Point of Pick up ZIP Code Required for Medicare Advantage Ambulance Claims

Date Issued: 9/4/2013

Ambulance claims for Medicare Advantage members must contain a Point of Pick-up (POP) ZIP code in box 23 of the HCFA 1500 to be processed. Claims that do not have a POP in box 23 will be denied.

Previously, we used the ZIP in box 32 if no POP ZIP was listed on the claim. This practice has been deemed non-compliant by the Centers for Medicare & Medicaid Services.