CMS Increases Part B Trip Fee Payments 

Change Request 8203 issued by CMS on March 15, 2013, revises the payment of travel allowances for 2013 when billed on a per mileage basis using HCPCS Code P9603 and when billed on a flat rate basis using HCPCS Code P9604. 

The new rate for HCPCS Code P9603, where the average trip to patients’ homes exceeds 20 miles round trip, is 0.565 cents per mile, plus an additional 45 cents per mile to cover the technician’s time and travel costs, for a total of $1.02 per mile (actual total of $1.015 rounded up to reflect systems capabilities). 

The new rate for HCPCS Code P9604 is paid on a flat-rate trip basis travel allowance of $10.15. 

Claims for these services will not be automatically adjusted. Providers must bring any previously paid claims to their contractors’ attention. The effective date for the increase is January 1, 2013, but the implementation date is June 17, 2013. 

Click to view CMS Change Request 8203 and CMS Medicare Learning Network (MLN) Matters Newsletter.