Indiana medicaid transportation reimbursement If you don’t schedule your trip and get it approved, your Reservation Numbers: Toll-Free Reservation Lines: Anthem Healthy Indiana Plan, Hoosier Healthwise, Hoosier Care Connect, or Indiana PathWays for Aging Members: 844-772-6632 Anthem Blue Cross and Blue Shield Medicare Indiana Medicaid provides a healthcare safety net to Hoosier children, aged, disabled, pregnant women, and other eligible populations under the umbrella of Indiana Health Coverage Programs (IHCP). It enables family members or associates to enroll as reimbursable drivers. Emergency Transportation: Medicaid pays for emergency medical transportation services at the lower of: 1. Your driver is trained to treat you with respect and to think of your needs. Accordingly, effective July 1, 2018, the Indiana Health Coverage Programs (IHCP) will provide reimbursement for services provided by CHWs. Nonemergency medical transportation services for most members served through the fee-for-service delivery system are brokered through Patients must call Southeasttrans, Indiana Medicaid’s transportation provider, at least 2 business days before appointment. Mileage/Gas Reimbursement . Transportation can take you to a pharmacy on the way home from a doctor visit. Let the person who answers the phone know you want to use gas mileage reimbursement. Reimbursement policies are designed to assist you when submitting claims to CareSource. These services are not reimbursable for specialty 617. Transportation will pick you up at the same place they dropped you off. in. Just call 1-800-356-1204 and choose the transportation option. ; You need to call or book online at least two business days before your appointments — but you can as much 45 days in advance. Indiana Medicaid provides a healthcare safety net to Hoosier children, aged, disabled, pregnant women, and other eligible populations To receive transportation benefits, a member enrolled in Hoosier Healthwise, Hoosier Care Connect or Healthy Indiana Plan must call their health plan’s transportation broker (similar to a dispatching service) at least 48 hours in advance. The member Transportation to and from an Indiana Medicaid covered service is provided as an optional service under this State Plan by the following methods: xWhen transportation is unavailable from a non-Medicaid reimbursed source, with the exception of Medicaid payments for family member mileage, Indiana Medicaid IHCP reimbursement for services or medical supplies resulting from a practitioner's order, prescription or referral requires the ordering, prescribing or referring (OPR) provider to be enrolled with the IHCP. On June 1, 2018, the Indiana Family and Social Services Administration began working with Southeastrans to manage all non-emergency transportation for Traditional Medicaid members (you may also see this called “fee-for-service” Medicaid. gov/Medicaid. They are routinely updated to promote accurate coding and policy clarification. These rates are published at the State's website, in. Fact Sheets: • Medicaid Transportation: Package A and Package C (CHIP) • Medicaid Transportation: Traditional Medicaid (Waivers) If you have any other questions about enrolling as a IHCP reimbursement for services or medical supplies resulting from a practitioner's order, prescription or referral requires the ordering, prescribing or referring (OPR) provider to be enrolled with the IHCP. Rides should be easy and enjoyable. Each MCE is responsible for meeting network Indiana Medicaid provides a healthcare safety net to Hoosier children, aged, disabled, pregnant women, and other eligible populations under the umbrella of Indiana Health Coverage Programs (IHCP). You can also contact the ModivCare Reservation Line as well as visit ModivCare. 2. The person requesting reimbursement must fill out W-9 and Direct Deposit forms. Reimbursement is restricted to transportation for the specific member completing the form. The Indiana Health Coverage Programs (IHCP) outlines these criteria, ensuring services are medically necessary, documented, and provided IHCP reimbursement for services or medical supplies resulting from a practitioner's order, prescription or referral requires the ordering, prescribing or referring (OPR) provider to be enrolled with the IHCP. Medicaid Family Member or Healthy Indiana Plan (HIP) – an affordable health care program created by the state of Indiana to cover adults ages 19 to 64 whose income is up to 138% of the Federal Poverty Level (FPL). This bulletin provides a correction to the rates published in BT202310. 