Covered and Noncovered Services : Covered Services and Requirements

Types of Non-Emergency Medical Transportation Rides

Three types of transportation rides are covered for members who have no other means of transportation going to and from covered services provided by a Medicaid-enrolled provider:

• Standing order rides
• Urgent rides
• Routine rides

The NEMT manager contracted with the Wisconsin DHS schedules and pays for these rides.

Standing Order Rides

A standing order ride is defined as regularly recurring transportation for members who have no other way to get a ride to a covered service. A standing order ride has the same pick-up point, pick-up time, destination, and return. To eliminate the need to call the reservation line to schedule every ride, the standing order process allows members or providers to arrange regularly recurring rides for three months at a time. Standing order rides to dialysis appointments can be scheduled for six months at a time.

Providers may refer to the NEMT manager website for information on scheduling standing order rides.

Members can also access MTM's mobile-friendly portal and mobile app for managing and scheduling rides. The portal and app also allow members to request pickup for their ride home after an appointment, to view the real-time location of their ride, and, if available, to view driver photos and vehicle information.

Routine Rides

A routine ride is a ride to an appointment that does not require a member to be seen right away, such as a yearly check-up or a vision exam. Most rides are considered routine.

Routine rides must be scheduled at least two business days before an appointment and can be scheduled for the current month and the following month. Routine ride scheduling is available 24/7 and can be scheduled by calling 866-907-1493 (711 TTY) or online on the NEMT manager website.

The member or health care provider can contact the NEMT manager to schedule regularly recurring rides for up to three months at a time. The member or health care provider can schedule regularly recurring rides for dialysis appointments for six months at a time.

Urgent Rides

An urgent ride can be one of the following:

• A health care situation in which the member does not need to call 911 for immediate help but cannot wait two business days before seeing a health care provider
• A hospital discharge
• A ride to a follow-up appointment if the follow-up appointment is for the same health care issue and is scheduled within two days of the previous appointment

A ride to an urgent appointment will be provided in three hours or less.

Providers and members can schedule an urgent ride by calling the reservation number at 866-907-1493 (711 TTY) 24 hours a day, seven days a week.

Note: If an urgent ride is requested by a member, the NEMT manager may contact the member's health care provider to confirm the urgency of the appointment.

Health care facilities can also access a dedicated portal to quickly book and manage rides for members. This portal can be used for one or multiple facilities, is accessible via web browsers, and does not require any software installation. For more information and to sign up for a demonstration, go to mtm-inc.net/wisconsin.