When it works
Shared rides work when pickups or drop-offs are close together in place and time: a senior building, a dialysis center’s shift change, an adult day program. Each rider’s pickup window and time on board still apply. Some riders must ride alone, because of their condition, their behaviour or the payer’s rules.
Billing a trip with several riders in fee-for-service Medi-Cal
When several recipients ride from a common loading point to the same destination, the Medi-Cal provider manual has the wheelchair van base code billed with a modifier for the number of patients: UN for two, UP for three, UQ for four, UR for five and US for six or more. Mileage is billed only on the first recipient’s claim, and each claim must come with an attachment listing the other riders’ names and Medi-Cal ID numbers. Riders picked up at different places, or dropped at different places, are billed as separate trips.
Brokers and plans set their own rules for shared rides; check each contract.
Related terms
- Run (route)A run, also called a route, is the ordered list of pickups and drop-offs one van and driver will do in a shift.
- Medi-Cal NEMT billing codes (HCPCS)HCPCS codes are the billing codes for each service on a claim.
- Loaded milesLoaded miles are the miles a vehicle drives with the rider on board, from pickup to drop-off.
- Space type (level of service)Space type, also called level of service, says how a rider travels and so what room they take in a vehicle: ambulatory (a seat), wheelchair, stretcher or bariatric.
Sources
Checked on . Rules change: check the current version with the payer before you bill.