Ambulance | Commercial | Mileage and Per Diem Reimbursement | Specialized Non-Emergency
Mileage and Per Diem Reimbursement - Montana’s Medicaid program covers mileage and per diem associated with travel to necessary medical care that is covered by the Montana Medicaid program.
Prior Authorization - Mountain-Pacific must preauthorize any reimbursement for travel. Prior authorization is obtained by calling Mountain-Pacific’s transportation center well in advance of the medical appointment. Callers must provide specific details about the medical appointment and the client for whom it is scheduled.
The transportation center can be reached 800-292-7114 or 406-443-6100, or by fax at 800-291-7791 or 406-443-0684.
Procedures - Once a medical appointment is scheduled, the transportation center is contacted and informed of the appointment. The following information is required: client’s name, Medicaid ID number, address, date/time of appointment, doctor or hospital name and medical service to be provided and the driver’s name and address and reason for appointment.
Freedom of Choice of Providers - Clients are free to choose their medical provider. Medicaid supports that choice by paying for Medicaid-covered medical services. However, travel funds are provided to the site of services nearest to the client. Clients are free to choose to accept mileage reimbursement to the closer site and travel farther for their medical care.
Review Requirements - The transportation center staff reviews the request for travel funds to assure that the travel is:
• prior authorized,
• for travel to a Medicaid-covered service,
• at the closest site of service (based on licensure),
• by the least-costly means, and
• for an eligible Medicaid client.
Out-of-State Travel Review Limitations - In addition to the review requirements listed above, requests for travel to out-of-state locations (more than 100 miles outside the Montana border) are reviewed to assure the travel is:
• to receive a Medicaid-covered service, which is not available in Montana;
• to a service that is not experimental or investigational;
• by the least-costly means suitable to the client’s medical needs.
Medicaid reimbursement for private vehicle mileage is $.33 per mile. Medicaid reimburses per diem at the following rates:
• Breakfast $5.00
• Lunch $5.00
• Dinner $5.00
• Lodging up to $25.00 a night (or a submitted receipt, whichever is less)
Transportation coverage is available for one attendant to accompany a client who is a minor child or whose medical condition requires attendant services.
Private vehicle reimbursement can be paid directly to the client who drives or to other individuals acting as drivers for the client.
Reimbursement of lodging up to a maximum of $25 per day is provided when the transportation center receives a copy of the lodging receipt documenting the costs incurred. Lodging receipts can be faxed toll free to 800-291-7791.
Limitations - Per diem costs are not reimbursed when a trip can be reasonably completed in one day.
This project is funded in whole or in part under a Contract with the Montana Department of Public Health and Human Services. The statements herein do not necessarily reflect the opinion of the Department.