A0140 Billing Code: Commercial Flights to Medical Care, Approvals, and State Pricing

What A0140 means

CMS lists A0140 in the national HCPCS code set as “Non-emergency transportation and air travel (private or commercial) intra or inter state.” The short description is “Nonemergency transport air.” The October 2026 quarterly file shows the code has been in the set since January 1, 1985. It carries coverage code I, which means Medicare does not pay it, and pricing indicator 00, which means Part B sets no price.

A0140 is a seat on a plane: an airline ticket, or a private flight, inside one state or across state lines. It is not an air ambulance. Air ambulance trips bill A0430 (fixed wing) or A0431 (rotary wing), with air miles on A0435 or A0436.

Medicaid pays for flights because 42 CFR 440.170(a) counts “the cost of transportation for the beneficiary by ambulance, taxicab, common carrier, or other appropriate means” as a travel expense, along with meals, lodging, and an attendant when needed. CMS’s Medicaid Transportation Coverage Guide (SMD 23-006, September 28, 2023) says a state may describe when air travel will be considered. Its limits must be reasonable and cannot be so strict that a member cannot reach covered care.

A0140 is billed with other codes on a long trip:

Code	What it pays for
A0140	The rider’s flight, and in some states the escort’s
A0180	Lodging for the rider
A0190	Meals for the rider
A0200	Lodging for an escort
A0210	Meals for an escort
A0100, A0130, and other ground codes	The rides between home, the airport, the hotel, and the clinic

See NEMT billing codes for the full code list.

When Medicaid pays for a commercial flight

The programs below pay for a flight only after they approve the trip, and most first approve the distant medical care itself:

Program	When a flight is covered	What must happen first
Louisiana	Out-of-state care when no comparable care exists in Louisiana and the risk to the rider’s health is grave if transported by other means	The broker contacts LDH, which must approve the flight. The out-of-state care needs prior approval from LDH’s fiscal intermediary, and the treating physician confirms the flight will not harm the rider. (Section 10.1, issued July 14, 2025)
Alaska	Travel to care in another community, as part of out-of-area travel	An enrolled health care provider asks for a service authorization, at least 10 business days ahead and up to a year in advance. Requests from members are not accepted. Requests for a particular airfare class or a chartered flight get an extra review. (Guide dated April 27, 2025)
Oregon	Brokerages may buy airline tickets when that is cost effective and safe for the rider	Prior authorization, as for every NEMT ride (OAR 410-136-3020, effective January 1, 2025)
Indiana	Airline travel	Prior authorization for any airline service, for interstate travel, and for out-of-state pickups and destinations except in designated sister cities (module version 6.1, August 19, 2025)
North Dakota	Travel by airline or another commercial carrier	Prior approval on form SFN 1507 from the human services zone or tribal office, plus a service authorization from ND Medicaid for travel to a provider more than 50 miles past the nearest state border. Without that authorization, the member owes the cost. (Manual updated January 2026)
Florida	Commercial airlines are an eligible NET provider type, and out-of-state trips are covered	The out-of-state medical care must be prior authorized, and the rider or attendant must have no other accommodations available (coverage policy, November 2019)

Alaska also lists what it does not pay for on air, ferry, and train travel. That includes weekend travel it did not authorize, travel to a provider not enrolled with Alaska Medicaid (military and veterans’ facilities excepted), and a ticket for a child 2 or younger traveling with an escort, unless the child’s condition keeps them from sharing the escort’s seat.

