Healthcare Providers FAQ'sMTO Regions

LogistiCare maintains a Facility Services Department dedicated to handling the non-emergency medical transportation needs of medical providers that serve Texas Medicaid and CSHCN clients who have no other way to get a ride, and who may need a single trip or regularly reoccurring (standing order trips) non-emergency medical transport (NEMT).   For example, transport three days each week to and from dialysis. A dedicated Facility Services Department staff, phone and fax numbers are available to book transportation needs received from these medical providers by phone, fax or online on behalf of the clients they serve.  You will find instructions and forms for arranging non-emergency medical transportation included on this web site and/or in the answers below.

Long distance travel requests require 5 days advanced notice.

Requests for routine NEMT services must be pre-authorized at least 2 business days in advance during our reservation hours: Monday – Friday between 8:00 a.m. and 5:00 p.m.  2 business days’ prior notice includes the day of the call but not the day of the appointment.  For example, call on Monday for an appointment on Wednesday as shown in the chart below.  Urgent care, hospital discharges, same day and next day trip requests can be requested with less than 2 business days’ notice during regular reservation hours.  All trips requested with less than 2 business days prior notice will have to be confirmed with the health care provider that the client needs to come in today or tomorrow and that the treatment cannot be delayed to another day.    Otherwise, the appointment will have to be rescheduled for another day.  Special transportation requests, such as excessive miles trips (trips over 100 miles), should be submitted with 5 business days’ notice.

Appointment on Call LogistiCare on
Saturday Thursday before
Sunday Thursday before
Monday Thursday before
Tuesday Friday before
Wednesday Monday before
Thursday Tuesday before
Friday Wednesday before

Weekends and recognized holidays are not considered business days.

If the client does not need to use the authorized transportation services, the client or the responsible adult should contact LogistiCare to cancel the particular trip no less than four hours prior to the time of the authorized trip.

LogistiCare maintains a staff to resolve any issues when a transportation provider is late or fails to show at the scheduled time. A dedicated Ride Assistance Line (referred to as the Where’s My Ride line) number is available 24 by 7 to find out the status of the ride and resolve issues.

"Where's My Ride"

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Urgent/same day trips are booked Monday through Friday between 8:00 a.m. and 5:00 p.m.   All urgent or same day trips will be verified with the physician’s office for medical necessity. If it is a case where the trip request was simply not called in timely, then in those cases the appointment should be rescheduled so that transportation can be booked with 2 business days’ prior notice.

Urgent request is an unscheduled request due to an episodic situation in which no immediate threat to life or limb exists, but the client’s treatment cannot be delayed. A request for nonemergency transportation for illnesses or injuries of a less than serious nature than those constituting emergencies but for which treatment is required to prevent a serious deterioration in client’s health and for which treatment cannot be delayed without imposing undue risk on the qualified client’s well-being until client secure services from regular physician. Examples of such trips are doctor appointments deemed urgent by the physician, and hospital discharges.

Emergency ambulance trips are not arranged through LogistiCare. If an emergency ambulance trip is needed, 911 should be called.

Sudden life-threatening medical situations, significant trauma, comas, shock, uncontrolled bleeding, respiratory distress, poisoning, drug overdose and any situation where immediate medical relief or treatment is necessary.

Hospitals may contact the Reservations Line at 877-633-8747.

Out-of-State, nonemergency trips require a minimum of 30 days for medical review to assess the necessity of out-of-state travel.

No.

Medicaid spend down is a term used to describe a formal process that will reduce an individual’s income so that s/he may be able to qualify for Medicaid benefits.  NEMT will be available to the client once spend down is met.

Their “preference” will be taken into consideration but cannot be guaranteed.

10 minutes from the scheduled pick-up time.

Clients 14 years of age and under must be accompanied by a parent, guardian or other pre-authorized adult. Click here to download Parental Authorization form

Clients 15 to 17 years of age may travel unaccompanied after a Minor Consent form is submitted by the parent or legal guardian, click here to download the form

It is regularly reoccurring transportation for those members who need transport 3 or more days per week for 3 or more month’s duration, e.g., a Monday, Wednesday and Friday dialysis patient. To eliminate the need to request transport for every one of those appointment, a standing order process has been created. This allows a facility to arrange 3 months’ worth of trips simply by filling out and faxing in the standing order form, or by completing an online request.  At the end of those 3 months, our Facility Services Department will call the medical provider and ask if the trip continues to be necessary. The facility will not have to submit new standing order or medical necessity forms at that time unless the client’s mobility has changed. 

Social workers, case managers or other licensed/certified medical professionals.  If a client requests regularly reoccurring transportation for 3 or more days per week and 3 or more months duration, then the Facility Services Department will then contact the social worker or case manager to secure a Standing Order for the client.

