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Nonemergency Medical Transportation (NEMT) Services (Overview)

Revised: 09-28-2017

  • Overview
  • Eligible Providers
  • Eligible Recipients
  • Covered Services
  • One-Time Transport Assessments and Upgrades
  • Multiple Riders
  • Multiple Trip Legs
  • Transportation between Two Similar or Same Facilities or Locations
  • Reconsideration Procedures
  • Noncovered Services
  • Excluded Costs Related to Transportation
  • Authorization Requirements
  • Documentation Requirements
  • Billing
  • Definitions
  • Legal References
  • Refer to the NEMT Guide for information about procedures.

    Overview

    MHCP covers the following categories of medical transportation services: (Select the links for service-specific coverage policies and billing procedures.)

    Nonemergency Medical Transportation Services (NEMT)
    NEMT provides Medical Assistance (MA) members with the safest, most appropriate and cost-effective mode of transportation to get to and from nonemergency medical service appointments. Recipients can arrange NEMT as one-way or round trips. Medical necessity determines for which of the following types or levels of transport and ancillary services the member is to be certified:

  • • Local county or tribal agency – (sometimes called “common carrier.”) Local agency NEMT includes private automobiles, volunteer drivers, bus, taxicab, light rail or other commercial carriers for transportation to and from covered medical services.
  • • State-administered NEMT services – transport services for recipients unable to use county or tribal administered NEMT because physical or mental impairment will require the transportation driver to provide door-to-door or door-through-door (station-to-station) assistance to the recipient. Recipients who qualify for state-administered NEMT may need the driver’s help up to, into, or in the residence or pickup location. This includes assistance to or from the appropriate medical appointment desk.
  • All NEMT transport services include reimbursement in the rates for all activities of the transport driver needed to ensure the safe loading, unloading and transport of the rider. This may include but is not limited to any of the following:

  • • Helping the rider enter or exit the vehicle including the use of a ramp or lift
  • • Securing the rider in the vehicle
  • • Securing the wheelchair or scooter
  • • Appropriate use of a child or booster seat
  • • Other actions necessary for safe transport of the rider while in the vehicle
  • Emergency Medical Transportation
    Ambulance Transportation Services
    is the transport of a recipient whose medical condition or diagnosis requires medically necessary services before and during transport. This includes air and ground, emergency and nonemergency ambulance services.

    Eligible Providers

    Eligible providers meet the following:

  • • MnDOT vehicle and driver requirements as established in Minnesota Statutes 174.29 and 174.30.and Minnesota Rules, Chapter 8840 or have a MnDOT certification variance (excludes not-for-hire (personal mileage), volunteer driver, and publically operated transit systems)
  • • Additional driver and attendant training for protected transportation services
  • • MHCP Provider Enrollment or local county or tribal agency criteria
  • Refer to the Provider Enrollment web page for general enrollment requirements. Refer to the Provider Basics, Provider Requirements, Access Services section for nonparticipating provider information.

    Provider Type Home Page Links
    Review related web pages for the latest news and additions, forms, and quick links.

    Eligible Recipients

    To be eligible to receive NEMT services, the recipient must meet one of the following criteria:

  • • Enrolled in Medical Assistance (MA)
  • • Enrolled in state-only funded MA benefits due to residing in an Institution for Mental Diseases (IMD)
  • • Enrolled in Emergency Medical Assistance (EMA)
  • • A MinnesotaCare enrollee under the age of 21
  • • A pregnant woman enrolled in MinnesotaCare
  • • Enrolled in Refugee Medical Assistance (RMA)
  • • Enrolled in Minnesota Family Planning Program (MFPP)
  • Recipients enrolled in a managed care organization (MCO) must contact the appropriate MCO for the process and procedures for obtaining transportation services.

    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—air fare 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.

    Transportation to services provided for a waiver program is the responsibility of the waiver program. For recipient transportation to waiver program services, see HCBS Waiver Services and Elderly Waiver (EW) and Alternate Care (AC) Program sections in the manual.

    Refer to these sections for specific policies about eligible recipients:

  • Local County or Tribal Agency Nonemergency Medical Transportation (NEMT) Transportation Services
  • Ambulance Transportation Services
  • State-Administered NEMT Services
  • Protected Transportation Services
  • A person who is certified for state-administered NEMT transport services must contact the provider to schedule transport for ramp or lift-equipped, protected, or stretcher transports. If certified for state-administered NEMT assisted transport or the local agency administered NEMT transports, the person must obtain transport through the local county or tribal agency.