0 with Indiana Medicaid to receive gas mileage reimbursement. Hoosier Care Connect – the state’s program for Indiana Medicaid enrollees who are aged, blind Non-Emergency Medical Transportation Provider Frequently Asked Questions On June 1, 2018, the Indiana Family and Social Services Administration began working with Southeastrans to manage all non-emergency transportation for Traditional Medicaid members (you may also see this called fee-for-service Medicaid. Nonemergency medical transportation services for most members served through the fee-for-service delivery system are brokered through Transportation to and from an Indiana Medicaid covered service is provided as an optional service under this State Plan by the following methods: Reimbursement for covered transportation services will be as follows: Non - emergency Ground Transportation: Taxi Services: Lower ofmetered or zoned rate or fee schedule rate. Members are selected for review based on their behavior patterns and utilization practices compared with other IHCP reimbursement for services or medical supplies resulting from a practitioner's order, prescription or referral requires the ordering, prescribing or referring (OPR) provider to be enrolled with the IHCP. The Right Choices Program (RCP) is the lock-in program developed by the Indiana Health Coverage Programs (IHCP) in accordance with Code of Federal Regulations 42 CFR Sections 455 and 456 and Indiana Administrative Code 405 IAC 1-1-2(c). The IHCP reimbursement for services or medical supplies resulting from a practitioner's order, prescription or referral requires the ordering, prescribing or referring (OPR) provider to be enrolled with the IHCP. Press Enter on an item's link to navigate to that page. Medicaid members who need to request Mileage Reimbursement should follow the . Medicaid Family Member or Coverage applies to Traditional Medicaid and other IHCP programs that include full Indiana Medicaid State Plan benefits; it does not necessarily reflect coverage under a limited-benefit plan. After your driver’s enrollment is complete, he or she will be contacted by the transportation broker that will be reimbursing his or her gas mileage. BT202221. IHCP announces HCBS bariatric ambulance grants to Indiana. Currently this site hosts information and forms that medical facilities and medical groups can use to schedule transportation for our clients. 50-$2. Please contact us at 1-317-233-1351 or 1-800-475-1355, option 4 for Travel Reimbursement information. For Indiana Fee-For-Service . HEALTHY INDIANA PLAN Transportation must be the least expensive type of transportation available that meets the medical needs of the member. Nonemergency medical transportation services for most members served through the fee-for-service delivery system are brokered through INDIANA HEALTH COVERAGE PROGRAMS BT202251 JUNE 30, 2022 Page 1 of 2 Transportation Services Codes Renal Dialysis Services Codes Reimbursement, PA and billing information applies to services delivered under the FFS delivery system. Meal INDIANA HEALTH COVERAGE PROGRAMS BT201766 SEPTEMBER 28, 2017 Page 1 of 1 Code 12-15-1. For information on gas mileage reimbursement or bus passes, please contact MHS Member Indiana Medicaid Policy Name & Number Date Effective Modifiers-IN MCD-PY-1347 03/01/2024 Policy Type REIMBURSEMENT Reimbursement Policies prepared by CareSource and its affiliates are intended to provide a general reference regarding billing, coding and documentation guidelines. Reimbursement updates for COVID vaccine INDIANA HEALTH COVERAGE PROGRAMS BT202322 MARCH 9, 2023 Page 1 of 3 IHCP announces changes to reimbursement for EMS providers As announced in Indiana Health Coverage Programs (IHCP) Bulletin BT202310, changes to the reimbursement rates will be effective July 1, 2023. Indiana Health Coverage Programs IHCP clarifies VFC and private stock vaccine reimbursement, effective January 1, 2020; IHCP to update CoreMMIS to capture fields present on standard national claim forms; New Program Integrity provider training available – Renal Dialysis Services Billing Guidelines Hospital, MCEs, Mental Health enrollment is required for each driver requesting reimbursement 1. Completion of this form is necessary for processing transportation requests. June 2018 Indiana Medicaid Policy Name & Number Date Effective Modifier 25-IN MCD-PY-1362 12/01/2024 Policy Type REIMBURSEMENT Reimbursement Policies prepared by CareSource and its affiliates are intended to provide a general reference regarding billing, coding and documentation guidelines. INDIANA HEALTH COVERAGE PROGRAMS BT202063 MAY 19, 2020 Page 1 of 4 IHCP provides billing guidance to EMS provider Ambulance to receive reimbursement. Where’s My Ride - press option 2 Spanish - press option 9. Get Indiana Medicaid Transport Form Form Call 911 if you need emergency transportation. IHCP