Medicaid Policy
Medicaid Policy
Effective Date: January 1, 2024
A. Non-Emergency Transportation
1. Non-emergency medical transportation is a covered benefit only for Traditional Medicaid recipients who need transportation to and from Medicaid providers to receive Medicaid covered services. Transportation to non-Medicaid providers or to receive non-Medicaid covered services, is not covered.
a. UTA Transit Cards, excluding Flex Trans, can be issued to Traditional Medicaid recipients for transportation to medical and mental health appointments.
b. Emergency medical transportation for medical emergencies is a covered benefit for Traditional recipients.
2. Recipients are encouraged to see Medicaid providers within their local area.
a. When the recipient must go outside their local area to receive care, medical transportation will be covered to the nearest qualified Medicaid provider. For example, a person in Moab cannot be reimbursed for transportation costs to go to SLC for medical care when the same care can be provided in Provo.
b. If the recipient chooses to receive services from a Medicaid provider that is not the nearest provider, reimbursement of mileage will only be paid for the distance to the nearest qualified provider.
B. Transportation for Urgent Care Needs
1. Transportation for urgent care needs, defined as care needed within 24 hours, but that does not require ambulance transportation, is a covered benefit for Traditional Medicaid recipients.
2. If the member does not have access to personal transportation and cannot wait for a UTA Transit Card to arrive, ModivCare services may be able to provide transportation (651-2).
C. Curb to Curb/Door to Door Transportation Services
1. Special transportation services are available for Traditional Medicaid recipients who need curb-to-curb or door-to-door services (651-2).
2. Nursing homes are required to provide non-emergency medical transportation for their residents. Nursing home residents cannot receive UTA Transit Cards, and any other non-medical emergency medical transportation not provided by the nursing home requires prior authorization.