Which place of service code goes on a NEMT claim?
Most transportation claims use CMS place of service 41 (ambulance, land), 42 (ambulance, air or water), or 99 (other place of service), entered on each line of the CMS-1500 in box 24B. States disagree about van rides: Colorado puts 41 on ground NEMT claims, while Oregon and North Carolina use 99 for non-ambulance vehicles and keep 41 and 42 for ambulances. Check your state manual before billing.
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What the place of service code does
A place of service code is a two-digit code that tells the payer where a service happened. CMS maintains the list, and the paper claim instructions from the National Uniform Claim Committee send every professional claim line to it for box 24B. CMS also tells billers to check each payer’s reimbursement policy for the codes, and transportation programs do not all agree.
For most services the place is a building: 11 for an office, 12 for a home, 21 for an inpatient hospital. A ride happens in a vehicle, so transportation claims draw on a short part of the list.
The three codes transportation uses
| Code | CMS name | CMS description |
|---|---|---|
| 41 | Ambulance - Land | “A land vehicle specifically designed, equipped and staffed for lifesaving and transporting the sick or injured.” |
| 42 | Ambulance - Air or Water | “An air or water vehicle specifically designed, equipped and staffed for lifesaving and transporting the sick or injured.” |
| 99 | Other Place of Service | “Other place of service not identified above.” |
There is no national code for a wheelchair van, stretcher van, or taxi. The programs below each assign one of these three to non-ambulance rides.
What state programs ask for
| Program | Ambulance | Van, car, taxi, bus |
|---|---|---|
| Colorado | 41 land, 42 air | 41 (the NEMT manual lists only 41 and 42) |
| Oregon | 41 land, 42 air or water | 99 |
| North Carolina | 41 (land) or 42 | 99 |
| Texas | 41 or 42 on Texas Medicaid ambulance claims | Medical Transportation Program: 99 on TexMedConnect, 09 on paper |
| Nevada NET encounters | 99, including A0428 trips | 99 in the claim’s facility code field |
Oregon requires a place of service on every professional transportation claim, and North Carolina’s manual, revised March 16, 2026, requires it on all claims. Texas’s claims filing section pairs each national code with a one-digit Texas code, and its 9, “other location,” covers national codes 41, 42, and 99. The MTP handbook’s paper value, 09, matches that one-digit 9, even though 09 on the national list is a prison or correctional facility.
Two programs also bring the rider’s location into it. Medi-Cal wants 21, inpatient hospital, when it transports someone who remains a hospital inpatient, with the pickup hospital’s address and NPI entered in boxes 32 and 32A. Texas accepts 41 and 42 on ambulance claims, and its claims filing section also has a row telling ambulance providers to indicate the destination with its location codes.
Where the code goes on the claim
- Paper CMS-1500: box 24B, on every service line. The field takes two digits. Our CMS-1500 guide covers the other boxes.
- Electronic 837P: Nevada’s transportation encounter guide shows the code in the claim’s facility code field, CLM05-1, with qualifier B for professional place of service codes. Our 837P guide walks through the file.
The trip’s actual pickup and drop-off do not go in the place of service field. Programs that track them use origin and destination modifiers, box 19, or an attached trip record.
Mistakes that trip up transportation claims
- Borrowing another state’s choice. A 99 that Oregon expects is not the 41 Colorado lists for the same wheelchair trip.
- Using the rider’s destination when the program wants the vehicle code, or the reverse in the few programs that ask for a location.
- Carrying Texas’s paper 09 onto an electronic claim or to another payer, where 09 stands for a correctional facility.
- Leaving box 24B blank on a line. Oregon and North Carolina require the code on every claim. See what makes a clean claim for the other fields payers check.
Frequently asked questions
- Should a wheelchair van use place of service 41 or 99?
- Follow the payer. The CMS definition of 41 describes a land vehicle designed, equipped, and staffed for lifesaving, which reads like an ambulance, and Oregon and North Carolina both assign 99 to non-ambulance rides. Colorado's NEMT manual labels 41 "land transportation" and lists no code besides 41 and 42, so a Colorado wheelchair van claim carries 41.
- Why does Texas ask for 09 on paper transportation claims?
- Texas keeps a table that pairs national place of service codes with one-digit Texas codes. In it, 9 means "other location" and stands in for national codes 41, 42, and 99, among others. The Medical Transportation Program handbook lists 09 for paper claims and 99 for claims keyed into TexMedConnect. On the national list, 09 belongs to prisons and correctional facilities. Keep the paper value away from other payers.
- Is the place of service the pickup address or the destination?
- Usually neither. For most programs the place of service is the vehicle, which is why transportation codes come from 41, 42, and 99. A few programs tie it to a location: Medi-Cal uses 21 when it transports a hospital inpatient out and back, and the Texas code table has a row for showing an ambulance's destination. The trip addresses themselves go in other claim fields or in the origin and destination modifiers.