Quick Reference Guide. com to obtain additional blank copies of the form. Questions about FFS reimbursement, PA and billing should be directed to Gainwell Technologies at 800-457 How To Set Up Your Ride. 3-18 – Reimbursement Rate Increase. Medical Transportation (NEMT) Guide. • Hoosier Healthwise – The state of Indiana’s Medicaid program, separated into Package A for children and pregnant members and Package C for children under age 19. This service allows individuals to travel to any medical facility for non-emergency medical services that are covered by Medicaid, such as appointments with doctors or dentists, dialysis treatments, and more. • Healthy Indiana Plan (HIP) – An affordable healthcare program created by the state of Indiana to cover adults ages 19 to 64 whose income is up to 138% of the Federal Poverty under the Indiana Medicaid State Plan or any other waiver service. • Medicaid enrollment appointments • WIC appointments • MHS special events HOOSIER CARE CONNECT (HCC) MEMBERS FREE unlimited transportation services to: • Doctor visits • Dental and vision visits • Pharmacy after a provider visit • Medicaid enrollment appointments • WIC appointments • MHS special events. Individual managed care entities (MCEs) establish and publish reimbursement, PA and billing information within the managed care delivery system. ) INDIANA HEALTH COVERAGE PROGRAMS BT202006 JANUARY 23, 2020 (FSSA) has received approval from the Centers for Medicare & Medicaid Services (CMS) for a rate increase and methodology change for services provided under the Division of nonmedical transportation may be billed using code T2003 with the modifier combination of U7 and U1 or U2 to measures. 19-B, page 1c), the Indiana Health Coverage Programs (IHCP) will adopt the The MDS resident assessment information is collected and processed for use in the NF reimbursement system by an independent state contractor, Myers and Stauffer. enrollment is required for each driver requesting reimbursement 1. For individuals covered under Managed Care plans For individuals covered under Hoosier Healthwise, a friend or family member can enroll as a transportation provider through the Indiana Health Coverage Programs (IHCP) using the information below. If you drive more than one family member, you need to IHCP reimbursement for services or medical supplies resulting from a practitioner's order, prescription or referral requires the ordering, prescribing or referring (OPR) provider to be enrolled with the IHCP. To learn more about the non-emergency transportation benefit, Traditional Medicaid members can visit Nonemergency medical transportation services for most members served through the fee-for-service delivery system are brokered through Southeastrans Inc. ” You can speak to a live transportation representative between 8 a. The list of impacted At LCP Transportation LLC, we offer a full range of non-emergency transportation services. 1-855-325-7586 Customer Service - press option 1. procedures cannot exceed the Medicare rate of reimbursement. to 8 p. ” You can reach MHS' transportation vendor through MHS Member Services at 1-877-647-4848 (TTY: 1-800-743-3333). Whether your question or need relates to members or providers; managed care or fee-for-service coverage; medical, pharmacy or other Serving Patients Across All Of Indiana. Press Space or Escape to collapse the expanded menu item. process below: Members should call ModivCare at 855-251-7100 and report the driver and their trip . They cannot pick up multiple family members at different locations. Whether you, your loved ones, or your patients need a ride, we’ve got you covered. Questions about FFS PA should be directed to Gainwell Technologies at 800-457-4584, option 7. Funding noted. ) The Indiana Health Coverage Programs (IHCP) reimburses for transportation of members to or from an IHCP-covered service, subject to the guidelines and limitations described in this module. Patients may have a copay of $0. Nonemergency medical transportation (NEMT): FFS NEMT services will Transportation Services iv Library Reference Number: PROMOD00050 Published: Dec. Reimbursement updates for COVID vaccine IHCP bulletin BT202158 JULY 20, 2021 Outpatient Fee Schedule Updates 1 of 25 Table 1 – Procedure codes that have had two rows on previous versions of the Outpatient Fee Schedule Procedure code Description Discrepancy resolution 77048 MRI of one breast w or w/o contrast Pricing is 15% of billed charges per BR201938 77049 MRI of both breast w or w/o contrast Meals and Lodging: Meals and lodging reimbursement is based on the rate established by the Indiana State Legislature . Reimbursement updates for COVID vaccine The Indiana Health Coverage Programs (IHCP) reimburses