Welcome to the Department of Health Care Services Welcome to Medi-Cal Welcome to the Department of Health Care Services

Medi-Cal Logo
Click to Sign Up for MCSS emails

Medi-Cal Benefit Added: Nonmedical Transportation

June 4, 2018

Pursuant to Welfare and Institutions Code (W&I Code) Section 14132 (ad) (1), effective for dates of service on or after July 1, 2018, non-medical transportation (NMT) is covered, subject to utilization controls and permissible time and distance standards, for eligible full-scope Medi-Cal fee-for-service recipients beneficiaries and pregnant women during pregnancy and for 60 days postpartum, including any remaining days in the month in which the 60th postpartum day falls. NMT includes transporting recipients to and from Medi-Cal covered medical, mental health, substance abuse or dental services.

W&I Code 14132 (ad)(2)(A)(i) defines NMT as including, at minimum, round trip transportation for a recipient to obtain covered Medi-Cal services by passenger car, taxicab, or any other form of public or private conveyance.

NMT does not include the transportation of sick, injured, invalid, convalescent, infirm or otherwise incapacitated recipients by ambulances, litter vans or wheelchair vans licensed, operated and equipped in accordance with state and local statutes, ordinances or regulations, as these would be covered as non-emergency medical transportation (NEMT) services.

Registering NMT Vehicles and Enrolling as an NMT Provider
Based upon the authority granted to the director of the Department of Health Care Services (DHCS) in accordance with W&I Code Section 14132(ad)(8), the director is establishing Medi-Cal provider enrollment requirements for the provision of NMT services by currently enrolled Medi-Cal NEMT providers that request to provide NMT services by passenger vehicle and for enrolling transportation providers for NMT only. These requirements implement W&I Code, Sections 14043.15 and 14043.26 and as such have the full force and effect of law.

Effective June 15, 2018, transportation providers who are currently enrolled in Medi-Cal as NEMT providers and who wish to provide NMT services may request to become an NMT provider and provide NMT services, as defined by W&I Code, Sections 14132 (ad)(2)(i) and 14132 (ad)(2)(ii). Current NEMT providers must submit a completed Medi-Cal Supplemental Changes (DHCS 6209) form. NEMT providers requesting to add NMT services should state so in the space provided on page 16, items 37 and 38 of the DHCS 6209 form. NMT vehicles may be added on page 13; copies of the Department of Motor Vehicles (DMV) 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 (DHCS 6206) form, a Medi-Cal Provider Agreement (DHCS 6208) form and a Medi-Cal Disclosure Statement (DHCS 6207) form.

All applicable information must be completed on the DHCS 6209 or DHCS 6206, which includes:

  • National Provider Identifier (NPI)

  • Provider type (Non-Medical)

  • Action requested (Add NMT vehicle[s] or driver[s])

  • For all NMT vehicles:

    • Vehicle identification number

    • Make and model of vehicle

    • Year of vehicle

    • License plate number

  • Legible copies of all of the following documents for all vehicles:

    • DMV vehicle registration

    • Proof of vehicle insurance

  • For all driver(s):

    • Driver’s name

    • California driver’s license

  • Legible copies of all of the following documents for all drivers:

    • California DMV driving record

    • Certificates for first aid and CPR

    • California driver’s license

    • Motor Carrier Safety Administration (MCSA) 5875 and MCSA 5876

    • Special driver permit (if applicable)

    • Standard pre-employment drug test (must list drugs tested for) and alcohol test lab results

Only enrolled providers who have been approved by DHCS to render NMT services may bill for NMT. Providers approved by DHCS to also provide NMT services may begin rendering services to eligible fee-for-service recipients and billing DHCS for dates of service on or after July 1, 2018. Detailed NMT coverage and reimbursement policy information will be published in the following sections of the Medi-Cal Provider Manual:

  • Medi-Cal Transportation – Ground
  • Medi-Cal Transportation – Ground: Billing Codes and Reimbursement Rates
  • Medi-Cal Transportation – Ground: Billing Examples