5-018.05B Transportation for Out-of-State Medical Treatment

Medicaid may cover transportation for out-of-state medical treatment for Medicaid-eligible clients.  

If out-of-state treatment is approved by Medicaid, Department staff may authorize transportation.  The client is not eligible for transportation assistance if the client is driving him/herself.

If out-of-state treatment is not approved because of a non-medical reason such as the out-of-state provider refusing to participate in Medicaid, transportation for out-of-state treatment may be approved (see 473 NAC 5-018.05B2). If out-of-state treatment is not approved for lack of medical necessity, transportation for out-of-state treatment must not be approved.  

If prior authorization for out-of-state treatment is not required (for example, receiving services in a border state), Department staff may authorize transportation under the usual procedures.  

{8/20/07}

5-018.05B1 Medicare (Primary) and Medicaid (Secondary)

5-018.05B2 Private Health Insurance (Primary) and Medicaid (Secondary)