Medical Transportation

Non-Emergency Medical Transportation

HOW TO ACCESS:

All Medicaid beneficiaries, who are eligible for transportation services and DO NOT receive transportation services through a managed care plan, should contact Verida to schedule a ride.

Beneficiaries may reach the Fee-For-Service broker, Verida, at 1 (855)325-7626.

Medicaid beneficiaries who DO receive transportation services from a managed care plan should contact the call centers as follows:

Health Plan Broker Phone Number TTY Phone Number
Aetna Better Health of Louisiana MediTrans 877-917-4150 866-288-3133

AmeriHealth Caritas of Louisiana

Verida

888-913-0364

866-428-7588

Healthy Blue

MediTrans

866-430-1101

800-846-5277

Humana Healthy Horizons

MediTrans

844-613-1638

800-618-4781 

Louisiana Healthcare Connections

Veyo/MTM

855-369-3723

855-369-3723 (TTY:711)

United Healthcare Community Plan

ModivCare

866-726-1472

844-488-9724

 

ELIGIBILITY:

Medicaid covered transportation is available to Medicaid beneficiaries when:

  • The beneficiary is enrolled in a Medicaid benefit program that explicitly includes transportation services; and
  • The beneficiary or their representative has stated that they have no other means of transportation.

 

COVERED SERVICES:

Transportation to and/or from Medicaid covered services, including carved-out services, or value added benefits (VAB) when no other means of transportation is available.

Beginning January 1, 2023, Medicaid will only reimburse for a beneficiary’s transportation services to a Fee-For-Service (FFS) provider or a managed care provider if that provider has enrolled through the Medicaid Provider Enrollment.

LDH granted all NEMT providers an extension for enrollment in the Medicaid Provider Portal.  LDH requires all NEMT providers to enroll in the Medicaid Provider Portal no later than June 30, 2023.

  

Attendants

An attendant shall be required when the beneficiary is under the age of 17.

The attendant must:

  • Be a parent, legal guardian, or responsible person designated by the parent/legal guardian; and
  • Be able to authorize medical treatment and care for the beneficiary.

Attendants may not:

  • Be under the age of 17; or
  • Be a Medicaid provider or employee of a Medicaid provider that is providing services to the beneficiary being transported, except for employees of a mental health facility in the event an beneficiary has been identified as being a danger to themselves or others or at risk for elopement.
  • Be a transportation provider or an employee of a transportation provider.

If a child is to be transported, either as the beneficiary or an additional passenger, the parent or guardian of the child is responsible for providing an appropriate child passenger restraint system as outlined by La. R.S. 32:295.

 

Meals and Lodging

Eligible expenses include the following when necessary to ensure the delivery of medically necessary services:

  • Transportation for the beneficiary and one attendant; and
  • Meals, lodging, and other related travel expenses for the beneficiary and one attendant when long distance travel is required. Long distance is defined as when the total travel time, including the duration of the appointment plus the travel to and from the appointment, exceeds 12 hours

Medicaid covers meals and lodging for trips that are not otherwise covered in the inpatient per diem, primary insurance, or other payer source.


COMMENTS:

Medicaid beneficiaries should contact transportation broker call centers at least 48 hours prior to the requested transportation services.

With the exception of urgent transportation requests and discharges from inpatient facilities, when requesting transportation services, the beneficiary’s and healthcare providers should schedule all services a minimum of 48 hours prior to the requested appointment.  The 48-hour minimum does not include non-business days. However, the MCO and/or transportation broker must make a reasonable attempt to schedule the trip with less than 48 hours’ notice.

MCOs shall make every effort to schedule urgent transportation requests and may not deny a request based solely on the appointment being scheduled less than 48 hours in advance.

  • Urgent transportation refers to a request for transportation made by a healthcare provider for a medical service, which does not warrant emergency transport but cannot be postponed.
  • Urgent transportation shall include chemotherapy, radiation, dialysis, OTP, or other necessary medical care that cannot be rescheduled to a later time.

All non-emergency out-of-state transportation must be prior approved by the MCO or transportation broker. The MCO may approve transportation to out-of-state medical care only if the beneficiary has been granted approval to receive medical treatment out of state when it is the nearest option available. Coordination of approvals may take longer than 48 hours.

Non-Emergency Ambulance Transportation (NEAT)

HOW TO ACCESS:

All Medicaid beneficiaries, who are eligible for transportation services and DO NOT receive transportation services through a managed care plan, should contact Verida to schedule a ride. 

Beneficiaries may reach the Fee-For-Service broker, Verida, at (225) 726-2800.

Medicaid beneficiaries who DO receive transportation services from a managed care plan should contact the call centers as follows:

 

ELIGIBILITY:

Medicaid covered transportation is available to Medicaid beneficiaries when:

  • The beneficiary is enrolled in a Medicaid benefit program that explicitly includes transportation services; and
  • The beneficiary or their representative has stated that they have no other means of transportation.

 

Health Plan Phone Number Fax Number Email Address
Aetna Better Health of Louisiana 877-917-4150 337-366-6760 Facility@Meditrans.com 
AmeriHealth Caritas of Louisiana 225-726-2800 225-448-2017 LACompliance@southeastrans.com
Healthy Blue 844-349-4324 337-366-6760 Facility@Meditrans.com 
Humana Healthy Horizons

844-613-1638

337-366-6760  Facility@Meditrans.com 
Louisiana Healthcare Connections 866-595-8133 480-757-6082 ClaimsLA@Veyo.com 
United Healthcare Community Plan 866-886-4081 877-457-3349 TXLAExceptions@modivcare.com 

 

 

 

 

 

 

 

 

 

GROUND AMBULANCE COVERED SERVICES:

NEAT is provided to a Medicaid beneficiary to and/or from a Medicaid covered service, including carved out services or value-added benefits (VAB) by ground or air ambulance when the beneficiary’s condition is such that use of any other method of transportation is contraindicated or would make the beneficiary susceptible to injury. The nature of the trip is not an emergency, but the beneficiary requires the use of an ambulance.

