What is non-medical transportation (NMT)?
Non-medical transportation (NMT) is a Medicaid ride category whose meaning depends on the program. Under home and community-based services waivers, NMT takes participants to the jobs, day programs, and community activities in their service plan. In California, Medi-Cal uses NMT for car, taxi, rideshare, bus, and mileage-reimbursed rides to covered care for members who do not need a medical vehicle.
On this page
Two meanings of NMT
The term changes meaning depending on the program paying for the ride. Operators run into both.
| Waiver NMT | Medi-Cal NMT (California) | |
|---|---|---|
| Goes to | Jobs, day programs, volunteer work, and community resources in the service plan | Medically necessary Medi-Cal services, prescription pickups, and medical supplies |
| Rider | A participant in a home and community-based services (HCBS) waiver | A Medi-Cal member who can travel by ordinary means |
| Typical mode | Provider car or van, transit passes, taxis | Passenger car, taxi, rideshare, bus pass, train ticket, or a private vehicle with mileage reimbursement |
| Legal basis | Section 1915(c) waiver or another HCBS authority | The managed care plan contract and All Plan Letter 22-008 |
| Approval | The participant’s service plan | Plan prior approval, with no physician form |
NMT under HCBS waivers
CMS defines waiver NMT as a service that helps participants reach waiver and other community services, activities, and resources named in their service plan. It is offered in addition to regular NEMT and can never replace it. A waiver participant’s ride to a doctor must still be billed as state plan transportation or charged as an administrative expense. Free help from family, neighbors, friends, or community agencies comes first. States can offer it through a 1915(c) waiver, a 1915(i), (j), or (k) state plan amendment, or a section 1115 demonstration.
Our entry on waiver transportation covers how these rides are authorized, logged, and billed, using Ohio’s rule as the example.
NMT in California Medi-Cal
In California, NMT sits inside the medical transportation benefit. Each Medi-Cal plan is responsible for NMT to covered services, including carved-out services such as dental, specialty mental health, and pharmacy. Health Net’s manual lists the modes: rideshare, passenger car, taxi, paratransit, bus, and mileage reimbursement. California Health & Wellness’s summary of All Plan Letter 22-008 adds two limits. The ride must be the least costly method that meets the member’s needs, and NMT does not cover trips to non-medical places or appointments that are not medically necessary.
NEMT in California is the step up. Under 22 CCR 51323, a wheelchair van, litter van, or ambulance is covered only when ordinary transport is medically contraindicated, and it needs a prescription and prior authorization. The California NEMT guide covers both benefits and their brokers.
Examples
- A Medi-Cal member who walks without help needs a ride to a dental cleaning. That is NMT: a car, taxi, or bus pass.
- The same member, after hip surgery, needs a wheelchair and cannot ride in a regular car seat. That becomes NEMT in a wheelchair van, with a Physician Certification Statement on file.
- In Ohio, an adult with a developmental disability rides to a job three days a week. That is waiver NMT, billed at a per-trip rate.
NMT vs nearby terms
- NEMT is transportation to covered medical care under the state plan.
- Ambulatory transportation describes a rider who can walk, whatever program pays.
- Level of service is how a broker or plan decides which vehicle and assistance a rider needs.
HealthRide matches wheelchair, stretcher, and oxygen needs to the right vehicle, so ambulatory rides and lift van trips share one dispatch board.
Frequently asked questions
- Does NMT need a doctor's form in California?
- No. Health Net's Medi-Cal manual states that a Physician Certification Statement is not required for NMT. California Health & Wellness's provider summary of DHCS All Plan Letter 22-008 adds that the plan approves NMT before the member uses it and may reauthorize it every 12 months. NEMT is different. A wheelchair van, litter van, or ambulance ride needs a PCS on file before the plan grants prior authorization.
- Can a NEMT company also provide waiver NMT?
- Yes, if it meets the waiver's own provider rules. In Ohio, for example, non-medical transportation providers need a Medicaid provider agreement and certification as an agency or independent provider, plus driving record checks and vehicle inspections set by the state rule.
- Is NMT the same as ambulatory transportation?
- They overlap but are not the same. Ambulatory describes the rider, who can walk and sit in a regular seat. NMT describes the program category. Federal NEMT rules count taxi rides and bus passes to medical care as NEMT, so an ambulatory rider going to a doctor is usually an NEMT trip. California labels that same ride NMT.