A0140 rates and pricing by state

A0140 has no national rate. Most programs price the actual ticket, within limits:

Program	How A0140 is priced	Effective
Louisiana	The lowest refundable coach or economy fare, for the rider plus at most one attendant. Upgrades and extras such as in-flight refreshments are not paid.	Rate dated October 1, 2015, on the schedule effective October 1, 2025
Alaska	Billed charges, with a service authorization. The escort’s fare bills as A0140 TK.	July 1, 2026 to June 30, 2027
Colorado	“Train and/or commercial air,” manually priced per trip	July 1, 2026
New Mexico	Individual pricing, and 1 unit equals 1 ticket	January 1, 2025
Indiana	Covered with no fixed fee (pricing method SYSMAN). Prior authorization and an attachment are required.	Schedule updated June 9, 2026
North Dakota	Covered, with a general rate of $3,606.16 on the schedule, the same figure it shows for bus travel. Providers bill their usual and customary charge.	July 1, 2026
Oregon	Airline tickets, bought by the brokerage	Guide last updated December 22, 2025
North Carolina (county-run rides)	The county pays for non-emergency air travel and claims it back from the state on the DHB-2055 reimbursement request	MA-2910 revised March 16, 2026
Hawaii fee-for-service	Listed at $0.00 on the schedule without modifiers	June 1, 2026

Alaska bills charter flights on a different code, T2004, which its schedule lists as commercial air, multi (charter), also at billed charges. That payment will not exceed Alaska’s medevac rates.

Worked example. A Louisiana child needs out-of-state care that LDH has approved, and a parent must come. The broker can approve two seats, one for the child and one attendant, at the lowest refundable coach fare. A round trip is 2 travelers × 2 flights = 4 fares, each paid at that fare. A seat upgrade or in-flight extras are not paid. The hotel and meals bill separately under A0180 through A0210, and the rides to and from each airport under ground codes.

Units, modifiers, and escorts for A0140

Program	Unit	Modifiers and escort rules
New Mexico	1 unit = 1 ticket	UC for the member, and U1, U2, and U3 for the first, second, and third family member, one of whom can be the attendant or escort
Alaska	One authorized fare	TK for the escort’s fare. No escort is paid on an air ambulance flight.
Louisiana	One fare per traveler	At most one attendant, if medically necessary or if the rider is a child
Colorado	One trip	None listed. An escort’s fare bills on T2001, also manually priced.

Oregon recovers the cost of any common carrier ticket or pass that a member sells or gives to someone else (OAR 410-136-3240). Keep your approval number with every ticket, and never bill units the approval does not show.

How a flight gets approved, booked, and paid

1. The doctor asks. In Alaska, an enrolled health care provider requests the travel, and after care is established the receiving provider takes over. In Louisiana, the out-of-state care is approved first.
2. The program approves the flight. Louisiana’s broker must get LDH’s approval, Indiana requires prior authorization, and North Dakota needs a service authorization for care more than 50 miles past the border.
3. Someone books the ticket. In Alaska, the member books the approved flight through the Medicaid Travel Office, and the carriers do not enroll directly with Medicaid. In Oregon, the brokerage buys the ticket. In North Carolina, the county pays and claims the cost back from the state.
4. The ground legs are scheduled. Rides to and from each airport are separate services. In Alaska, each travel voucher (form AK-04) shows the ground units approved.
5. The claim is paid at the fare. Louisiana pays no more than the lowest refundable coach fare, and Alaska pays billed charges.

Where a NEMT company fits into a flight

The flight is rarely your claim, but the rides around it often are. Alaska’s April 2025 guide lists shuttle, taxi, bus, and wheelchair van rides for out-of-area travel next to flights, lodging, and meals. A member flying to Anchorage for care needs rides from the airport to a hotel or patient housing, to each appointment, and back.

Hawaii’s fee-for-service dental rides show how those legs are coded. Its memo, effective April 15, 2024, has the transportation company bill A0100 plus mileage, with a wheelchair or stretcher add-on when needed, and a modifier for each leg:

Modifier	Leg
RI and IR	Neighbor island residence to the airport, and back
IP and PI	Oahu airport to the dental office, and back
RP and PR	Residence to the dental office on the same island, and back

If you drive long-distance trips yourself, bill your ground codes and loaded miles, and settle in writing who pays for your driver’s meals and lodging on an overnight trip. North Dakota may authorize them for a driver, but not for both a driver and an attendant unless the referring provider finds one person cannot do both jobs. See long-distance medical transport and rural NEMT for how these trips fit your schedule.