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Non-Medical Transportation: Enrollment, Document and Application Fee Updates

November 6, 2018

Changes have been made to the following non-medical transportation (NMT) policy since its first release in June 2018. Updates are shown in bolded type (excluding the subheading).

NMT policy became a covered Medi-Cal benefit effective July 1, 2018.

Pursuant to Welfare and Institutions Code (W&I Code) Section 14132 (ad)(1), NMT is covered, subject to utilization controls and permissible time and distance standards, for eligible full-scope Medi-Cal fee-for-service recipients 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.

Transportation providers who are currently enrolled in Medi-Cal as NEMT providers and who wish to provide NMT services may request to become NMT providers 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 “Other Information” section of the DHCS 6209 form. NEMT providers wishing to use already reported NEMT vehicles to provide NMT services must also report that to the department in the “Other Information” section of the DHCS 6209.

Currently enrolled providers may add new NMT vehicles or NEMT vehicles for NMT on page 13 of the DHCS 6209. Copies of the Department of Motor Vehicles (DMV) commercial vehicle registration and proof of commercial 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, a Medi-Cal Disclosure Statement (DHCS 6207) form and an application fee.

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 commercial vehicle registration
    • Proof of commercial 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
    • California driver’s license
    • Motor Carrier Safety Administration (MCSA) 5875 and MCSA 5876

The NMT organizations/entities shall ensure that all NMT drivers comply with all applicable state and federal licensing and certification requirements and any and all applicable state and federal statutes and/or regulations relating to the operation of a motor vehicle and/or transportation of passengers.

Only enrolled providers who have been approved by DHCS to render NMT services may bill for NMT. The effective date of enrollment for approved NMT services will be retroactive to the date a complete application was submitted.

This information will be reflected soon in the provider manuals.