Frequently Asked Questions for Medi-Cal Transportation Services
How can I become an NMT provider?
Transportation providers who are currently enrolled in Medi-Cal may request to become an NMT provider by submitting a completed Medi-Cal Supplemental Changes form (DHCS 6209). NEMT providers wishing to use already reported NEMT vehicles to provide NMT services, must also report that to the department in the “Other Information" section of the DHCS 6209 and submit a letter stating that they will use existing NEMT vehicles and drivers previously approved by DHCS.
NEMT providers requesting to add NMT services should state so in the space provided on page 17, items 37 and 38 of the DHCS 6209 form. NMT vehicles may be added on page 13; copies of the Department of Motor Vehicles vehicle registration and proof of vehicle insurance must be included.
Transportation providers who wish to newly enroll in Medi-Cal for NMT will need to submit a completed Medi-Cal Transportation Provider Application package, which includes a “Medi-Cal Medical Transportation Provider Application" form (DHCS 6206), a “Medi-Cal Provider Agreement" form (DHCS 6208) and a “Medi-Cal Disclosure Statement" form (DHCS 6207).
How can transportation providers verify a beneficiary's eligibility?
Providers may verify a beneficiary's eligibility information through Medi-Cal's Automated Eligibility Verification System (AEVS). Providers must verify beneficiary eligibility and obtain verbal or written attestation before providing NMT or have a written prescription from a licensed Medi-Cal provider for NEMT.
Does NMT require a prescription from a licensed provider?
No. NMT does not require a prescription from a licensed provider. However, beneficiaries will need to attest to the provider verbally or in writing that they have an unmet transportation need and all other currently available resources have been reasonably exhausted.
Are there any forms the beneficiary needs to sign?
No, DHCS does not require completion of any standard forms related to NMT services. However, transportation providers will need to ensure and maintain documentation that beneficiaries attested either verbally or in writing that they have an unmet transportation need and all other transportation options have been reasonably exhausted.
Are there any mileage restrictions?
No, NMT does not have a mileage restriction.
Are there any geographical restrictions for NMT?
No, NMT does not have a geographical restrictions and can be provided statewide.
Does NMT require prior approval?
If the beneficiary has FFS Medi-Cal, more than eight one-way trips per month requires documentation on the claim form or an attachment stating that the beneficiary required the transportation to obtain necessary Medi-Cal covered services.
Some MCPs may require prior approval for NMT. Please check with the MCP. For information regarding Medi-Cal MCP prior approval requirements, if any, please refer to All Plan Letter 17-010.
Where can I find more information about Medi-Cal's FFS reimbursement policies for NMT?
Additional information is available in the following Medi-Cal Provider Manual sections:
Medical Transportation – Ground
Medical Transportation – Ground: Billing Codes and Reimbursement Rates
Medical Transportation – Ground: Billing Examples
Who can I contact if I have questions?
Providers may direct questions about billing to the Telephone Service Center at 1-800-541-5555
. For Benefits-related questions, providers may direct inquiries to the DHCS-Benefits@dhcs.ca.gov
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