Dry runs in fee-for-service Medi-Cal
The Medi-Cal provider manual says ground transport providers may be reimbursed for responding to a call without transporting the recipient. The dry run is billed with the transport’s HCPCS code, such as A0130 for a wheelchair van or T2005 for a stretcher van, with modifier DS followed by modifier QN. DS combines origin code D and destination code S.
A dry run at night, between 7 p.m. and 7 a.m., takes modifier UJ instead, with the time of the call on the claim and no other modifiers or lines.
Plans and brokers
Managed care plans and brokers set their own dry run rules; many pay nothing, and those that pay want proof. Check each contract before billing one.
What it means for the provider
Whether a dry run is paid or not, record it the same way as a no-show: arrival time, place and wait. It explains the miles on the van and protects the provider if the rider complains.
Going deeper: No-shows and dry runs in NEMT: what counts, what payers pay for, how to document them
Related terms
- No-showA no-show is a pickup where the van arrives on time but the rider isn’t there or won’t ride.
- Medi-Cal NEMT billing codes (HCPCS)HCPCS codes are the billing codes for each service on a claim.
- Trip leg (A leg and B leg)A trip leg is one one-way ride from a pickup to a drop-off.
- Payer (funding source)The payer, also called the funding source, is whoever pays for a trip leg: a broker, a health plan directly, Medi-Cal fee-for-service, a facility, a workers’ compensation administrator or the rider.
Sources
Checked on . Rules change: check the current version with the payer before you bill.