    Covered Services

    MHCP covers NEMT services when provided for an eligible MHCP recipient to or from the site of an MHCP-covered medical service and either of the following apply:

  • • Services are provided by an enrolled MHCP health care provider (ambulance and STS)
  • • Services are provided by a local county services or tribal agency provider (ATS)
  • Refer to these sections for specific covered service policies:

  • Local County or Tribal Agency Nonemergency Medical Transportation (NEMT) Transportation Services
  • Ambulance Transportation Services
  • State-Administered NEMT Services
  • Protected Transportation Services
  • Spenddown
    Non-emergency medical transportation (NEMT) and the related ancillary service charges ARE NOT applied to an existing spenddown obligation of a recipient. Recipients with a spenddown obligation are eligible for NEMT and related ancillary services to get them to and from their medical appointments. MHCP will reimburse for transports and ancillary services to the local agencies or enrolled NEMT provider.

    Responsible Person
    NEMT services may be provided for the recipient and, when necessary, one responsible person. The responsible person is included in the reimbursement for ground transports.

    A responsible person is an adult or emancipated minor who is needed to make medical decisions, learn about the recipient’s medical care or is necessary to allow the recipient to receive a covered medical service.

    In most situations, the responsible person must be transported with the MHCP recipient to receive payment or reimbursement for the NEMT services. An eligible responsible person includes, but is not limited to one of the following:

  • • Immediate family
  • • Other relatives
  • • Authorized representative
  • • Legal guardian
  • Family Members Transported Without the Recipient
    MHCP covers transportation of responsible persons and one or more siblings from a single location separately from the recipient when necessary to enable family therapy services as established in the recipient’s plan of care to be completed. For example, the responsible person, sibling or spouse of a child or parent living in a residential facility may be required to attend therapy sessions or complete therapy services. Such cases do not require the recipient receiving care to be included in the transport. Use the recipient’s MHCP ID number when billing.

    Organ Transplant Donor
    MA may reimburse the costs of the appropriate level of NEMT transport and ancillary services to get the MA organ transplant donor from his or her location to Minnesota and back to the initial location. This ONLY includes transport and ancillary services for organ transplant donors from locations WITHIN the United States.

  • • The local county or tribal agencies (or transportation coordinator working on behalf of one or more local agencies) must provide the criteria for NEMT transport and ancillary service reimbursements when services are requested by or for the organ transplant donor.
  • • The local agencies and transportation coordinators will follow their usual NEMT and ancillary service authorization and approval process when considering services, including that the service is the least costly to meet the needs of the organ transplant donor.
  • • The organ transplant donor may require ancillary services for a reasonable period of time prior to and following the surgical procedure based on medical necessity. Verify with the transplant service provider.
  • • All standard documentation and receipt requirements for NEMT transport and ancillary services apply to the organ transplant donor services.
  • • Kidney transplants do not require prior authorization from the MHCP medical review agent.
  • • All other organ transplants require prior authorization by the MHCP medical review agent.
  • The recipient is responsible for obtaining the documentation necessary to give to the local agency for MA to provide and reimburse transport and ancillary services properly. The recipient gets the information or documentation from his or her managed care organization (MCO).

    Service Animals
    Under the Americans with Disabilities Act (ADA), a service animal is any dog that is individually trained to do work or perform tasks for the benefit of a person with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability. Other species of animals whether wild or domestic, trained or untrained, are not service animals for the purpose of this definition. In addition to dogs, the ADA allows miniature horses to be service animals if they have been individually trained to do work or perform tasks for the benefit of the person with a disability.

    Recurring Trips
    A recurring trip is when an MHCP member needs transportation to appointments with sequential dates and times on a daily, weekly, or bi-weekly basis for an extended period. MHCP members may schedule recurring trips for up to 30 days at a time in most cases. Members may schedule for more than 30 days in advance for the following conditions or services (including but not limited to):

  • • Dialysis
  • • Child day treatment programs (Fraser, Lazarus, etc.)
  • • Chemotherapy
  • • Dialectical behavior therapy
  • Transport for Repair of Medical Equipment
    MHCP covers transportation for medical equipment repair only when the recipient and medical equipment are transported together.

