CTS provider guide: New Hampshire Medicaid rides through Coordinated Transportation Solutions

Where CTS fits in New Hampshire Medicaid

CTS (Coordinated Transportation Solutions, Inc.) is a Trumbull, Connecticut nonprofit that has managed transportation since 1997. It owns no vehicles. CTS books each ride on the cheapest mode suited to the rider and hands it to an operator in its network. Its network mixes taxi and livery companies, wheelchair-accessible fleets, ambulance services, and public transit. In New Hampshire, CTS is the NEMT broker behind three separate streams of Medicaid trips.

Each New Hampshire Medicaid health plan works with its own broker. CTS covers the fee-for-service group, meaning members outside every plan. One Call held that contract until CTS took over on May 1, 2022, and health plan members were not affected by the switch. CTS also schedules for AmeriHealth Caritas New Hampshire and for the adult dental program. The state’s one-page ride guide, effective October 17, 2025, gives these details:

NH Healthy Families and WellSense Health Plan book through MTM instead, which our MTM Health provider guide covers. A company that wants the whole Medicaid market in its towns needs both contracts. For state licensing and plan background, see the New Hampshire NEMT guide.

Across all its programs, the 2025 CTS annual report counts 351 network providers with 5,487 vehicles, 2,532,396 trips performed, and 204,015 covered members. Medicaid NEMT accounted for about $141.5 million of roughly $152.9 million in operating revenue. In New Hampshire, CTS also lists the Manchester VA Medical Center, the Manchester School District, Amoskeag Health, and Greater Seacoast Community Health among its clients. The request form asks whether you want student work, so a network company can add trips outside Medicaid.

Which Medicaid riders reach a transportation company

New Hampshire tries cheaper options before it books a vehicle, so every trip that lands on your schedule has already cleared two screens. The DHHS order runs like this:

1. Mileage reimbursement first. A member who owns a car, or has a relative or friend with one, is expected to claim mileage through the Family and Friends Mileage Reimbursement Program. CTS enrolls those family and friends drivers, and the reimbursement is paid to the member, who then pays the driver. Someone with a car who declines the program qualifies for other help only without a valid license, without a working household vehicle, when unable to travel or wait unaccompanied, or with a limiting condition (physical, mental, cognitive, or developmental).
2. Public transit second. The bus is required when three things are all true: the member’s home is under half a mile from a bus line, the provider’s office is too, and the member is an adult younger than 65. Exceptions include pregnancy and the six weeks after birth, traveling with two or more children under 6, limited mobility, moderate to severe breathing conditions, visual impairment, developmental delay, severe mental illness, and cases a medical provider approves.
3. A contracted ride last. Members who clear neither screen get a trip from a network company in a taxi or sedan, a wheelchair van, an ambulance, or another mode.

That order decides who rides with you. The people left for a network company have no usable car and no family or friend to drive them, and they also live or see providers too far from a bus line, are 65 or older, or hold an exception such as limited mobility. Build your vehicle mix and driver training for them.

AmeriHealth Caritas New Hampshire adds non-medical trips through CTS. Members can take as many as 14 one-way social rides a calendar year, each capped at 30 miles, to places like the grocery store, a laundromat, a support group, a job interview, or legal aid. The plan tells members to schedule the ride home when they book the ride out, that two people can share one ride before approval is needed for more, that the booked pickup time carries a 15-minute allowance for late drivers, and that a driver calls before leaving if the rider is not outside.

Getting into the CTS network

DHHS tells transportation companies that want Medicaid riders to contact the health plans and their brokers. For CTS, that means a short request form and then credentialing. This order avoids rework.

1. License what you run. For-hire wheelchair vans need the state license described below. Under He-W 572.03, an ambulance service must be licensed in the state where it operates and enrolled as a New Hampshire Medicaid provider. CTS also asks for a state certificate of good standing, or proof that you are registered to do business in the state.
2. Bind the insurance. Three policies are required: workers’ compensation, commercial auto liability, and commercial general liability. An umbrella policy is added when a contract calls for one. Minimum limits vary by state and contract, so get the numbers in writing before you sign. What moves premiums up or down is covered in NEMT insurance cost.
3. Submit the request form. It sits on the Transportation Providers page at ctstransit.com. Have ready your company and legal names, contact details, years in business, driver headcount, your count of taxis, stretcher vehicles, wheelchair vehicles, and ambulances, the GPS or vehicle location system you use, and the brokers you contract with now.
4. Clear credentialing. CTS network companies keep written policies showing good standing. They verify and attest that no employee appears on an OIG, SAM, or state debarment list, and they check driving records and criminal backgrounds routinely. A typical broker packet is laid out in NEMT broker credentialing.
5. Train the drivers. Drivers need sensitivity, customer service, passenger assistance, and defensive driving courses, plus first aid and CPR wherever a contract mandates them. CTS keeps its provider training materials behind a password it gives network companies. NEMT driver training covers course options.

Each vehicle needs current licensing, inspection, and insurance under federal, state, and local rules, along with working safety equipment, the inside and outside signage your contract names, and a two-way link between the driver and dispatch. Maintenance schedules follow transportation and motor vehicle department rules, CTS standards, and the contract. Every CTS trip also leaves four records behind: the pre-trip inspection report, the driver log, the driver manifest, and the reimbursement request.