A copy of the Standing Order Request Form is located on this web site and can be downloaded for your convenience. Alternately, the LogistiCare Facility Services Dept. staff can fax the form to you, or the standing order can be setup through the Facility Web Service Portal at https://facility.logisticare.com/

The Standing Order Request Form should be faxed to the LogistiCare Facility Services Department at 877-585-8793.

Call the Facility Services Dept. or do it online.

If a request for NEMT falls under one or more of the denial criteria listed below, then LogistiCare must deny the request:

  • The Client is not eligible for NEMT services on the date of service.
  • The Client does not have a medical need that requires NEMT services.
  • The medical service for which NEMT service is requested is not a covered medical service.
  • The client has access to available transportation.
  • Transportation to the medical service for which NEMT service is requested is covered under another program.
  • The trip was not requested timely and the request cannot be accommodated because of this reason.
  • Additional documentation was requested and was not received timely.
  • The Client refuses the appropriate mode of transportation.
  • The Client refuses the NEMT provider assigned to the trip and another appropriate NEMT provider is not available.
  • The Client refuses to cooperate in determining status of Medicaid eligibility.
  • The Client exhibits uncooperative behavior or misuses/abuses NEMT services.
  • The Client is consistently not ready to board NEMT transport ten (10) minutes after the scheduled pick up time. 

No.

NEMT will be authorized for transporting a client to the closest, Texas Medicaid – enrolled medical or dental provider unless:

  1. Client just moved.  In that case the client has one (1) month to locate a closer medical provider, or
  2. The trip is to a specialist who is the closest available, or
  3. No appointment is available at the closest medical provider within the next 30 days for a child or the next 45 days for an adult.

Generally, the nearest appropriate provider is within the city or county where the member resides. Logisticare may request additional medical information if the trip exceeds 100 miles.

Call LogistiCare we will locate a provider with the correct equipment to transport your patient.  Since this may require more time to locate a provider with the proper equipment, please call us with as much advance notice as possible.

LGTC will provide transport to the closest Medicaid, CSHCN, or TICP medical provider to clients who are eligible for the program.

It would be considered a non-covered service because for Diagnosis Related Group patients’ hospital-to-hospital transport is not covered unless the client is first discharged.

Non-emergency transportation is only covered for taking nursing home members to and from dialysis treatments.

If the program is a covered service and is not receiving funding for transporting clients to and from the program then you can contact LogistiCare to arrange transportation for the clients.  At that time please identify the Medicaid-enrolled transportation provider that you wish to continue using for your patients.

Yes.

No, LogistiCare will only reimburse for mileage.

Once their appointment is finished, the client or someone at the medical provider’s office can call the "Where's My Ride" and request that transportation be sent to pick-up the client. A transportation provider will be dispatched and will have 60 minutes to pick-up the client.

"Where's My Ride"

Six types of non-emergency medical transportation services are available if you have no other way to get a ride.

Demand Response Transportation: Commercial transportation providers contracted by LogistiCare to perform the requested trips. Two levels of service are provided:

  • Ambulatory: Indicates that the client is able to walk. An ambulatory client may require the assistance of a walking device such as a cane or walker
  • Wheelchair: Indicates that a client must be transported in a wheelchair by a wheelchair van.

Bus/Mass Transit tickets: LogistiCare will determine that mass transit is the appropriate mode of transportation for the client. LogistiCare will ensure that clients do not live more than a quarter mile (¼) from a public fixed route stop. Additionally, LogistiCare will ensure that mass transit tickets are received by the client before the client’s appointment.

Mileage Reimbursement: Logisticare provides mileage reimbursement for Logisticare prior authorized no emergency medical transportation to an ambulatory client’s covered service appointment.

  • The client, friend, or family member qualifies for mileage reimbursement if the client, friend or family member is unable to provide the transport without financial assistance.
  • The client, friend or family member responsible for transporting the client is referred to as the Individual Transportation Provider (ITP). The ITP selected by the client to drive him/her to the appointment must have be fully compliant with the program requirements. Click here to download the application.

Meals and Lodging Clients 0-20yrs old: Service is provided for a client when healthcare treatment requires an overnight stay outside county of residence or beyond adjacent counties.

Advanced Funds Clients 0-20yrs old: Funds are made available to Medicaid/CSHCN clients 0 through 20 years of age and who are facing financial hardship and in need of transportation services to attend a Medicaid/CSCHN healthcare appointment Reservations should be submitted 5 business days prior the appointment date.

Out of State Travel Clients 0-20yrs old: Requires a minimum of 5 days advance notice.

Commercial Air Transportation: Service is provided for out of state travel after prior authorization.

Yes, LogistiCare will provide transportation for a mother who goes visit a newborn client for infant bonding, learning how to care of sick child, and other types of visits.