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HCPCS A0225 · Level II · A code

A0225: Ambulance service, neonatal transport, base rate, emergency transport, one way, HCPCS Level II A code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); PFS relative value file: RVU26D, released August 26, 2026 (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; RVU27A with the CY2027 PFS final rule, effective January 1, 2027 for the PFS relative value file.

Key facts for A0225

Medicare payment
no PFS amount
PFS status I
Coverage code
I
not payable by Medicare
Practitioner MUE
0
MAI 3
OPPS status
SI E1
Non-allowed item or service
NCCI PTP pairs
0
practitioner file
LCDs and articles
0 / 0

TL;DR

CMS describes HCPCS A0225, added in 1985, as "Ambulance service, neonatal transport, base rate, emergency transport, one way". The physician fee schedule lists A0225 with status I (not valid for Medicare: Medicare uses another code), so the PFS carries no national amount for it. CMS caps A0225 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy) units per day in the 2026 Q4 MUE tables. No current LCD or billing article lists A0225; its HCPCS coverage code is I (not payable by Medicare). OPPS status indicator E1: Non-allowed item or service. HCPCS record: BETOS O1A (ambulance); pricing indicator 00; type of service D (ambulance). 7 other active codes open with "Ambulance service"; related codes: A0426, A0427, A0428, A0429.

A0225 descriptor and code status

The October 2026 HCPCS Level II file describes A0225 as “Ambulance service, neonatal transport, base rate, emergency transport, one way”. It sits in the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational), listed with the other A codes.

HCPCS file attributes of A0225
FieldValue
Short descriptorNeonatal emergency transport
Added to HCPCS1985-01-01
Last actionN (no maintenance), effective 2003-04-01
Coverage codeI: not payable by Medicare
Pricing indicator00: not separately priced by Part B
BETOS categoryO1A: ambulance
Type of serviceD: ambulance

Medicare payment for A0225

The physician fee schedule lists A0225 with status I (not valid for Medicare: Medicare uses another code), so the PFS carries no national amount for it. The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.

Physician fee schedule (RVU26D)

Status I: not valid for Medicare: Medicare uses another code. Global period XXX (global surgery concept does not apply); PC/TC indicator 9 (professional/technical concept does not apply).

Hospital outpatient (OPPS Addendum B)

Status indicator E1 (Non-allowed item or service), with no separate OPPS payment rate.

Medically Unlikely Edits for A0225

CMS caps A0225 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy) units per day in the 2026 Q4 MUE tables. The practitioner MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for A0225 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services03 Date of Service Edit: ClinicalCMS Policy
Facility outpatient hospital03 Date of Service Edit: ClinicalCMS Policy

The MUE lookup for A0225 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists A0225 in v323r0.

A0225 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Pair counts show exposure, not the answer for one claim. Check A0225 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for A0225

No current LCD or billing and coding article lists A0225. The HCPCS coverage code I means not payable by Medicare, and any National Coverage Determination for the service still applies.

Denials to expect on A0225

CARC 50 · N115

the service is not reasonable and necessary for the diagnosis on the claim

CARC 151 · N362

units of A0225 exceed the practitioner MUE of 0 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier

Where QuickIntell fits for A0225 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for A0225 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.

See QuickCode for coder reviewSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS A0225

What does HCPCS code A0225 describe?

"Ambulance service, neonatal transport, base rate, emergency transport, one way" (short descriptor "Neonatal emergency transport"), in the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational). Added 1985-01-01; last action N (no maintenance) effective 2003-04-01.

Is A0225 a CPT code?

It is not. A0225 belongs to the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational) of HCPCS Level II, the CMS code set, not to AMA CPT.

What does Medicare pay for A0225?

The physician fee schedule lists A0225 with status I (not valid for Medicare: Medicare uses another code), so the PFS carries no national amount for it.

How many units of A0225 can be billed per day?

CMS caps A0225 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy) units per day in the 2026 Q4 MUE tables. For the practitioner MUE (MAI 3), units above 0 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover A0225?

No current LCD or billing article lists A0225; its HCPCS coverage code is I (not payable by Medicare).

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.