Specialized Transportation Guide
A minimum of 5 BUSINESS days is needed to ensure requests may be reviewed, authorized, and transport scheduled. Any requests made in less than 5 business days cannot be guaranteed for transportation.
Specialized Transportation FAQ’s
- I just recently completed a PCSP/SRT, I selected “no” to specialized transportation and it forced me to complete the sections on specialized transportation when The PTP did not request. What do you do then?
This has been fixed in FP
- What if they forget about an appointment and call when they’ve remembered? Will everything need to be updated again for that one appointment? Would it be expedited?
Yes, you would need to update the PCSP and even if you expedited it may not be enough time to give the 3 days notice to the transportation provider, so make sure you are asking the ptp before the visit date to gather all information on appointments (especially the specialized transportation ones.
- What if this is an MCO transfer or previous nursing facility PTP should a change event be completed? for example last PCSP is NF PCSP in portal.
Yes, NF PCSP’s would never have HCBS services on them, so a visit would be needed. Visit in this situation would also be due, because the ptp has gone from NF to HCBS and if HCBS services are not already in place at the time of referral, then they would need to be discussed.
- MATP will still be “Other” on the PCSP correct?
Correct, only if the ptp does is not requesting specialized transportation. If the ptp needs paralift and does not have Medicare Advantage plan coverage, then “non-medical transportation” for MATP would be used for specialized transportation requests.
- Do we need to update PCSP for PTP that’s already getting these services?
You would update the PCSP any time the participant is asking for a new trip. Specialized transportation is requested Monthly and based on specifics about the trip.
- If a ptp has a medical appointment like 2 months later, can we update the pcsp and srt now or do we wait until 3 days before the medical appointment?
Yes, update the PCSP as soon as you know the information for the specialized transportation request. We need to make sure that we are submitting requests from participants right away! Three days prior to the appointment will likely result in the ptp not getting the transportation they need, because the transportation providers need a minimum of 3 days notice for appointments and PHW would not have enough time to review or build an authorization.
- Is this for dialysis ptps or regular apts?
Specialized transportation can be used for medical appointments, only if the participant needs ambulance, stretcher, or paralift transport and it is not going to be covered by a Medicare Advantage Plan. If a ptp meets that criteria, then the type of appointment requested does not matter.
- So if it’s a medical appointment the provider is MATP but it’s listed as NMT in PCSP?
If it is a specialized transportation request, for paralift, to a medical appointment and the ptp does not have Medicare Advantage plan coverage, then yes, MATP would be on the PCSP and “non medical transportation” would be selected. For Ambulance and stretcher, you would select MTM and “non medical transportation”.
- So we are updating the pcsp and srt each time for a medical appointment every month if it’s not the same medical appointment?
You will be reminding the ptp prior to any visits to have all of the information for any trips that will require a specialized transportation request. You can submit up to a year of specialized transportation, it is just requested by month. So if there are 3 months of trips being requested during the next year, then you will add all 3 months worth of trip information to the PCSP/SRT, but you must have all of the required information about the trips. If these are new appointments the ptp is scheduling after you did your regular visit and the ptp gives you the information for the trips separately, then yes, you would update the PCSP/SRT each time. Talk with your participants about this prior to the first time they request specialized transportation, so they know to give you any requests that they can at the same time. When you are updating the PCSP with the ptp, ask them for any future visits they have as well, to help decrease the amount of updates needed.
- How are we figuring out the miles?
You would look at both addresses the ptp provided you with and use whatever app or site you use for directions. And add together the mileage for the trips for that day.
- Is Mtm for specialized transportation? PHW is saying for medical appointments for specialized transportation to use MTM
Yes, MTM should be used for specialized transportation for ambulance and stretcher transport to medical appointments. You would still specify what type of appointment it is. For Paralift, MATP, is the provider for specialized transportation. Please make sure you check if they have a Medicare Advantage plan and if it would be covered through that first though.
- Do these updates require visits monthly
You are not doing a visit for specialized transportation requests, unless a visit is already due for the participant. If no Annual, Change event, or Quarterly is due, then you would just update the PCSP/SRT to include the information on Ambulance, Stretcher, or Paralift transport.
- Can you provide the examples you mentioned in PCSP format for specialized and normal transportation for reference?
Yes, as soon as Function Portal is updated with all the questions, then examples from FP will be in Knowledge Base, which you can access at any time. In KB, search for “transportation” and all related documents will show up.