providers who sign the joint agreement (see table below).
    • The appropriate additional reimbursement percentage will be applied to code A0425 beginning on April 1, 2021.
Provider participation Additional percentage for mileage
If providers currently participate under the joint ambulance contract or sign it between Jan. 1 and March 31, 2021

5%
If all participating Blue Cross commercial providers participate under the combined agreement (allowing Blue Cross to retire the individual provider agreement) 15%
If the percentage of providers who sign the joint contract equals 90%, thereby expanding the number of participating providers.

20%

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2020 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.