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Modes of Medicaid Transportation
The following is a list of modes of Medicaid transportation provided by the state of New York.
If a Medicaid enrollee uses a private vehicle for their regular daily activities the enrollee is to utilize the same means of transportation for medical care and services.
If a Medicaid enrollee uses a private vehicle for medical care and services they may be eligible for mileage reimbursement.
If a Medicaid enrollee uses a bus for their regular daily activities the enrollee is to utilize the same means of transportation for medical care and services.
If an enrollee uses the bus for medical care and services bus passes may be available, enrollee should contact their local caseworker.
If a commercial bus is medically appropriate and the most cost effective mode of transportation for medical care and services it should be utilized.
Prior authorization of taxi and livery services is required to ensure that a Medicaid enrollee uses the means of transportation most appropriate to his medical needs. Orders for taxi/livery services shall be made in advance by either the enrollee or the enrollee’s medical provider.
Taxi services may be available curb to curb or as ambulatory when enrollee is in need of door through door assistance.
Ambulette transportation may be requested if any of the following conditions is present:
- The Medicaid enrollee needs to be transported in a recumbent position and the ambulette service is able to transport a stretcher as previously described;
- The Medicaid enrollee is wheelchair-bound and is unable to use a taxi, livery, private vehicle or public transportation;
- The Medicaid enrollee has a disabling physical condition which requires the use of a walker or crutches and is unable to use a taxi, livery, private vehicle or public transportation;
- An otherwise ambulatory Medicaid enrollee requires radiation therapy, chemotherapy, or dialysis treatments, which result in a disabling post-treatment physical condition, making the enrollee unable to access transportation without the personal assistance of an ambulette service.
- The Medicaid enrollee has a disabling physical condition other than one described above or a disabling mental condition requiring personal assistance provided by an ambulette service; or
- The ordering practitioner certifies in a manner designated by and submitted to the Department that the Medicaid enrollee cannot be transported by a taxi, livery, private vehicle, or public transportation, necessitating use of an ambulette service.
Ambulance services are covered by the New York State Medicaid Program.
In non-emergency situations, a determination must be made by the appropriate prior authorization official whether the use of an ambulance is medically necessary as opposed to a non-specialized mode such as an ambulette, taxi service, livery service or public transportation.
The Medicaid enrollee’s physician, physician’s assistant, or nurse practitioner must order non-emergency ambulance services.
Non-emergency ambulance transportation may be ordered when the Medicaid enrollee is in need of services that can only be administered by an ambulance service. The ordering practioner must note in the enrollee's patient record the condition which qualifies the use of non-emergency ambulance services. An ordering practioner , or facilities and programs ordering transportation on the practioner's behalf, which do not meet these rules, may be sanctioned according to the regulations established by the New York State Department of Health.
In an emergency medical situation dial 911 for assistance.
If a train is medically appropriate and the most cost effective mode of transportation for medical care and services it should be utilized.
If commercial air travel is medically appropriate and the most cost effective mode of transportation for medical care and services it should be utilized.