Revised: January 11, 2019
Local county or tribal agency nonemergency medical transportation (NEMT) service is transportation provided for eligible Minnesota Health Care Programs (MHCP) members by local county and tribal agencies to allow the members access to receive covered medical services or to attend MHCP service-related appeal hearings. Members eligible for fee-for-service (FFS) NEMT and related ancillary services must contact their county of residence (COR) local agency for policies and procedures to obtain service or service reimbursements.
The local county or tribal agency must inform the members of their transportation options and requirements to correctly access those services. Information to members must include but is not limited to the following:
Medical Transportation Management’s Minnesota Nonemergency Transportation (MTM-MNET) coordinates local agency NEMT for some counties through host county contracts.
For all other counties, contact the local county or tribal agency for NEMT transport and ancillary service processes and procedures.
Local agency NEMT transport services include the following:
Local agency NEMT transportation services provided by the NEMT provider include the following:
Ancillary Access Services
Local county and tribal agencies administer reimbursement of related travel expenses when necessary to allow members to obtain a covered health service.
Ancillary access services available to eligible members include:
Refer to the Access Services Ancillary to Transportation section for more information.
The county or tribal agency uses transportation providers or private automobile to provide transportation services to FFS members. Contact the local county or tribal agency for their transportation service enrollment or contracting information and requirements.
Examples of local agency NEMT providers include the following:
County and Tribal Agencies
All NEMT providers must comply with the operating standards for vehicles and drivers according to Minnesota Statutes 174.29 and 174.30. Publicly operated transit systems, volunteers, and not-for-hire vehicles are exempt from the requirement.
Provider Type Home Page Links
Fee-for-service MHCP members enrolled in the following programs are eligible to receive transportation services:
For members enrolled in a managed care organization (MCO), or transportation services provided through a waiver program, refer to Eligible Recipients in the Nonemergency Medical Transportation (NEMT) Services (Overview) section.
MinnesotaCare members enrolled in a managed care plan with dates of service on and after January 1, 2017, will only receive or be reimbursed for personal mileage (mode 1), unassisted transport— out-of-state airfare only (mode 3), and out-of-state transport and ancillary services (lodging, meals, parking or tolls) through the local county or tribal agencies. All other NEMT transports are accessed through the health plan.
Members must contact MNET or their local county or tribal agency for policies and procedures for scheduling or obtaining local agency NEMT-related ancillary services or reimbursements.
Refer to Covered Services in the Nonemergency Medical Transportation (NEMT) Services (Overview) section for general service coverage requirements.
Also see One-time Transport Assessments and Upgrades in the Transportation Overview section.
Local agency NEMT is a covered service when nonemergency transportation services are provided for the following:
MA members residing in, or being admitted to or discharged from a licensed nursing facility automatically qualify for state-administered NEMT-level transportation for all non-stretcher state-administered NEMT transport level trips. These people do not need a LOS certification through KEPRO. The local county human services agency updates the member’s living arrangement code and must indicate the member resides in a nursing facility. The member living arrangement must be one of the following for the provider to receive reimbursement for state-administered NEMT transports (verify these living arrangement codes through the recipient Eligibility Request in MN–ITS):
Exception: NEMT transport to nursing facility on date of discharge from the hospital
Local agency administered NEMT transports for an MHCP member to a nursing facility on the date of discharge from a hospital are eligible for reimbursement if the county has not updated the member’s living arrangement three months after the month of admission. See documentation requirements later in this section.
Electroconvulsive therapy, dialysis and outpatient procedures with sedation
Members who receive electroconvulsive therapy (ECT), dialysis, or outpatient procedures with sedation are eligible for local agency NEMT to and from the service. Members may require a higher mode of NEMT transport for the return trip. This could include a state-administered mode or level of transport. Refer to the State-Administered NEMT Transportation Services section for Authorization Requirements. Refer to Transportation Upgrade in the State-Administered NEMT Transportation Services section for covered services.
