Section He-W 574.10 - Mileage Limits and Rate(a) The rate paid shall be that established by the commissioner in accordance with RSA 161:4, VI(a) .(b) The maximum allowed traveled round trip mileage to medicaid enrolled providers by recipient drivers shall not exceed the following limits: (1) 75 miles to a hospital;(2) 45 miles to a physician or mental health provider;(3) 300 miles to a dentist;(4) 75 miles to a physical, speech, or occupational therapist;(5) 90 miles to a dialysis provider;(6) 400 miles to a referred medical provider; and(7) 20 miles to a pharmacy.(c) The maximum allowed billable round trip mileage for travel to medicaid enrolled providers by volunteer drivers shall not exceed the following limits: (1) 95 miles to a hospital;(2) 65 miles to a physician or mental health provider;(3) 320 miles to a dentist;(4) 95 miles to a physical, speech, or occupational therapist;(5) 110 miles to a dialysis provider;(6) 420 miles to a referred medical provider; and(7) 40 miles to a pharmacy.(d) Determination of the least costly route shall be by the use of a web-based mapping tool containing a mileage calculator, which has the functionality to allow the input of addresses and the calculation of distance between them and to identify toll roads.N.H. Admin. Code § He-W 574.10
(See Revision Note at chapter heading He-W 500); ss by #6163, eff 1-4-96, EXPIRED: 1-4-04
New. #8732, eff 9-30-06
Amended byVolume XXXV Number 18, Filed May 7, 2015 , Proposed by #10810, Effective 4/9/2015, Expires4/9/2025.