NY Manual
SHP Manual

New York Provider Manual
10.8 Hospice - Medicaid CHPlus FHPlus Medicare and Commercial | 10.10 Custodial-Long-Term-Care-Placement

10.9 Transportation

Emergency Transportation

All Healthfirst members are eligible for emergency transportation benefits. To obtain emergency transportation to the nearest emergency facility when there is a life-threatening situation, dial 911.

Transportation for Newborns (Medicaid)

Healthfirst covers transportation of newborns from the birth hospital to a Regional Perinatal Care Center (RPCC) for neonatal services. RPCCs directly arrange for one-way transport of newborns to the RPCC, and this service should be billed as rate code A0225 for an enrolled newborn or the newborn of an enrolled mother. Transport from the RPCC to the hospital is arranged by Healthfirst’s transportation vendor, not by the RPCC, and is billed by the transportation vendor as a routine transportation service.

Public Transportation

Participating PCPs, OB/GYNs, behavioral health providers, dental providers, and hospital facilities are responsible for distributing a round-trip MetroCard, or its equivalent, for each verifiable visit for Medicaid services. PCPs, OB/GYNs, and hospital facilities are also responsible for distributing a round-trip MetroCard, or its equivalent, for specialty care services. If services are provided at a hospital, the member must present his/her Healthfirst card and proof of an encounter/visit to the hospital’s transportation coordinator before reimbursement is given. Reimbursement for public transportation is available (in MetroCards) regardless of the member’s proximity to the service site.

If it is essential that an escort(s) accompany the member in need of care or if a child accompanies a parent/guardian, a round-trip MetroCard will be provided for each escort. There is no limit to the number of escorts who may accompany a member.

All provider MetroCard transportation forms should be mailed to Logisticare for reimbursement. Providers should call Logisticare at 1-877-564-5925 for details and instructions for reimbursement deliveries.

Special Program for Medicaid Members

This program offers free car service to qualified Healthfirst Medicaid members who need the following services: 

·     Prenatal visits – Only if in the first trimester of pregnancy (0 to 3 months) or first prenatal visit within forty-two (42) days, or six (6) weeks, of enrollment with Healthfirst.
·     Post-partum visit – Only if within twenty-one (21) to fifty-six (56) days, or three (3) to eight (8) weeks, after delivery
·     Well-child visits and immunizations:
·     Offered for members up to twenty-four (24) months old (total of six (6) round trips)
·     Two (2) weeks after birth
·     Six (6) weeks after birth
·     One (1) round trip every two (2) months thereafter for a maximum of six (6) round trips

To access this service, members located in Nassau, Suffolk, and Westchester should call Member Services at 1-866-463-6743. Members located in the New York City area should contact Logisticare at 1-877-564-5925. 

Nonpublic, Non-emergency Transportation

If a member has a non-emergent medical condition but requires an ambulance, ambulette, stretcher ambulette, or livery service to access medical care, the PCP, OB/GYN, behavioral healthcare, or dental provider must notify Member Services (for all Medicare and Medicaid members outside New York City) or Logisticare (for Medicaid and Essential Plan members located in New York City) 48 hours before the transportation is required. Member Services will arrange for appropriate transportation based on the member’s medical needs. Member Services is staffed Monday through Friday, 9 am to 6 pm, and can be reached by calling 1-866-463-6743. The after-hours service maintained by Healthfirst has instructions for assistance with transportation needs. Logisticare can be reached at 1-877-564-5925 to schedule transportation for Medicaid members in New York City.

Ambulance, Ambulette, and Livery Providers

Transportation providers who wish to have written confirmation that transportation was approved and arranged by Healthfirst have the option to request documentation on a Transportation Arrangement Form. To receive this form on a regular basis, transportation providers should contact their Network Representatives.

See Appendix IX for copies of all transportation forms.