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December 2016 Texas Medicaid Provider Procedures Manual

Ambulance ServicesHandbook : 2 Ambulance Services : 2.2 Services, Benefits, Limitations, and Prior Authorization : 2.2.1 Emergency Ambulance Transport Services : 2.2.1.1 Prior Authorization for Emergency Out-of-State Transport

2.2.1.1
All emergency out-of-state (air, ground, and water) 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 2.6, “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.
Texas Medicaid & Healthcare Partnership (TMHP) is responsible for processing prior authorization requests for all Medicaid clients.

Texas Medicaid & Healthcare Partnership
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