Beginning January 1, 2023, Medicaid will only reimburse for a beneficiary’s transportation services to a FFS provider or a managed care provider if that provider has enrolled through the Medicaid Provider Enrollment.  All ambulance providers are required to enroll in the Medicaid Provider Portal no later than December 31, 2022.

Please note that ALL NEAT trips will require a completed, valid Certification of Ambulance Transportation (CAT). The beneficiary’s treating physician, a registered nurse, the director of nursing at a nursing facility, a nurse practitioner, a physician assistant, or a clinical nurse specialist must certify on the Certification of Ambulance Transportation (CAT) that the transport is medically necessary and describe the medical condition, which necessitates ambulance services. 

The MCO, transportation broker, and/or the ambulance provider shall verify, prior to scheduling, beneficiary eligibility, that the originating or destination address belongs to a medical facility, and that a completed Certification of Ambulance Transportation form for the date of service is obtained, reviewed, and accepted by the MCO, transportation broker, and/or the ambulance provider prior to transport.

 

Attendants
An attendant shall be required when the beneficiary is under the age of 17.

The attendant must:

  • Be a parent, legal guardian, or responsible person designated by the parent/legal guardian; and
  • Be able to authorize medical treatment and care for the beneficiary.

Attendants may not:

  • Be under the age of 17; or
  • Be a Medicaid provider or employee of a Medicaid provider that is providing services to the beneficiary being transported, except for employees of a mental health facility in the event an beneficiary has been identified as being a danger to themselves or others or at risk for elopement.

 

Comments:

Medicaid beneficiaries should contact the broker’s call centers at least 48 hours prior to the requested transportation services.

With the exception of urgent transportation requests and discharges from inpatient facilities, when requesting transportation services, the beneficiary’s and healthcare providers should schedule all services a minimum of 48 hours prior to the requested appointment.  The 48-hour minimum does not include non-business days. However, the MCO and/or transportation broker must make a reasonable attempt to schedule the trip with less than 48 hours’ notice. 

MCOs shall make every effort to schedule urgent transportation requests and may not deny a request based solely on the appointment being scheduled less than 48 hours in advance.

Urgent transportation refers to a request for transportation made by a healthcare provider for a medical service, which does not warrant emergency transport but cannot be postponed. 

Urgent transportation shall include chemotherapy, radiation, dialysis, OTP, or other necessary medical care that cannot be rescheduled to a later time.

All non-emergency out-of-state transportation must be prior approved by the MCO or transportation broker. The MCO may approve transportation to out-of-state medical care only if the beneficiary has been granted approval to receive medical treatment out of state when it is the nearest option available. Coordination of approvals may take longer than 48 hours.

 

Nursing Facility Ambulance Transportation 

Nursing facilities are required to provide medically necessary transportation services for Medicaid beneficiary residing in their facilities.

Any nursing facility beneficiary needing non-emergency, non-ambulance transportation services are the financial responsibility of the nursing facility. NEAT services provided to a nursing facility beneficiary must include the Certification of Ambulance Transportation, in accordance with the Coverage Requirements section, to be reimbursable by the MCO and/or transportation broker; otherwise, the nursing facility shall be responsible for reimbursement for such services.

 

Air Ambulance: 

Air ambulances may be used for emergency and non-emergency ambulance transportation when medically necessary.

All air ambulance services must comply with state laws and regulations governing the personnel certifications of the emergency medical technicians, registered nurses, respiratory care technicians, physicians, and pilots as administered by the appropriate agency of competent jurisdiction.

The MCO shall cover air ambulance services only if:

  • Speedy admission of the beneficiary is essential and the point of pick-up of the beneficiary is inaccessible by a land vehicle; or
  • Great distances or other obstacles are involved in getting the beneficiary to the nearest hospital with appropriate services.

If both land and air ambulance transport are necessary during the same trip, the MCO shall reimburse each type of provider separately according to regulations for that type of provider.

The MCO and/or transportation broker may not require prior review or authorization for emergency air ambulance transportation, both rotary and fixed wing.

The MCO and/or transportation broker may require prior review or authorization for non-emergency air ambulance transportation, both rotary and fixed wing.

 

Emergency Ambulance Transportation (EMT)

HOW TO ACCESS:

Emergency ambulance providers, Dial 911 for all situations requiring emergency medical services.

ELIGIBILITY:

Medicaid covered transportation is available to Medicaid beneficiaries when:

  • The beneficiary is enrolled in a Medicaid benefit program that explicitly includes emergency transportation services


COVERED SERVICES:

Emergency ambulance transportation is provided for a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in any of the following:

  • Placing the health of the beneficiary (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy;
  • Serious impairment to bodily functions; or
  • Serious dysfunction of any bodily organ or part.

A beneficiary may also require emergency ambulance transportation if he or she is psychiatrically unmanageable or needs restraint.

Beginning January 1, 2023, Medicaid will only reimburse for a beneficiary's transportation services to a FFS provider and/or managed care provider if that provider has enrolled through the Medicaid Provider Enrollment Portal


CONTACT:

All Transportation inquiries (both NEMT, NEAT, and EMT)

Email: MedicaidTransportation@la.gov

Phone Number: 225.342.9566 or 225.333.7473

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