AHCCCS covers NEMT to or from the closest appropriate AHCCCS registered provider, when a member is not able to find his/her own transportation.
For NEMT services on and after May 1, 2019, the following also apply:
For members living in Maricopa and Pima Counties:
NEMT services to and from a pharmacy are only covered for trips within 15-miles of the pick-up location, except for trips to (1) compounding or specialty pharmacies and (2) pharmacies in an MSIC or IHS/638 facilities.
The 15-miles is calculated from the pick-up location to the drop-off location, for one direction.
Trips to compounding or specialty pharmacies over 15 miles may be covered if your health plan gives prior authorization for the transportation.
Trips to a pharmacy in an MSIC or IHS/638 facility, can go over 15 miles without getting a prior authorization from your health plan.
The 15-mile distance does not apply to members who do not live in Maricopa or Pima County.
If you need a ride to an appointment, ask a friend, family member or neighbor first. If you cannot get a ride DDD can help you. Please work with your Support Coordinator if transportation is needed.
DDD covers medically necessary non-emergency transportation services are covered under the following conditions:
- The medical or behavioral health service for which the transportation is needed is a covered Division service.
- The member is not able to provide, secure, or pay for their own transportation, and free transportation is not available, and
- The transportation is provided to and from the nearest appropriate AHCCCS registered provider.
Medically Necessary Non-Emergency Transportation Furnished by Non-Ambulance providers must adhere to the following:
- The member must not require medical care enroute.
- Passenger occupancy must not exceed the manufacturer’s specified seating occupancy.
- Members, escorts, and other passengers must follow state laws regarding passenger restraints for adults and children.
- Vehicle must be driven by a licensed driver, following applicable State laws.
- Vehicles must be insured.
- Vehicles must be in good working order.
- Members must be transported inside the vehicle.
- School-based providers should follow the school-based policies in effect (AMPM Chapter 700).
Medically necessary non-emergency transportation furnished by ambulance providers is appropriate if:
- Documentation that other methods of transportation are contraindicated, and
- The member’s medical condition, regardless of bed confinement, requires the medical treatment provided by the qualified staff in an ambulance.