RxDoctor Payments Data

HCPCS A0426

Ambulance service, advanced life support, non-emergency transport, level 1 (als 1)

$327.62Medicare-allowed amount per service, averaged across 215,270 services
Providers submitted
$1530.32

Asking price, not received

Medicare allowed
$327.62

The fee schedule figure

Medicare paid
$259.27

Balance is patient coinsurance

Providers submitted an average of $1530.32 for this code and Medicare allowed $327.624.7× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $259.27 (79%); the rest is the patient’s coinsurance and deductible.

Services
215,270

Medicare Part B, 2024

Beneficiaries
198,639
Providers billing it
1,507
Total allowed
$70,526,757

Services × allowed amount

What Medicare pays for HCPCS A0426

Across 215,270 services billed by 1,507 providers to 198,639 beneficiaries, Medicare allowed an average of $327.62 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills A0426

SpecialtyServicesBeneficiariesAvg allowedProviders
Ambulance Service Provider215,270198,639$327.621,507

A0426 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

StateServicesAllowedStandardized pmtProviders
Florida15,415$319.00$253.4253
Ohio15,214$308.71$252.7057
Texas14,496$325.94$252.9195
California11,945$379.17$252.0266
Illinois11,165$323.10$253.7862
Pennsylvania10,282$320.94$253.8699
New York8,623$347.78$253.2864
Michigan7,686$316.60$252.5956
Tennessee7,238$305.59$252.4658
Arkansas6,876$316.93$252.2034
Massachusetts6,522$350.11$253.8626
Virginia6,380$325.21$252.4728
North Carolina6,318$313.85$252.0745
Arizona6,222$341.71$252.2025
Oklahoma5,946$313.39$253.5545
Wisconsin5,604$328.37$252.3351
Maryland5,488$345.28$253.3312
Missouri4,869$311.20$253.3651
Nebraska4,801$334.66$251.2523
Georgia4,569$307.30$250.5141
Indiana4,381$311.38$253.4934
Alabama3,830$305.12$251.8048
Minnesota3,328$364.21$253.3724
South Carolina3,318$309.56$252.9414
Kentucky3,062$302.20$253.1859
Louisiana2,837$302.57$254.034
Kansas2,537$320.61$252.8524
West Virginia2,488$303.89$252.2632
Washington2,436$359.11$252.7321
Mississippi2,360$306.28$252.7115
Iowa2,131$317.89$253.0033
Colorado2,043$361.05$251.5626
Connecticut1,816$349.23$253.9810
Utah1,609$345.37$250.7121
Oregon1,532$351.14$251.6723
New Mexico1,429$325.45$251.9810
Nevada1,229$337.85$252.8712
New Hampshire1,142$346.06$252.827
Maine1,021$333.19$251.2521
South Dakota952$380.20$251.5111
Vermont835$338.53$252.1910
Idaho711$345.10$251.4615
Montana697$377.60$250.8214
Hawaii568$363.27$248.401
North Dakota388$390.11$249.1012
Wyoming313$383.36$253.407
Alaska292$390.89$245.303
Delaware143$327.61$254.451
Rhode Island134$337.09$254.262
New Jersey49$346.74$251.972

Related codes

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.