    Transportation to an Opioid Treatment Program (OTP)
    As of July 1, 2015, providers and drivers must be chosen on a random basis, when feasible, for all NEMT transportation to Opioid Treatment Program (OTP) clinics. You can find more about this in the NEMT Guide.

    Pharmacy Transports
    Allow pharmacy-only transports when transport is the only option available based on pharmacy requirements or absence of other means to obtain the prescription(s). Recipients must use all means to obtain pharmacy items which includes, but is not limited to the following:

  • • Obtaining the prescription from the out-patient pharmacy at the medical facility or office location
  • • Using mail, delivery or courier services
  • • Obtaining prescription(s) on return to residence or work from the medical appointment (additional mileage is reimbursable for this purpose)
  • • Obtaining prescription(s) while other activities of daily living are completed
  • If pharmacy-only transport is required, the following apply:

  • • All prescriptions must be coordinated for pick-up on the same date
  • • Multiple trips per week or per month are not allowed
  • One-time Transport Assessments and Upgrades

    One-time assessment is for same-day service upgrade requests. The local county or tribal agency may authorize upgrade requests for county or tribal agency-level NEMT; the MHCP medical review agent may authorize requests for state-administered NEMT. One-time assessments are completed when recipients with temporary conditions or sudden changes in condition require a higher level of transport service than they are currently approved to receive. Approve the one-time upgrade when the medical service is urgent, a medical provider who has seen or spoken with the person that day requests the medical service, or as required for discharge from the hospital.

    Urgent care is care for any illness or severe condition which, under reasonable standards of medical practice, would be diagnosed and treated within a 24-hour period and if left untreated, could rapidly become a crisis or emergency. Transportation requests for urgent care include any calls for transportation services when the person indicates his or her medical provider has told him or her to come to the provider’s office or to obtain other medical treatment or services that same day or within a 24-hour period.

    Complete the same-day NEMT upgrade using the assessment process to ensure the proper level of transport is established and provided based on medical necessity. Same-day, after hours, weekend, and holiday transport services depend on provider availability.

    Hospital Discharges
    Members being discharged from a hospital after hours, including weekends and holidays, may need a higher mode of services. Hospital staff may initiate a one-time assessment for this purpose. Hospital staff must first determine if the person has a current level of transport service established for NEMT. If the person has a local county or tribal agency NEMT level of transport established, does not require a greater level of service for discharge and the transport level providers are available, inform the person that he or she may call the county or tribe directly to schedule the transport.

    If the recipient’s medical needs require a higher level of transport or the recipient’s current transport level providers are not available, hospital staff must review the recipient’s conditions and establish the appropriate level of transport based on the person’s current medical needs.

    The discharge provider must also contact the MHCP state-administered NEMT transport medical review agent within seven business days of the transport to have the level-of-service (LOS) assessment finalized when state-administered NEMT was necessary. The medical review agent will not review or certify the transport if they do not receive the information within seven business days. The provider or member may then contact the transportation provider to schedule transport.

    Multiple Riders

    For dates of service on and prior to June 30, 2017, a provider may transport two or more MHCP recipients in one vehicle from the same or different points of pickup to the same or different destinations. Transportation base and mileage payments are prorated only when multiple riders use the same pickup or origination point. The destination or drop-off point of each rider does not determine if proration of reimbursement is required.

    Report the number of riders picked up at the same point of origin on the 837P electronic claim form. Proration applies to all NEMT transports having separate base and mileage reimbursements available. All riders are prorated the same percentages for the base service and mileage rates for the entire distance of the transport. For example, if two riders are picked up at the same location, both riders will have their base rate prorated to 80 percent and their total mileage to 50 percent.

    Allowed base rate and mileage rate percentages

    Number of Riders

    % of Allowed Base Rate
    Per Person in the Vehicle

    % of Allowed Mileage Rate

    1

    100

    100

    2

    80

    50

    3

    70

    34

    4

    60

    25

    5–9

    50

    20

    10 or more

    40

    10


    Multiple rider examples

    Example 1:
    Rider A is picked up at his or her residence and travels with transport provider to pick up rider B at his or her residence. Both riders A and B are dropped off at the same or different destinations. No proration is required. The riders were not picked up at the same point of origin (pick-up point). The destination point(s) does not determine if proration applies to the transport.