for transportation of members to or from an IHCP-covered service, subject to the guidelines and limitations described in this module. The identified driver must enroll as an Indiana Medicaid transportation provider. The FSSA also contracts with Myers and Stauffer to complete periodic MDS reviews for all residents of Medicaid-certified NFs in Indiana, regardless of payer source. Nonemergency medical transportation services for most members served through the fee-for-service delivery system are brokered through For more information on Medicaid Transportation, visit INF2F’s . Providers must bill for all transportation services provided to the same member on the same date of service on one claim form. Coverage for CHW services applies to all IHCP programs subject to limitations established for certain benefit packages, for dates of service (DOS) on or after July 1, 2018. details to obtain a trip # for their ModivCare Trip Log, aka Mileage Reimbursement form. Reimbursement, PA and billing information apply to services delivered under the FFS delivery system. Please treat the driver in the way you wish to be treated. Other transportation activities not allowed under • Family Member mileage reimbursement Flexibility Greater flexibility in terms of destinations, focusing Managed through Medicaid transportation brokers, excluding those services that are carved out. Nonemergency medical transportation services for most members served through the fee-for-service delivery system are brokered through Overview. In Indiana, Medicaid reimbursement is governed by criteria that healthcare providers must meet to receive compensation for services to eligible individuals. Eastern time, or book online. Non-Emergency Medical Transportation for Traditional Medicaid: Southeastrans Frequently Asked Questions . ** C7903, G0017 and G0018 are covered for specialties 616 and 618–621. gov. For reimbursement of brokered NEMT services for FFS members, transportation providers – including common carriers (ambulatory and nonambulatory), taxis, buses and Verida arranges transportation for all Indiana Fee For Service Medicaid members residing in Indiana. 8671, which equals 75% of the 2014 MPFS conversion factor of $35. Please be ready when your ride arrives. . 245 cents per mile for trips over 49 miles one-way. The driver’s application must include: A completed . We have enclosed a blank reimbursement form with this letter along with instructions and a sample log for guidance. The transportation broker will explain what you and your driver need to do each time you go to a medical appointment. These services are not reimbursable for specialties 616 or 618–621. IHCP reimbursement for services or medical supplies resulting from a practitioner's order, prescription or referral requires the ordering, prescribing or referring (OPR) provider to be enrolled with the IHCP. The member You can reach MHS’ transportation vendor through MHS Member Services at 1-877-647-4848 (TTY: 1-800-743-3333). Indiana Medicaid provides a healthcare safety net to Hoosier children, aged, disabled, pregnant women, and other eligible populations Indiana Health Coverage Programs Behavioral Health Services Codes Published: March 13, 2025 4 Table 1 Notes * 96136 and 96137 are covered only for specialty 617. • Any other non-emergency transportation is not IHCP bulletin INDIANA HEALTH COVERAGE PROGRAMS BT201847 AUGUST 30, 2018 Page 1 of 3 IHCP revises family member transportation policy Indiana Administrative Code 405 IAC 5-4-3 permits a family member or close associate of a Medicaid member to be enrolled as a transportation provider for the purposes of reimbursement if the member has to make frequent Medicaid transportation in Indiana provides non-emergency medical transportation (NEMT) services to eligible members. Other claim reimbursement Gas Mileage Reimbursement: You, a friend or even a relative can drive to a doctor, dentist or clinic and be paid back. These proprietary policies are not a guarantee of payment. Unlimited Indiana Medicaid rides with these exceptions: Hoosier Healthwise (HHW) Package C: • $10 copay for ambulance ride for non-emergencies between medical facilities when asked for by a participating physician. paid to Indiana state employees for travel-related expenses. We pay $0. Indiana Medicaid provides a healthcare safety net to Hoosier children, aged, disabled, pregnant women, and other eligible populations under the umbrella of Indiana Health Coverage Programs (IHCP). You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement. Coding methodology, regulatory requirements, industry INDIANA HEALTH COVERAGE PROGRAMS BT202083 JUNE 30, 2020 Indiana Family and Social Services Administration (FSSA) Office