Licensing a wheelchair van for hire

The state EMS office licenses for-hire wheelchair vans under Saf-C 5917, in effect since May 24, 2019. Its formal name is the Division of Fire Standards and Training and Emergency Medical Services, part of the Department of Safety.

A licensed van may carry a passenger’s own prescribed oxygen, provided the passenger can adjust it without help.

What He-W 574 puts on every ride

He-W 574 (Document #14393, effective October 1, 2025) is the DHHS rule for Medicaid NEMT. It loads the recordkeeping onto the broker, so CTS will collect it from your company.

The broker needs an active Medicaid provider number. It must look up each driver in the OIG exclusion database when hired and monthly after that. It must also confirm that vehicles carry registrations under RSA 261:40 and meet the lift, ramp, and securement standards of 49 CFR 38.23. Every transportation company driver has to participate through the broker, which holds the following for six years:

• Company papers: a credentialing packet you have signed and dated, the IRS notice that issued your federal tax ID number, a W-9 from enrollment, and your nonprofit determination letter if you are tax-exempt.
• Driver papers: a valid license, background checks, training records, and the hire-date and monthly exclusion screenings.
• Coverage and equipment: proof of auto liability insurance, refreshed whenever the policy renews or changes, and proof that the vehicle is safe to carry passengers.
• Trip and money records: dispatch travel logs that name the driver, company, rider, and service date and carry everyone’s signatures, the complaint file with how each complaint was investigated and closed, and billing and payment records.

Two coverage rules decide whether you get paid. If a driver falls short of these participation rules, Medicaid treats the trip as non-covered. Also excluded is a Medicaid-enrolled provider driving its own patient to its own site, unless that provider has joined the broker as a driver. Wheelchair van companies hold on to registration and insurance proof covering each date they carried a Medicaid rider, produce it when the broker asks, and comply with 49 CFR Parts 37 and 38. A driver file checklist keeps each packet whole.

The universal mobility form

A wheelchair van ride is covered when three conditions line up: on the day of service the rider cannot walk without a wheelchair, cannot travel in a private car without special equipment, and has a mobility form that a health care professional completed and sent to the broker ahead of the ride. The form’s full title is the Mobility Determination for Non-Emergency Medical Transportation Universal Form for All Medicaid Plans.

All four New Hampshire Medicaid programs share it. It records the mode: nonemergency ambulance, stretcher van (with an option for carrying the rider down steps), wheelchair vehicle, or car. It marks whether the rider needs hand-to-hand help, door-to-door help, or only curb-to-curb service. It also sizes the equipment, with standard chairs at 16 to 18 inches, bariatric chairs at 20 to 30 inches, standard stretchers at 24 inches, and bariatric stretchers at 37 inches, and it asks about oxygen, transfers, and wheelchair weight. A form marked permanent stays valid unless the rider’s needs change, while a temporary one gets updated every year. For AmeriHealth Caritas and fee-for-service members, send it to CTS at fax 203-375-0511 or Nteamleads@ctstransit.com.

A Division of Medicaid Services notice to hospitals dated August 11, 2026 restated the rule. Before booking any ride that needs extra mobility help or a specialized vehicle, such as an ambulance, stretcher, or wheelchair van, the hospital completes the form and either files it with the broker beforehand or hands it over when the vehicle arrives. When dispatch has no form on file for a wheelchair or stretcher trip, have the driver ask the facility for it at pickup.

How CTS pays, and the state’s payment rules

CTS bills on a fixed calendar:

• Claims are entered in the CTS Provider Web Portal.
• Days 1 to 15 form one batch, and day 16 through month end forms the next.
• Each batch has to be in by the fifth business day after its period ends.
• CTS pays a clean claim within 30 days of submission.

He-W 574 defines the parts of a Medicaid wheelchair van payment. Your CTS agreement sets your actual rates for each program, so check how it maps to these parts.

• Base rate: earned once for a single one-way ride or for each leg of a round trip, and twice when the same rider takes two separate one-way trips that day.
• Mileage: loaded miles only, counted along the most direct path whatever road the driver took, and paid a single time per trip even with several riders aboard.
• Wait time: paid only on round trips, capped at two hours, and rounded to the closest half hour. One-way trips earn no wait time.
• One claim per trip: several riders on the same trip still add up to one claim.
• Tolls and parking: reimbursed when the receipt goes in with the travel log.

Example: a van drives 6 empty miles to pick up a wheelchair rider, carries them 18 miles to a dialysis center, waits through treatment, and brings them home. Under the He-W 574 structure the trip earns two base rates, 36 loaded miles, and at most 2 hours of wait time. The 6 deadhead miles are unpaid.

Round-trip mileage caps apply as well. Going past one means the broker must get DHHS approval in advance (prior authorization), with the rider’s condition and why the care cannot be found closer.

CTS and state contacts

Keeping CTS paperwork ready in HealthRide

He-W 574 asks for a travel log signed by everyone on the trip, and New Hampshire pays wheelchair vans on loaded miles only. HealthRide’s driver app takes each signature on screen. Every trip keeps its GPS-recorded miles along with when pickup and drop-off happened. The full trip log downloads in CSV or PDF format. License and insurance dates trigger reminders before they lapse, and an expired credential triggers a warning the moment dispatch tries to put that driver or van on a trip. More on the driver app.