    Example 2:
    Riders A and B are both picked up at the same pick-up point and dropped off at different locations. Proration applies to the base and mileage reimbursements because the riders were picked up at the same point of origin.

    Example 3:
    Riders A and B are both picked up at the same point of origin and are dropped off at the same destination. Proration applies to the base and mileage reimbursements because the riders were picked up at the same point of origin.

    Example 4:
    Riders A, B, and C are all picked up at the same point of origin and dropped off at the same or different destinations. The same proration calculation applies to the base and mileage reimbursements for all riders because all riders were picked up at the same point of origin.

    Example 5:
    Riders A, B, and C are all picked up at different points of origin and dropped off at the same or different destinations. Proration does not apply because the riders were not picked up at the same origination point location.

    Effective for dates of service on and after July 1, 2017, the proration of NEMT multiple rider transports for Modes 1 through 7 DOES NOT apply. The transportation provider may continue to transport multiple riders; however, proration is no longer required.

    Multiple Trip Legs

    Each complete round trip will include multiple segments by one or multiple transportation providers.

    Example: Recipient is picked up at point A and transported to point B service provider. The transportation provider then transports the recipient from point B service provider to point C service provider and then to final destination A. This is three trip legs or units.

    Transportation between Two Similar or Same Facilities or Locations

    MHCP covers transportation between two hospitals; two LTC facilities; or two medical or residential facilities or other similar or same facilities or locations when a medically necessary health service that is part of the recipient's plan of care is not available at the originating facility.

    The following requirements apply:

  • • The transportation provider must obtain a statement signed by the physician or a member of the nursing staff at the originating facility or location.
  • • The recipient must be admitted to the final destination hospital, skilled nursing facility (SNF) or medical or residential facility.
  • • For ambulance transportation, use the Ground Ambulance Billing Checklist (DHS-5208A) (PDF) or Air Ambulance Billing Checklist (DHS-5208) (PDF).
  • Reconsideration Procedure

    A reconsideration of a level-of-service (LOS) determination follows this procedure:

  • • Members send a request for LOS reconsideration for a denied transport assessment or for an assessment that is approved, but at a lower level than requested, within 10 business days of the date of the assessment determination letter as follows:
  • • For state-administered NEMT, contact the MHCP medical review agent
  • • For local agency administered NEMT, contact the local county or tribal agency.
  • • The state medical review agent or the county or tribal agency will require additional medical documentation from the member for their review and reconsideration. This may include a statement of medical necessity.*
  • • If the reconsideration results in a reversal of the initial LOS determination, the medical review agent or the local county or tribal agency must notify the member of the service level they approve.
  • • If the reconsideration results in maintaining the initial denial, the medical review agent or the local county or tribal agency must notify the member of the denial and the reason for the denial.
  • • The approval or denial notice must include appeal information.
  • * Statement of medical necessity: The statement of medical necessity must indicate the medical necessity for the person to be present at the medical facility. The transportation coordinator will contact the person for information required to send to the treating provider requesting a statement of medical necessity for the transport, ancillary services, or medical provider destination. Once the transportation coordinator receives the medical necessity information, they review it for approval of transportation and ancillary services costs.

    Noncovered Services

    MHCP does not cover the services listed below as medical transportation service costs for fee-for-service (FFS) (this list is not all-inclusive):

  • • Transportation of a recipient to a noncovered MHCP service and those services excluded from transportation payment
  • • Transportation of a recipient from his or her residence to or from a Day Training and Habilitation (DT&H) location or Adult Day Program. Refer to the DT&H section of the MHCP Provider Manual for more information
  • • Extra attendant charges for personal care assistants (PCAs) accompanying recipients for whom they are providing services
  • • Use of a higher level of transport that is not medically necessary to meet the needs of the recipient
  • • Transportation to waiver program services (see HCBS Waiver Services and Elderly Waiver (EW) and Alternate Care (AC) Program sections in the manual)
  • • Transportation to the emergency room, unless it is for a scheduled appointment or the emergency room is the entrance of an urgent care clinic
  • • Transportation to an additional stop to pick up a parent, guardian, PCA or additional passenger to accompany the client.
  • • Transportation to a destination that is different from the originally scheduled drop off. The drop-off destination cannot be changed after the trip is scheduled unless the transportation coordinator approves the change (The “transportation coordinator” could be the county, tribe, or any entity hired to coordinate NEMT on their behalf
  • • Transportation and ancillary services for hospital visits that are not necessary for making medical decisions
  • • Transport of an EMA recipient to receive routine or preventative care (care that is not related to an approved EMA medical condition)
  • Excluded Costs Related to Transportation

