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Changes to Medical Transportation Services Effective June 1, 2021

Last updated on 5/21/2021

Effective June 1, 2021, claims for fee-for-service (FFS) nonemergency medical transportation services (NEMT) will now be processed and paid by Texas Medicaid & Healthcare Partnership (TMHP) on a statewide basis.

Demand Response Transportation Services (DRTS) Providers (including Transportation Network Companies)

  • For currently enrolled Demand Response Transportation Services (DRTS) providers in Managed Transportation Organization (MTO) Region 4, for dates of service prior to June 1, 2021, providers will continue to use procedure code A0100. This procedure code will be end-dated effective May 31, 2021.
  • For dates of service on or after June 1, 2021, TMHP will process claims for DRTS providers statewide when the client is enrolled in Medicaid FFS, Children with Special Health Care Needs (CSHCN) Services Program, and Transportation for Indigent Cancer Patients (TICP) program. Providers will need to use new procedure code T2003 when submitting claims for reimbursement.

Procedure Code

Modifier

Medicaid Fee

T2003

U1 (Metro/Urban County)

$27.06

T2003

U2 (Rural County)

$63.71

T2003

U3 (Micro/Suburban County)

$49.85

Individual Transportation Participants (ITP)

  • Effective June 1, 2021, TMHP will process applications and claims for ITPs providing NEMT in Medicaid FFS, CSHCN, and TICP on a statewide basis.
  • ITPs will be required to keep the following documentation updated with TMHP:
    • Driver’s license
    • Vehicle insurance
    • Vehicle Registration

Effective June 1, 2021, ITP claims for Medicaid FFS, CSHCN, and TICP must be sent directly to TMHP at the following address:

Texas Medicaid & Healthcare Partnership 
Attn: Claims 
PO Box 200555 
Austin, TX 78720‐0555 

Training will be available for DRTS providers, including TNCs, to guide the claims submission process.

Providers can find training on the TMHP Learning Management System (LMS). An LMS account, including username and password, is required to access training courses. For instructions on creating an LMS account, review the Learning Management System (LMS) Registration and Navigation Job Aid for Providers.

For more information, call the TMHP Contact Center at 800-925-9126.