ZIP Code/Point of Pickup

Medicare bases payment on the POP ZIP Code under the ambulance fee schedule. Report it as a 5-digit ZIP Code. It determines the applicable geographic practice cost index (GPCI) and whether a rural adjustment applies. Report the POP ZIP Code on every claim.

The CMS IOM Publication 100-04, Chapter 15, Section 20.1.5 contains the POP ZIP Code requirements.

For Part B use Box 23 of the CMS 1500 form or ANSI version X-12N837 (5010) loop 2310E.

The claims processing system reports the POP ZIP Code to the Common Working File (CWF). CWF reports it to the national claims history file, along with the rest of the ambulance claims record.

Medicare bases payment on the POP ZIP Code under the ambulance fee schedule. Report it as a 5-digit ZIP Code. It determines the applicable geographic practice cost index (GPCI) and whether a rural adjustment applies. Report the POP ZIP Code on every claim.

The CMS IOM Publication 100-04, Chapter 15, Section 20.1.5 contains the POP ZIP Code requirements.