    The costs listed below are excluded by MHCP as medical transportation service costs for FFS. MHCP does not reimburse for these services and the provider cannot bill the recipient for them:

  • • Transportation of a recipient to a hospital or other site of health services for detention ordered by a court or law enforcement agency except when ambulance service is medically necessary
  • • Transportation of a recipient to a facility for alcohol detoxification that is not medically necessary
  • No-load transportation, including no shows (refer to Ambulance Covered Services section for no-load exception)
  • • Additional charges for luggage, stair carry of the recipient, and other airport, bus or railroad terminal services
  • • Airport surcharge
  • • Federal or state excise or sales taxes on air ambulance service
  • Authorization Requirements

    Types of transports requiring authorization

    Types of Transports

    Descriptions

    Transports exceeding 30- and 60-mile limits

    Local county human services or tribal agencies are responsible for authorization of NEMT services when a MHCP-covered medical service can only be received at a location more than 30 miles from the recipient’s home or residence for primary care and more than 60 miles from the recipient’s home or residence for specialty care. This does not include authorization for any protected transport (mode 6) services.

    FFS authorization is based on medical necessity and no provider within those 30- and 60-mile distances is capable of providing the level of care needed. The agency maintains documentation of the authorization by the local agency in the recipient’s file. It is not entered into the MHCP claims processing system.

    Out-of-state nonemergency transportation

    Does not include origination or destination points located in neighboring states when the county of the neighboring state is contiguous to Minnesota.

    The DHS medical review agent must approve FFS authorization of the out-of-state medical service and provide the authorization to the NEMT transport coordinator or provider.

    The agency maintains documentation of the authorization by the local agency in the client’s file and it is not entered into the MHCP claims processing system.

    Further review by DHS policy staff may also be required.

    Nonemergency stretcher services

    All NEMT stretcher transports, including nursing facility residents, must be certified through the MHCP NEMT medical review agent. 

    Refer to the following for service specific authorization requirements:

  • Local County or Tribal Agency Nonemergency Medical Transportation (NEMT) Transportation Services
  • Ambulance Transportation Services
  • State-Administered NEMT
  • Protected Transportation Services
  • Refer to the Authorization section for general authorization requirements.

    Out-of-State Medical Services
    Local county/tribal agencies and state-administered NEMT providers considering requests for out-of-state medical transportation must obtain proof of authorization for out-of-state medical services from the recipient or responsible person. The MHCP medical review agent completes FFS authorization for out-of-state medical services. Referral by the managed care organization is required for recipients enrolled in a managed care plan. Refer to the Out-of-state Services authorization requirement section of the MHCP Provider Manual for more information.

    Transportation of a Minor
    Transports of minors aged 17 and under require parental consent for transport if the parent or legal guardian is unable to accompany the minor. The transportation coordinator should keep the signed parental authorization form in their records. The signed form is valid for one year.

    Billing

    Refer to Billing Policy for general MHCP billing policies and the following sections for service specific billing procedures:

  • Local County or Tribal Agency Nonemergency Medical Transportation (NEMT) Transportation Services
  • Ambulance Transportation Services
  • State-Administered NEMT Services
  • Protected Transportation Services
  • MHCP-enrolled state-administered NEMT and ambulance providers bill MHCP directly for FFS transport services.

    Local agency administered NEMT transportation providers do not bill MHCP for service reimbursements. Contact the local county or tribal agency for reimbursement processes. Bill according to the following:

  • • Use the electronic 837P format
  • • Use the HCPCS code that best describes the services rendered. Use the code that reflects the level and type of service provided, not the type of vehicle used
  • • Use appropriate modifier(s) on both base and mileage claim lines
  • • Bill the most direct mileage, rounded only to the nearest mile (for example, for .6 miles to .9 miles, round up to the next mile; for .1 to .5 miles round down to the closest number of miles.
  • • Bill miles only when transporting a qualified passenger
  • • Do not use zone or regional mileage calculations
  • • Use commercially available software or Internet-based applications to determine the most direct mileage route
  • Retroactive Local Agency or State-Administered NEMT Certification

    All requests to backdate the level of service based on a retroactive MHCP determination or for a person who is already an eligible MHCP member require completion of the level-of-service transport or ancillary services assessment. The DHS medical review agent must mail the denial letter following the level-of-service determination and mails an approval letter, if requested.

