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2012 Texas Medicaid Provider Procedures Manual

Ambulance Services Handbook : 2. Ambulance Services : 2.2 Services/Benefits, Limitations, and Prior Authorization : 2.2.1 Emergency Ambulance Transport Services : Prior Authorization for Emergency Out-of-State Transport
Prior Authorization for Emergency Out-of-State Transport
All emergency out-of-state (air, ground, or specialized vehicle) transports require authorization before the transport is considered for payment.
Prior authorization for emergency transport is required for out-of-state providers with the exception of those providers located within 200 miles of the Texas border.
Refer to:
Subsection 2.5, “Out-of-State Medicaid Providers” in Section 2, “Texas Medicaid Fee-for-Service Reimbursement” (Vol. 1, General Information) for additional information on providers who are not considered out-of-state providers.
To initiate the prior authorization process, providers must call 1-800-540-0694.
TMHP is responsible for processing prior authorization requests for all Medicaid clients.

Texas Medicaid & Healthcare Partnership
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