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2012 Texas Medicaid Provider Procedures Manual

Inpatient and Outpatient Hospital Services Handbook : 4. Outpatient Hospital (Medical/Surgical Acute Care Outpatient Facility) : 4.2 Services, Benefits, Limitations, and Prior Authorization

4.2 Services, Benefits, Limitations, and Prior Authorization
4.2.1
The hospital is responsible for requesting prior authorization for the non-emergency transport to the client's home or to a nursing home after a non-scheduled outpatient visit.
Refer to:
Form AM. 1, “Nonemergency Ambulance Prior Authorization Request (2 Pages)” in the Ambulance Services Handbook (Vol. 2, Provider Handbooks), for additional information about prior authorization requests for non-emergency transports.

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