of Medicaid Policy and Planning (OMPP) has received approval from the Centers for Medicare & Medicaid Services (CMS) for changes to services for the Division of Transportation, Level 2 T2002 U7 U5 U2 U7=Waiver U5=DD We want to remind providers of the significant changes to provider reimbursement across all Indiana Medicaid programs, focusing on physician and ancillary services. Feel free to make copies of the blank form for any future trips. Medicaid Members. The responsibility for the content of this file/product is with the Indiana Health Coverage INDIANA HEALTH COVERAGE PROGRAMS BT2020128 DECEMBER 17, 2020 Page 1 of 2 DME and medical supply items Effective February 1, 2021, the Indiana Health Coverage Programs (IHCP) will change the reimbursement methodology for select durable medical equipment (DME) and medical supply & Medicaid Services (CMS). Indiana Medicaid provides a healthcare safety net to Hoosier children, aged, disabled, pregnant women, and other eligible populations Indiana Health Coverage Programs Procedure Code Modifiers for Professional Claims Published: February 11, 2025 2 Table 1 – Procedure Code Modifiers (Excluding Transportation Origin and Destination Modifiers) Reviewed/Updated: January 1, 2025 Modifier Type Description 55 Processing Postoperative management only IHCP reimbursement for services or medical supplies resulting from a practitioner's order, prescription or referral requires the ordering, prescribing or referring (OPR) provider to be enrolled with the IHCP. After you are directed to the member prompt, say “transportation. The purpose of this document is to provide information on the processes for Medicaid prior authorization, claim reimbursement, administrative review, and appeals. This fee schedule reflects current IHCP coverage and reimbursement policy for procedure codes and revenue codes billed for IHCP outpatient services under the FFS delivery system. Transportation Services (all levels) Transportation Services (all levels) Workplace Assistance Workplace Assistance Indiana Medicaid sets a minimum fee schedule. Monday through Friday. Welcome to the Modivcare Facility web site for Indiana. Please follow these steps: Yes, but not if the family has Medicaid. IHCP Family Member or Associate Transportation Provider Enrollment and Profile Maintenance Packet A copy of this . Call Verida to arrange NEMT to covered medical services at least two (2) business To receive transportation benefits, a member enrolled in Hoosier Healthwise, Hoosier Care Connect or Healthy Indiana Plan must call their health plan’s transportation broker (similar to a Reimbursement is available for emergency and nonemergency transportation to or from a Medicaid covered service. This reimbursement update provides detailed insights into the key components and implications of the project. Nonemergency medical transportation services for most members served through the fee-for-service delivery system are brokered through INDIANA HEALTH COVERAGE PROGRAMS BT202020 MARCH 17, 2020 Page 1 of 2 pending CMS approval The Indiana Family and Social Services Administration (FSSA) Office of Medicaid Policy and Planning (OMPP) has requested approval from the Centers of Medicare & Medicaid Services (CMS) for changes to rates and services for the Transportation, Level T2003 SE Nonemergency transportation; encounter/trip; state and/or federally funded programs/service T2007 SE Transportation waiting time, air ambulance and non-emergency vehicle, one-half increments; state and/or federally funded programs/service T2007 U3 Transportation waiting time, air ambulance and nonemergency vehicle, one-half (1/2) hour • Hoosier Healthwise – The state of Indiana’s Medicaid program, separated into Package A for children and pregnant members and Package C for children under age 19. Indiana Medicaid provides a healthcare safety net to Hoosier children, aged, disabled, pregnant women, and other eligible populations Press Enter or Space to expand a menu item, and Tab to navigate through the items. Medicaid Non-Emergency. For this reason, in accordance with the clinical laboratory reimbursement methodology set out in Indiana Administrative Code 405 IAC 5-18-1 and in the approved Indiana Medicaid State Plan (Attachment 4. Payments for claims may be subject to limitations and Indiana Medicaid conversion factor is $26. Reimbursement for treat-no-transport will be made for Healthcare Common Procedure Coding System (HCPCS) code A0998 at the Indiana Medicaid Criteria for Medicaid Reimbursement in Indiana. IHCP reimbursement for services or medical supplies resulting from a practitioner's order, prescription or referral requires the ordering, prescribing or referring (OPR) provider to be Indiana Medicaid Prior Authorization and Claim Reimbursement Processes . 