N.J. Admin. Code § 10:54-5.44

Current through Register Vol. 56, No. 11, June 3, 2024

Section 10:54-5.44 - Transportation services

(a) The Division recognizes transportation services as covered services when a beneficiary is transported for the purpose of obtaining a Medicaid/NJ FamilyCare covered service. The mode of transportation is based upon the beneficiary's medical condition, as follows:

1. An ambulatory patient who does not require assistance or supervision shall be eligible for "lower mode" transportation (that is, car, bus, train or taxi);

2. A wheelchair-bound patient who does not need emergency ambulance service and/or a patient who is physically unable to use public conveyances shall be eligible for invalid coach service;

3. When emergency service is needed or the beneficiary is stretcher-bound, the beneficiary may obtain ambulance service directly from a provider of ambulance service, including Mobile Intensive Care Unit (MICU) service or air ambulance service when these modes of transportation are medically justified;

4. Non-emergency medical ground transportation services shall be provided by an independent transportation broker or vendor under contract with the Division of Medical Assistance and Health Services. This includes, but is not limited to:

i. Ground ambulance service (non emergency);

ii. Mobility assistance vehicle service;

iii. Livery services, including modified livery services; and

iv. All lower-mode transportation services, including arranging for transportation by taxi, train, bus, plane or other public conveyance;

5. Emergency ground transportation services and all air ambulance services shall be provided by transportation providers enrolled in the Medicaid/NJ FamilyCare program in accordance with 10:49-3.2 and 10:50; and

6. In all cases, the least expensive mode of transportation appropriate to the beneficiary's medical needs shall be used.

(b) For further information on authorization for transportation services see N.J.A.C. 10:50, Transportation Services.

N.J. Admin. Code § 10:54-5.44

Amended by R.2001 d.51, effective 2/5/2001.
See: 32 N.J.R. 3929(a), 33 N.J.R. 555(a).
Rewrote the section.
Amended by R.2012 d.124, effective 7/2/2012.
See: 43 N.J.R. 1477(a), 44 N.J.R. 1884(a).
In the introductory paragraph of (a), inserted "/NJ FamilyCare"; rewrote (a)1, (a)2, (a)3 and (b); added new (a)4 and (a)5; and recodified former (a)4 as (a)6.