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​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​Medi-Cal Ground Emergency Medical Transportation Supplemental Reimbursement Program

GEMT Program Overview

California Welfare and Institutions (W&I) Code §14105.94, enacted October 2, 2011, authorized the Ground Emergency Medical Transportation Services (GEMT) supplemental reimbursement program. This voluntary Certified Public Expenditure (CPE) based program provided additional funding to eligible governmental entities that provide GEMT services to Medi-Cal beneficiaries. The Centers for Medicare and Medicaid Services (CMS) approved State Plan Amendment (SPA) 09-024 on September 4, 2013, authorizing the federal share of the supplemental reimbursement payments based on uncompensated costs for Med​i-Cal fee-for-service transports, effective January 30, 2010. In accordance with W&I Code §14105.94(i), supplemental Medi-Cal reimbursements described under SPA 09-024 became inoperative on January 1, 2023. 

GEMT Program Eligibility

For a publicly owned GEMT service provider to be eligible for the program, the following requirements had to  be met, as specified in  Welfare and Institutions (W&I) Code § 14105.94:

  • Provided GEMT services to Medi-Cal beneficiaries (further defined in SPA 09-024 ),
  • Be enrolled as a Medi-Cal provider for the period being claimed, and
  • Are owned or operated by an eligible governmental entity, to include the state, a city, county, city and county, fire protection district, special district, community services district, health care district, or a federally recognized Indian tribe.

Eligible Providers who chos​​​​e to participate in the GEMT program must have also,

  • Entered into a Provider Participation Agreement (PPA) with the Department of Health Care Services (DHCS), and 
  • Agreed to reimburse DHCS for their allocated share of the administrative costs associated with overseeing the program.​

GEMT Reimbursement

GEMT service providers eligible to participate in this program received supplemental reimbursement payments by completing a CMS approved cost report form annually. The supplemental reimbursement payment was ​based on claiming federal financial participation on CPEs that have already been incurred by the public provider. The supplemental reimbursement amount was determined by the methodology approved by CMS in SPA 09-024 .

How To Contact Us

If you have any questions related to the GEMT program, please email: GEMT@dhcs.ca.gov. ​​​

Policy and Procedure Letters
  • PPL 25-001
    November 11, 2025 - Administrative cost reimbursement under the Supplemental Reimbursement for Publicly Owned or Operated Ground Emergency Medical Transportation Providers program.
  • PPL 14-001
    December 18, 2014 – Allowable reimbursement of GEMT contracted billing and accounting service costs.
  • PPL 14-002
    December 18, 2014 – Eligibility for public providers that contract for the provision of GEMT services with other public providers.
  • PPL 13-001
    September 30, 2013 – Eligibility for public providers that contract for the provision of GEMT services with private providers.
  • PPL 13-002
    November 21, 2013 – Aligning Provider’s financial fiscal year with the State fiscal year for cost reporting requirements.
Training Slides
Additional Resources & Links
  • CMS-PUB 15-1
    CMS Provider Reimbursement Manual - Part 1
  • OMB Circular A-87
    Office of Management and Budget (OMB) Cost Principles for State, Local, and Indian Tribal Governments.
Last modified date: 1/6/2026 9:01 AM