CurrentUtah MedicaidPolicy 01-06

Transportation/Administrative

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This policy governs transportation, mileage, meals, lodging, and attendant-related assistance for Utah Medicaid recipients traveling to receive approved medical treatment or covered services. It also addresses transportation assistance for one parent accompanying a dependent child and prior authorization for out-of-state travel.

Policy Summary

PayerUtah Medicaid

PolicyTransportation/Administrative

Policy CodePolicy 01-06

Change TypeNo material change

Effective DateJanuary 1, 2001

Next Review DateN/A

Key ActionPrior authorize all out-of-state travel with Medicaid before transportation occurs.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

Actual milesPrivate-vehicle reimbursement is limited to actual miles traveled

1 parentMaximum accompanying parent for a dependent child

1 attendantAttendant transportation and per diem may be covered when medically justified

Prior authorizationRequired for out-of-state travel

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CurrentUtah MedicaidPolicy 01-06

Transportation/Administrative

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Sign up for Utah Medicaid Policy 01-06 alerts

Get alerted when Policy 01-06 changes without checking for updates manually.

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Policy Summary

PayerUtah Medicaid

PolicyTransportation/Administrative

Policy CodePolicy 01-06

Change TypeNo material change

Effective DateJanuary 1, 2001

Next Review DateN/A

Key ActionPrior authorize all out-of-state travel with Medicaid before transportation occurs.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

Actual milesPrivate-vehicle reimbursement is limited to actual miles traveled

1 parentMaximum accompanying parent for a dependent child

1 attendantAttendant transportation and per diem may be covered when medically justified

Prior authorizationRequired for out-of-state travel

Transportation and Related Travel Assistance

Recipient transportation and travel expenses

Administrative transportation assistance is available for necessary transportation of recipients to and from providers of medical services.

Recipient transportation assistance: Transportation is necessary for travel to or from a provider of medical services; travel is by an approved means; and any reimbursement is subject to the Department-established limits.Private vehicle reimbursement is limited to actual miles traveled.

Recipient meals and lodging

Meals and lodging assistance may be provided when necessary during approved treatment.

Recipient per diem: The recipient remains away from home, outside of a medical facility, while receiving approved treatment; the per diem is applied toward meals and lodging; and the amount does not exceed the Department-established maximum.Maximum established by the Department in R414-306-6(12).

Parent accompanying dependent child

Transportation and per diem may be provided for one parent accompanying a dependent child.

Parent accompaniment: The traveler is one parent accompanying a dependent child; the child is receiving covered services; the recipient must remain away from home, outside of a medical facility, while receiving approved treatment; and transportation and per diem do not exceed the Department-established maximums.Maximum established by the Department in R414-306-6(12).

Medically necessary attendant

Attendant transportation and per diem may be covered when an attendant is medically necessary.

Attendant assistance: The recipient is receiving covered services; there is a justifiable medical need for an attendant; the attendant has responsibility for hands-on care of the recipient; and transportation and per diem do not exceed the Department-established maximums.Maximum established by the Department in R414-303-6(12).

A parent or another individual may serve as the attendant. Salary may be included when the attendant is not a member of the patient's family. Standby time is not covered.

Out-of-state travel

Out-of-state transportation is subject to additional authorization and medical-need criteria.

Out-of-state travel: Medicaid has provided prior authorization; and the medical need cannot be met within Utah.Prior authorization is required before out-of-state travel.

Attendant standby time is not covered. Coverage applies only while the attendant has responsibility for hands-on care of the recipient.

Authorization, Documentation, and Billing Rules

Prior Authorization

Prior Authorization for Out-of-State Travel

Obtain Medicaid prior authorization before any out-of-state travel for a recipient to receive covered services.

Billing Rule

Reimburse Actual Mileage

For transportation in a private vehicle, calculate reimbursement using the actual miles traveled, subject to the per-mile rate established by the Department.