Policy Allowing Reimbursement of Emergency Ambulance Treatment in Place (TIP) Services

TO: Ambulance Service Providers

DATE: 7/8/2026

Dear MetroPlusHealth Provider,

To comply with New York State reimbursement policy guidelines for dates of service retroactive to October 1, 2024, MetroPlusHealth will reimburse claims for Treatment in Place (TIP) services provided by emergency ambulance providers in response to a 911 emergency call. TIP services are limited to the delivery of medically necessary emergency care at the scene without transporting the member to a hospital or other destination.

Billing Codes and Reimbursement Criteria

• Providers should bill with the appropriate ambulance HCPCS code and must append the new destination modifier “W” to designate “Treatment in Place” (TIP), which means administration of emergency medical services, consistent with the Public Health Law (PHL) §3001, by an employee or volunteer of an ambulance service.
• Please note, mileage is not reimbursable for TIP claims.
• Claims submitted with the appropriate HCPCS code but without modifier “W” will be denied

Thank you for your continued partnership and for your commitment to providing quality care to our members. If you have any questions, please contact the Provider Relations department at [email protected].

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