A0390 Advanced life support mileag

Als mileage (per mile)

Medically Unlikely Edits (effective October 1, 2026)

Medicare pricing for A0390

Physician Fee Schedule (CY 2026, RVU26D)

Status I: not valid for Medicare (Medicare uses another code).

Payer policies and prior authorization for A0390

Payer coverage policies that name A0390

A0390 appears in 18 coverage policies from Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross & Blue Shield of Rhode Island, Blue Shield of California, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
AnthemAmbulance Services: Ground; Emergent (CG-ANC-05)covered if criteria are metNov 6, 2025payer document
AnthemAmbulance Services: Ground; Non-Emergent (CG-ANC-06)covered if criteria are metMay 14, 2026payer document
Blue Cross & Blue Shield of MississippiAmbulance And Medical Transport Services (L.9.01.400)covered if criteria are metpayer document
Blue Cross & Blue Shield of Rhode IslandAmbulance Services - Groundcovered if criteria are metSep 17, 2025payer document
Blue Shield of CaliforniaBSC10.02 | Non-emergency Ground Ambulancelisted, no stancepayer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)Ambulance and Transport Services (MED201.058)
HCPCS Codes A0021, A0080, A0090, A0100, A0110, A0120, A0130, A0140, A0160,		listed, no stanceJun 15, 2026payer document
UnitedHealthcareAmbulance Services (MP.001.25)
Ground/Other Ambulance		listed, no stanceJun 1, 2026payer document
UnitedHealthcareAmbulance Services (CS003.T)
Ground/Other Ambulance		listed, no stanceJun 1, 2026payer document
UnitedHealthcareAmbulance Services (for Idaho Only) (CS003ID.C)
Ground/Other Ambulance		listed, no stanceAug 1, 2026payer document
UnitedHealthcareAmbulance Services (for Kansas Only) (CS003KS.03)
Ground/Other Ambulance		listed, no stanceJul 1, 2026payer document
UnitedHealthcareAmbulance Services (for Kentucky Only) (CS003KY.09)
Ground/Other Ambulance		listed, no stanceJul 1, 2025payer document
UnitedHealthcareAmbulance Services (for Nebraska Only) (CS003NE.S)
Ground/Other Ambulance		listed, no stanceAug 1, 2026payer document
UnitedHealthcareAmbulance Services (for New Jersey Only) (CS003NJ.Q)
Ground/Other Ambulance		listed, no stanceJul 1, 2026payer document
UnitedHealthcareAmbulance Services (for New Mexico Only) (CS003NM.C)
Ground/Other Ambulance		listed, no stanceAug 1, 2026payer document
UnitedHealthcareAmbulance Services (for North Carolina Only) (CSNC.MP.001.09)
Ground/Other Ambulance		listed, no stanceAug 1, 2026payer document
UnitedHealthcareAmbulance Services (for Ohio Only) (CS003OH.E)
Ground/Other Ambulance		listed, no stanceJul 1, 2026payer document
UnitedHealthcareAmbulance Services (for Pennsylvania Only) (CS003PA.T)
Ground/Other Ambulance		listed, no stanceJun 1, 2026payer document
UnitedHealthcareAmbulance Services (for Tennessee Only) (CS003TN.R)
Ground/Other Ambulance		listed, no stanceAug 1, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.