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December 2016 Texas Medicaid Provider Procedures Manual

Ambulance ServicesHandbook : 2 Ambulance Services : 2.4 Claims Filing and Reimbursement : 2.4.8 Extra Attendant

2.4.8
The use of additional attendants (procedure code A0424) must be related to extraordinary circumstances when the basic crew is unable to transport the client safely.
An extra attendant on a nonemergency transport must be prior authorized. On an emergency transport, the billing provider’s medical documentation must clearly indicate the services the attendant performs along with a rationale for the services to indicate medical necessity of the attendant.
The information supporting medical necessity must be kept in the billing provider’s medical record and is subject to retrospective review.
Situations when an extra attendant may be required beyond the basic crew include, but are not limited to:
Necessity of additional special medical equipment or treatment en route to destination (describe what special treatment and equipment is required and why it requires an attendant).
The use of an extra attendant for air transport is not a benefit of Texas Medicaid. Claims submitted with procedure code A0424 will be denied if billed with air transports (procedure code A0430 or A0431).

Texas Medicaid & Healthcare Partnership
CPT only copyright 2014 American Medical Association. All rights reserved.