00, depending on coverage. • Healthy Indiana Plan (HIP) – An affordable healthcare program created by the state of Indiana to cover adults ages 19 to 64 whose income is up to 138% of the Federal Poverty INDIANA HEALTH COVERAGE PROGRAMS BT202127 APRIL 1, 2021 Page 1 of 3 CMS approves FSSA request for attendant care transportation options The Centers for Medicare & Medicaid Services (CMS) has approved the Family and Social Services Administration (FSSA) Division of Aging (DA) receive reimbursement, the attendant care aide must also perform To talk to someone about your transportation experience, please contact: Toll-Free Reservation Line . The best way to find the correct Indiana Health Coverage Programs (IHCP) contact information (phone or fax number, email address, mailing address, or web link) is to check the IHCP Quick Reference Guide. 1, 2023 Version: 6. 5, 2024 Policies and procedures as of Sept. MCEs set their own reimbursement at or above that level, so any crossover payment is dependent on each MCE’s reimbursement. Nonemergency medical transportation services for most members served through the fee-for-service delivery system are brokered through For more information on Medicaid Transportation, visit INF2F’s Fact Sheets: • Medicaid Transportation: Package A and Package C (CHIP) • Medicaid Transportation: Traditional Medicaid (Waivers) If you have any other questions about enrolling as a You can also get mileage reimbursement through them. Coding methodology, regulatory requirements, industry-standard To expedite your credentialing for mileage reimbursement, we have transitioned to directing members to the state of Indiana online portal to complete the forms required by the state. Nonemergency medical transportation services for most members served through the fee-for-service delivery system are brokered through IHCP reimbursement for services or medical supplies resulting from a practitioner's order, prescription or referral requires the ordering, prescribing or referring (OPR) provider to be enrolled with the IHCP. 03/22/2022. Providers located within Indiana or in a designated out -of- state When transportation is unavailable from a non-Medicaid reimbursed source, with the exception of Medicaid payments for family member mileage, Indiana Medicaid reimburses Medicaid On June 1, 2018, the Indiana Family and Social Services Administration began working with Southeastrans to manage all non-emergency transportation for Traditional Medicaid members Effective immediately, the Indiana Health Coverage Programs (IHCP) is revising its policy to require family members or close associates enrolled as drivers for Traditional Medicaid Fee-for-service (FFS) claim reimbursement for nonemergency medical transportation (NEMT) will be performed by the NEMT broker, Southeastrans (SET). - 8 p. 8228. Transportation Policy. If you have an emergency, call 911 or go to the nearest ER. The provider's submitted charge; or. Here’s how to set up your rides for your healthcare-related trips: Call Anthem Transportation Services at 844-772-6632 (TTY 888-238-9816) Monday through Friday, 8 a. EMS provider agencies will be allowed to bill for the drug and its administration. For questions, contact: rateincreaseplan@fssa. Indiana medicaid waiver reimbursement rates 2023 were substantially lower, so it's important that as a family caregiver you see a good payment and Indiana Medicaid rate increase as well as the agency. m. Please follow the guided directions included below. Whether transportation was provided and, if so, the destination This form allows Indiana Medicaid members to request reimbursement for transportation services. The entire Professional Fee Schedule can be viewed online, or a search tool is available to view only results for a specific procedure code, code range IHCP reimbursement for services or medical supplies resulting from a practitioner's order, prescription or referral requires the ordering, prescribing or referring (OPR) provider to be enrolled with the IHCP. Trips must be billed according to the level of service rendered and not according to the vehicle type. Nonemergency medical transportation services for most members served through the fee-for-service delivery system are brokered through These reimbursement policies apply to our Indiana Medicaid plans. For members remaining in FFS, IHCP recently updated our Professional Fee Schedule to be set at 100% of the Medicare rate. Transportation. Use is limited to use in Medicare, Medicaid or other programs administered by the Centers for Medicare and Medicaid Services (CMS). nmozuuybpbmlcowcgeteypcgheexnropvuhcgbosafwoveqdpzvnwdartqzfwowxdvzayhnexlzm