    You will need a retroactive level-of-service assessment completed for the following:

  • Seven Business Day Policy: When an eligible MHCP member receives a state-administered NEMT transport without a state-administered NEMT certification in place, the member or the member’s representative has seven business days from the date of transport for the medical review agent to complete an LOS assessment to determine the member’s state-administered NEMT level of service.
  • 60-day deadline for completing level-of-service assessment: When the member is determined eligible for retroactive medical coverage that includes NEMT transport and related ancillary services benefits, the member must do the following within 60 days of the eligibility determination:
  • • Request completion of the transportation level-of-service assessment by the local agency transportation coordinator for local agency administered NEMT services used during the retroactive period
  • • Request completion of the level-of-service assessment by the state contracted medical review agent for state-administered NEMT if state-administered NEMT was used during the retroactive period
  • • Submit all transportation and ancillary service reimbursement requests, including all required documentation, to the local agency
  • All cost reimbursements must be within the eligibility period and include appropriate documentation that would otherwise be required.

    Documentation Requirements

    Retain transportation records for five years from the date the service is first billed to MHCP.

    STS providers only: refer to Documentation Requirements for STS documentation requirements:

    Trip documentation sheets must be consistent with the following Minnesota Statutes 256B.0625, Subd. 17b requirements:

  • • The record must be in English and must be legible according to the standard of a reasonable person
  • • The recipient's name must be on each page of the record
  • • Each entry in the record must document the following:
  • • The date on which the entry is made
  • • The date or dates the service is provided
  • • The printed last name, first name, and middle initial of the driver
  • • The signature of the driver attesting to the following: "I certify that I have accurately reported in this record the trip miles I actually drove and the dates and times I actually drove them. I understand that misreporting the miles driven and hours worked is fraud for which I could face criminal prosecution or civil proceedings."
  • • The signature of the recipient or authorized party attesting to the following: "I certify that I received the reported transportation service.", or the signature of the provider of medical services certifying that the recipient was delivered to the provider
  • • The address, or the description if the address is not available, of both the origin and destination, and the mileage for the most direct route from the origin to the destination
  • • The mode of transportation in which the service is provided
  • • The license plate number of the vehicle used to transport the recipient
  • • Whether the service was ambulatory or non-ambulatory until MHCP implements the modes of transportation under Minnesota Statutes 256B.0625, Subd. 17 (h) for dates-of-service on and after July 1, 2016
  • • The time of the pickup and the time of the drop-off with "a.m." and "p.m." designations
  • • The name of the extra attendant when an extra attendant is used to provide special transportation service
  • • The electronic source documentation used to calculate driving directions and mileage
  • Documentation must also include the following:

  • • Provider’s NPI or UMPI number
  • • Recipient’s MHCP ID number
  • Record all required trip information on your trip sheet and make this information available for review.

    Definitions

    Adult: A person over the age of 18 authorized to make transportation decisions for a minor.

    ALS: Advanced Life Support.

    Advanced Life Support, Level 1 (ALS1): Transportation by ground ambulance vehicle, and the provision of medically necessary supplies and services, including an ALS assessment by ALS personnel or the provision of at least one ALS intervention.

    Advanced Life Support, Level 2 (ALS2):

  • • Three or more different administrations of medications by intravenous push or bolus or by continuous infusion excluding crystalloid, hypotonic, isotonic, and hypertonic solutions (Dextrose, Normal Saline, Ringer’s Lactate), or transportation, medically necessary supplies and services, and
  • The provision of at least one of the following ALS procedures: manual defibrillation or cardioversion; endotracheal intubation; central venous line; cardiac pacing; chest decompression; surgical airway; intraosseous line.
  • Ambulance Service: The transport of a recipient whose medical condition or diagnosis requires medically necessary services before and during transport.

