HPSJ spells out how to bill a transport claim.
Health Plan of San Joaquin publishes the most detailed billing rules we found from any Medi-Cal plan for transportation claims: which CMS-1500 box holds what, which codes to use and how long you have to file.
From Health Plan of San Joaquin’s own documents, checked on . Not legal or billing advice.
At a glance
- Claim form
- CMS-1500, or electronic through a clearinghouse
- NEMT codes
- A0130, A0380, A0422, A0425, A0426, A0428, T2001, T2005
- Timely filing
- 365 days from the date of service
- PCS
- Reviewed by the plan; up to 12 months
- Litter van
- Not available, due to county ordinance (plan policy UM55)
Billing, box by box
HPSJ’s June 2024 billing alert for ground emergency and non-emergency transportation sets out:
- The authorization number goes in box 23.
- The referring physician goes in box 17 and their NPI in box 17B.
- Several trips for the same member on the same day need the time of day and the destinations in box 19, or they “may be denied as duplicate services.”
- The NEMT codes are A0130, A0380, A0422, A0425, A0426, A0428, T2001 and T2005; mileage is A0380 for litter and wheelchair vans and A0425 for ambulance, with the total miles in box 24G and the full addresses in box 19.
- Trips between 7 p.m. and 7 a.m. take modifier UJ.
These follow the Medi-Cal fee-for-service rules described under Medi-Cal NEMT billing codes.
Filing deadline and clearinghouses
HPSJ’s claims section (January 2025) gives a timely filing guideline of 365 days from the date of service, longer than Medi-Cal fee-for-service’s six months. Electronic claims go through a clearinghouse; HPSJ lists its payer IDs for Office Ally (HPSJ1) and Change Healthcare (68035).
Authorization and modes
HPSJ’s policy UM55 keeps the review of the PCS form with the plan (it is not delegated to a broker), and the plan notifies the transportation vendor of the approval. Authorizations run for up to 12 months. The same policy notes that litter van service is not available due to county ordinance, so stretcher trips here are not a litter van job.
Not in the plan’s published documents
We couldn’t confirm these from HPSJ’s own pages, so ask the plan or its vendor:
- Whether HPSJ uses a named broker, and how members book rides and with how much notice.
- An official list of the counties served.
Running HPSJ trips in MileCall
Each leg keeps its authorization number, its pickup and drop-off times and addresses, and its loaded miles, so the boxes HPSJ asks for are filled from the trip record. Trip sheets export in the columns you set up for HPSJ as CSV or Excel.
MileCall doesn’t send claims; your biller or clearinghouse does. When the 835 comes back, paid, partly paid and denied legs post with the reasons in words.
MileCall isn’t connected to HPSJ or its vendor; trips come in as files you upload.
See billingSources
Checked on . Rules change: check the current version with the payer before you bill.
Other Medi-Cal plans
How the rest compare, and the rules every plan shares, are on NEMT in California.
L.A. Care Health Plan
Call the Car is the NEMT and NMT vendor; L.A. Care reviews the PCS form.Inland Empire Health Plan (IEHP)
NEMT managed by IEHP since May 12, 2026; Call the Car keeps NMT. Five days’ notice.Health Net (Medi-Cal)
ModivCare schedules NEMT and NMT; Health Net’s Care Ride Unit approves the PCS first.Anthem Blue Cross (Medi-Cal)
ModivCare takes reservations, contracts providers and pays claims. Five business days’ notice.Partnership HealthPlan of California
No broker: Partnership’s Transportation Services coordinates rides. TAR plus PCS for NEMT.San Francisco Health Plan
ModivCare oversees the vendors since December 2024; SFHP approves NEMT in five business days.
See your HPSJ trips in MileCall.
Bring a day of trips and the trip file you get today. We’ll map it in front of you, plan and dispatch the day, and show what billing holds and why.