Transportation services prior authorized by the Medical Transportation
Program (MTP) or transportation providers include:
(1) Demand response transportation services provided
when fixed route services are either unavailable or do not meet the
health care needs of clients. Services must be timely and provided
by qualified, courteous, knowledgeable, and trained personnel;
(2) Mass transit tickets when determined to be the
appropriate mode of transportation for the client, ensuring the client
does not live more than a quarter (1/4) mile from a public fixed route
stop, the appointment is not more than a quarter (1/4) mile from a
public fixed route stop, and that mass transit tickets are received
by the client before the client's appointment;
(3) Individual transportation participant services
provided by volunteers who enter into an agreement and are reimbursed
for mileage if they are prior authorized to drive a client to a covered
health care service in a personal car;
(4) Meal and lodging services for clients and an attendant
when a covered health care service requires an overnight stay outside
the client's county of residence or beyond adjacent counties. Clients
and attendants must receive the same quality of services provided
to other guests and the lodging services must be equivalent or better
than those listed in the Office of the Texas Comptroller's State Travel
Management Program;
(5) Transportation to and from renal dialysis services
for clients enrolled in the Medicaid program who are residing in a
nursing facility, as required by the Human Resources Code;
(6) Advance funds disbursed before the covered health
care service to clients when a lack of transportation funds will prevent
a child from traveling to the service. Advance funds are for clients
through age 20 and Children with Special Health Care Needs services
program clients 21 and over who have been diagnosed with cystic fibrosis.
Advanced funds may be issued to cover meals, lodging, and/or mileage;
(7) Out-of-state transport to contiguous counties or
bordering counties in adjoining states (Louisiana, Arkansas, Oklahoma,
and New Mexico) that are within 50 miles of the Texas border, if services
are medically necessary and it is the customary or general practice
of clients in a particular locality within Texas to obtain services
from an out-of-state provider that is enrolled as a Texas Medicaid
provider; and
(8) Commercial airline transportation services for
a client and attendant to a covered health care service, when it is
the most cost effective option or when necessary to meet the client's
medical needs.
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