P9604 One-way allow prorated trip
Also known as: Transport reimbursement trip, Trip allowance
One-way transportation allowance calculated and prorated based on trip charges for patient transport.
In Plain Language
Payment for medical trip
Clinical Context
Medicare reimbursement for patient transportation using trip-based billing rather than mileage.
RVU Information
CPT P9604 does not have a physician work RVU assigned by CMS. This is typical for supply, drug, and equipment codes — reimbursement is based on Average Sales Price (ASP), fee schedules, or payer contracts rather than the RVU system.
Billing & Documentation
P-codes cover pathology screening and blood product services. Documentation must include the ordering provider, clinical indication, and specimen type. For blood products, include the product type, volume, and transfusion details.
Specialties
Frequently Asked Questions
What is CPT code P9604?
CPT P9604 (One-way allow prorated trip) is a P Codes code. One-way transportation allowance calculated and prorated based on trip charges for patient transport.
Does Medicare cover P9604?
Medicare coverage for P9604 depends on medical necessity and applicable Local Coverage Determinations (LCDs). Medicare reimbursement for patient transportation using trip-based billing rather than mileage. A physician order is typically required.
When is CPT P9604 used?
Medicare reimbursement for patient transportation using trip-based billing rather than mileage.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.