When and How to Bill A0426 for Non-Emergency ALS Transport

When to Use Code A0426

HCPCS A0426 represents Advanced Life Support (ALS) Level 1, non-emergency transport.
It’s used when a patient requires ALS-trained personnel or advanced equipment during transport but the situation is not an emergency.

• •Service type: ALS Level 1 (non-emergency)
• •When to bill: When ALS monitoring or intervention is required during scheduled transport
• •Who uses it: Licensed ambulance providers with ALS certification

Common scenarios:

• •Transport for patients on IV medication requiring monitoring
• •Scheduled transfer of cardiac patients with telemetry needs
• •Non-emergency transfer for ventilator-dependent patients

Insurance Verification Tips for A0426

1. •Confirm the payer distinguishes ALS vs. BLS coverage.
2. •Verify if medical necessity documentation supports ALS-level care.
3. •Include crew credentials and services rendered (e.g., cardiac monitoring).
4. •Use modifiers to indicate the origin/destination (e.g., RH = residence to hospital).

Pro tip: Document the specific ALS procedures performed, even if minimal.

Example Case

A ventilator-dependent patient is transferred from a long-term care facility to a hospital for scheduled respiratory testing.
ALS-trained staff provide monitoring during transport.
The claim includes one unit of A0426 (ALS non-emergency) and A0425 for mileage.