Personal mileage reimbursement
Personal mileage is the least costly method of transport and is reimbursed by the local county or tribal agency. Members who have a vehicle must use personal mileage and are not eligible for other modes of transport.
Personal mileage reimbursement cannot be denied based on a minimal distance driven to obtain the MHCP covered medical service. The mileage to and from the eligible service by the most direct route is reimbursable. The local agency may hold personal mileage reimbursement until a reasonable amount has been accrued before generating a payment. The local county or tribal agency may deny personal mileage that exceeds the 30 or 60 mile limits when not authorized, coordinated or delivered according to local agency policies and procedures.
Refer to the following exceptions from the use of the personal mileage requirement:
Personal mileage reimbursement requirements include, but may not be limited to the following:
MHCP covers corporate or business foster care provider mileage reimbursement when:
Volunteer mileage reimbursement
Local agency-recognized volunteer drivers must meet both of the following:
Refer the volunteer driver or volunteer driver organization to the Minnesota Department of Revenue’s website and their Volunteer Mileage Reimbursement page for information related to volunteer driver reimbursement, possible tax implications and requirements for issuing Form 1099.
For reimbursement of parking, meals and lodging, refer to the Access Services Ancillary to Transportation page.
Trip documentation must be consistent with Minnesota Statutes 256B.0625, subdivision 17b which includes the following requirements:
Refer to Noncovered Services in the Nonemergency Medical Transportation (NEMT) Services (Overview) section.
Transport provided by a PCA, HHA, corporate foster care, county social worker or case worker, etc., is not reimbursable if transportation is reimbursed by other program funds.
Transport of an Emergency Medical Assistance (EMA) member for the purpose of obtaining routine or preventative medical care or services is not covered.
Refer to Authorization for general authorization requirements. Refer to the Authorization section in the Nonemergency Medical Transportation (NEMT) Services (Overview) for more specific information. Local county or tribal agencies may require authorization for the transportation services they provide or reimburse.
Refer to the Nonemergency Medical Transportation (NEMT) Services (Overview) section for out-of-state medical services.
Refer to Billing in the Nonemergency Medical Transportation (NEMT) Services (Overview) section for billing policy information. Refer to the MN–ITS User Guide for specific billing instructions.
Local agency administered NEMT providers do not bill MHCP for service reimbursements. Contact the local county or tribal agency for reimbursement processes.
County or Tribal Agencies
Local county and tribal agencies may reimburse the member or the provider directly for costs incurred. Reimbursement is the lesser of the member’s or provider’s submitted charge and the MHCP calculated allowable. The calculated allowable is the maximum amount MHCP will reimburse the local agency.
For more information about the NEMT billing process, procedure codes, modifiers and payment rates refer to the Local County or Tribal Agency Nonemergency Medical Transportation (NEMT) Services Claim, Service, and Rate Informationsection.
For the ancillary access services billing process, refer to the Ancillary Access Service Procedure Codes, Modifiers and Payment Rates web page.
Laws of Minnesota 2014, chapter 312, article 24, section 28 NEMT provider requirement
Laws of Minnesota 2014, chapter 312, article 24, section 45 Waiver Applications for Nonemergency Medical Transportation Service Providers
Minnesota Statutes 174 (Department of Transportation)
Minnesota Statutes 174.29-174.30 (Coordination of Special Transportation Service)
Minnesota Statutes 256B.0625, subd.17 (Transportation costs)
Minnesota Statutes 256B.0625, subd.17a (Payment for ambulance services)
Minnesota Statutes 256B.0625, subd.18 (Bus or taxicab transportation)
Minnesota Statutes 256B.0625, subd.18a (Access to medical services)
Minnesota Rules 8840.5925 (Vehicle Equipment)
Minnesota Rules 9505.0315 (Medical Transportation)
Minnesota Rules 9505.0445 (Payment Rates)