    Ancillary Services: Health services, incidental to ambulance transportation services that may be medically necessary on an individual basis, but are not routinely used and are not included in the base rate for ambulance.

    Attendant: An employee of a NEMT provider who meets all MnDOT driver certification requirements.

    Basic Life Support (BLS): Transportation by ground ambulance vehicle and medically necessary supplies and services, plus the provision of BLS ambulance services.

    BLS Emergency: When medically necessary, the provision of BLS services as described in the BLS definition, in the context of an emergency response.

    Client: A person enrolled in MHCP using nonemergency medical transportation services.

    Client reimbursement: client mileage reimbursement provided to clients who have their own transportation.

    Common Carrier Transportation: The transport of a recipient by bus, taxicab, other commercial carrier, or by private automobile.

    Day Training and Habilitation (DT&H) Services: Refer to DT&H.

    Level of Service (LOS): Assessment necessary to determine what mode of state or local agency NEMT is appropriate and most cost effective for each recipient.

    Local agency Nonemergency medical transportation (NEMT): Transportation services coordinated, provided, or reimbursed by the county and tribe for dates of service on and after July 1, 2016. Previously referred to as “Access Transportation Services (ATS).”

    Medical review agent: An organization that MHCP (DHS) contracts with for review of the specific types of state-administered NEMT service level certification requests.

    Medical Transportation: The transport of a recipient for the purpose of obtaining a covered service or transport of the recipient after the service is provided. The types of medical transportation are common carrier, special transportation and life support.

    Minnesota Department of Transportation (MnDOT): The principal Minnesota state agency to develop, implement, administer, consolidate and coordinate state transportation policies, plans and programs (Minnesota Statutes 174).

    Minnesota Nonemergency Transportation (MNET): The program that coordinates and provides all local county and tribal agency administered NEMT transport services in the nine-county Twin Cities metro area (Anoka, Chisago, Dakota, Hennepin, Isanti, Ramsey, Sherburne, Stearns and Washington) through a host county contract for the metro group. The current host county is Hennepin. Effective August 1, 2016, Wright County will join the MNET MCC contract group.

    Minor Child: A person from birth through age 17.

    NEMT Coordinator: An entity made up of one or more county, tribe or contracted provider with the responsibility of coordinating the appropriate level of transportation services for the client.

    No Show: Client is not at pickup location when scheduled or client has cancelled a scheduled trip within the following:

  • • Less than two hours before the scheduled pickup time for trips under 30 miles
  • • Less than four hours before the scheduled pickup time for trips over 30 miles
  • Nonemergency Medical Transportation (NEMT): Local county or tribal administered and state-administered transportation services provided to enable MHCP recipients access to medically necessary covered services or to attend MHCP service related appeal hearings.

    State-administered nonemergency medical transportation (NEMT): effective July 1, 2016, this refers to transportation services administered and reimbursed directly to the MHCP enrolled providers by DHS for transport of MHCP-eligible recipients certified to use one of the state-administered levels of transport to get to and from an MHCP covered medical service. This includes assisted, ramp or lift-equipped, protected and stretcher transports.

    Transportation coordinator: The local county or tribal l agency (or their contracted entity) that reviews clients eligibility for NEMT and related ancillary services and completes a level-of-service (LOS) assessment for the transport services they coordinate, provide (using their contracted transportation providers), reimburse (the client or transportation provider), and bill to MHCP. 

    Trip or trip leg: The transport of the recipient from the pickup (origination) location to the drop-off (destination) location. This is the unit of billing.

    Volunteer transport: A transportation program that provides transportation by volunteers using their own vehicles.

    Legal References

    Minnesota Statutes 144E.10: Ambulance Service Licensing
    Minnesota Statutes 144E.16
    : Ambulance Service Local Standards
    Minnesota Statutes 174
    : DOT Requirements
    Minnesota Statutes 174.29
    : Coordination of Special Transportation Service
    Minnesota Statutes 174.30
    : Operating Standards for 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.17b: Covered Services, Documentation Required
    Minnesota Statutes 256B.0625
    subd. 18: Bus or Taxicab Transportation
    Minnesota Rules 8840.5925
    : Vehicle Equipment
    Minnesota Rules 9505.0315
    : Medical Transportation
    Minnesota Rules 9505.0445
    : Payment Rates

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