How much does Medicare pay for HCPCS A0434?

Medicare allowed an average of $919.21 per service and paid $730.10 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $3995.46, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code A0434?

Specialty care transport (sct). It was billed 68,990 times to 59,782 Medicare beneficiaries by 573 providers in 2024.

Which specialty bills A0434 most?

Ambulance Service Provider, with 68,990 services from 573 clinicians.

HCPCS A0434

Specialty care transport (sct)

$919.21Medicare-allowed amount per service, averaged across 68,990 services

Providers submitted

$3995.46

Asking price, not received

Medicare allowed

$919.21

The fee schedule figure

Medicare paid

$730.10

Balance is patient coinsurance

Providers submitted an average of $3995.46 for this code and Medicare allowed $919.21 — 4.3× 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 $730.10 (79%); the rest is the patient’s coinsurance and deductible.

Services: 68,990
Beneficiaries: 59,782
Providers billing it: 573
Total allowed: $63,416,298

What Medicare pays for HCPCS A0434

Across 68,990 services billed by 573 providers to 59,782 beneficiaries, Medicare allowed an average of $919.21 per service. That is 1.2 services per beneficiary, so this is a code patients typically receive more than once. 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 A0434

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ambulance Service Provider	68,990	59,782	$919.21	573

A0434 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.

State	Services	Allowed	Standardized pmt	Providers
California	11,266	$1023.82	$712.85	59
Illinois	6,826	$880.21	$713.85	33
New Jersey	4,717	$974.54	$714.65	10
New York	4,484	$986.03	$712.61	29
Massachusetts	3,726	$950.92	$712.77	24
Florida	3,664	$859.91	$713.51	30
Texas	3,291	$873.28	$712.42	36
Michigan	2,838	$855.74	$714.16	23
Maryland	2,496	$944.93	$714.12	9
Wisconsin	2,288	$873.78	$712.41	23
Washington	1,731	$956.36	$712.87	10
Louisiana	1,624	$823.23	$715.73	4
Indiana	1,313	$839.49	$713.94	11
Ohio	1,268	$835.31	$713.60	11
Oregon	1,183	$960.71	$706.84	12
Oklahoma	1,113	$831.17	$713.98	6
Minnesota	1,017	$935.84	$671.73	17
Arizona	1,011	$912.56	$711.87	12
North Carolina	999	$845.56	$713.87	10
Nevada	933	$897.72	$710.94	10
West Virginia	904	$820.55	$711.55	18
Connecticut	847	$944.62	$708.43	11
Pennsylvania	804	$891.78	$714.55	8
Maine	779	$888.60	$706.82	19
Arkansas	777	$829.33	$714.65	10
Georgia	773	$857.95	$710.30	11
Mississippi	770	$810.22	$712.93	8
Nebraska	639	$848.25	$712.06	3
Alabama	631	$819.97	$712.63	17
South Carolina	520	$836.42	$714.23	6
Virginia	500	$859.08	$713.64	7
Idaho	464	$919.83	$706.56	13
Utah	443	$890.90	$709.89	6
New Hampshire	396	$914.05	$711.83	4
Tennessee	387	$822.08	$714.20	9
Vermont	314	$889.47	$713.59	5
Missouri	222	$842.74	$713.84	7
Colorado	203	$968.22	$714.83	7
Kentucky	196	$818.31	$714.31	8
New Mexico	192	$867.44	$702.96	4
Alaska	162	$990.10	$714.71	2
Montana	110	$985.71	$705.40	4
South Dakota	57	$976.28	$714.83	2
Hawaii	48	$983.81	$713.61	1
Wyoming	24	$1100.27	$712.11	2
Kansas	24	$835.52	$714.84	1
Iowa	16	$838.15	$714.83	1

Related codes

A0425Ground mileage$9.46
A0436Rotary wing air mileage$38.43
A0427Ambulance service$522.48
A0428Ambulance service$261.47
A0435Fixed wing air mileage$14.65
A0429Ambulance service$446.93
A0426Ambulance service$327.62
A0433Advanced life support$752.44
A0431Ambulance service$5614.16
A0430Ambulance service$5195.78

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.