NEMT Mileage Reimbursement

Get Reimbursed for Driving to Your Medical Appointments

If you drive yourself or someone else to a covered medical appointment, you may qualify to be reimbursed for your mileage, at 67¢ per mile. The mileage reimbursement is covered by the Non-Emergency Medical Transportation (NEMT) benefit.

NEMT is a service for eligible MO HealthNet participants that provides transportation or help with gas costs to covered MO HealthNet services. To learn more, visit the NEMT webpage for participants.

How do I qualify for reimbursement?

To qualify for mileage reimbursement, the ride must meet all the following:

The participant is eligible for NEMT services.
The trip is to a covered medical service
The trip distance is appropriate based on Missouri NEMT policy.

What are the covered medical services?

Some examples include:

Visits with your Primary Care Provider or specialist (including pregnancy check-ups)
Behavioral health follow-ups after a hospital stay
Dental appointments
Counseling
Eye exams

To learn more, call Constituent Services at 800-392-2161.

How do I know if the trip distance is appropriate?

The participant must request NEMT services to a MO HealthNet qualified, enrolled medical service provider located within the travel standards, willing to accept the participant. The travel standards are based on the participant’s county of residence. Counties are classified as urban, basic, and rural. The counties are categorized as follows:

Urban - Clay, Greene, Jackson, Jefferson, St. Charles, St. Louis and St. Louis City
Basic - Boone, Buchanan, Cape Girardeau, Cass, Christian, Cole, Franklin, Jasper, Johnson, Lincoln, Newton, Platte, Pulaski, St. Francois and Taney
Rural - All other counties

The mileage that a participant can travel is based on the county classification and the type of provider being seen. The following table contains the mileage allowed under the travel standards for different types of providers.

Travel Standards: Maximum Mileage

Physicians

Provider/Service Type	Urban Access County	Basic Access County	Rural Access County
Primary Care Physicians (PCP)	10	20	30
Obstetrics/Gynecology	15	30	60
Neurology	25	50	100
Dermatology	25	50	100
Physical Medicine/Rehab	25	50	100
Podiatry	25	50	100
Vision Care/Primary Eye Care	15	30	60
Allergy	25	50	100
Cardiology	25	50	100
Endocrinology	25	50	100
Gastroenterology	25	50	100
Hematology/Oncology	25	50	100
Infectious Disease	25	50	100
Nephrology	25	50	100
Ophthalmology	25	50	100
Orthopedics	25	50	100
Otolaryngology	25	50	100
Pediatric	25	50	100
Pulmonary Disease	25	50	100
Rheumatology	25	50	100
Urology	25	50	100
General surgery	15	30	60
Psychiatrist-Adult/General	15	40	80
Psychiatrist-Child/Adolescent	22	45	90
Psychologists/Other Therapists	10	20	40
Chiropractor	15	30	60

Hospitals

Provider/Service Type	Urban Access County	Basic Access County	Rural Access County
Basic Hospital	30	30	30
Secondary Hospital	50	50	50

Tertiary Services

Provider/Service Type	Urban Access County	Basic Access County	Rural Access County
Level I or Level II trauma unit	100	100	100
Neonatal intensive care unit	100	100	100
Perinatology services	100	100	100
Comprehensive cancer services	100	100	100
Comprehensive cardiac services	100	100	100
Pediatric subspecialty care	100	100	100

Mental Health Facilities

Provider/Service Type	Urban Access County	Basic Access County	Rural Access County
Inpatient mental health treatment facility	25	40	75
Ambulatory mental health treatment providers	15	25	45
Residential mental health treatment providers	20	30	50

Therapy Services

Provider/Service Type	Urban Access County	Basic Access County	Rural Access County
Physical Therapy	30	30	30
Occupational Therapy	30	30	30
Speech Therapy	50	50	50
Audiology	50	50	50

What exceptions are allowed to the trip distance policy?

The transportation broker must transport the participant when the participant has chosen a qualified, enrolled medical service provider who is not within the travel standards if the participant is eligible for one of the exceptions listed below and can provide proof of the exception:

The participant has a previous history of other than routine medical care with the qualified, enrolled medical service provider for a special condition or illness.
The participant has been referred by a PCP to a qualified, enrolled medical service provider for a special condition or illness.
There is not a routine or specialty care appointment available within 30 calendar days to a qualified, enrolled medical service provider within the travel standards.

The broker shall transport the participant to the following MO HealthNet covered services without regard to the travel standards:

The participant is scheduled for an appointment arranged by the Family Support Division (FSD) for a Medical Review Determination (MRD) to determine continued MO HealthNet eligibility.
The participant has been locked into a medical service provider by the state agency. The broker shall receive prior authorization from the MO HealthNet for lock-in trips that exceed the travel standards.
The broker must transport the participant when the participant has chosen to receive MO HealthNet covered services free of charge from the Veterans Administration or Shriners Hospitals. Transportation to these facilities must be to the closest, most appropriate Veterans Administration or Shriners Hospital. The broker must document and maintain verification of service for each transport provided to free care. The broker must verify each request of such transport meets all NEMT criteria including, but not limited to participant eligibility and MO HealthNet covered service.

How to get reimbursed?

There are Two Ways to Submit Your Mileage:

Use the MTM Link Member app (Recommended)
1. Faster reimbursement — no need for paperwork.
2. Automatically tracks and submits your trips
3. Get step-by-step instructions below or in the MTM User Guide
Use the Paper Trip Log
1. Download the NEMT Mileage Reimbursement Trip Log
2. Follow instructions printed on the log
3. Submit completed logs to MTM as directed

Where can I learn more about the mobile app?

You can view the entire user guide online: MTM Link Member Mobile App User Guide.

How do I use the app to get reimbursed?

Claiming Gas Mileage Reimbursement (GMR) Trips

If your health plan allows GMR, you can submit your claims from the mobile app. This means you do not need to use a paper trip log. You will receive payment quicker. Your claim must be submitted on the day of your valid GMR ride. You can only submit a full claim. You cannot submit a partial claim.

When you begin your trip from your starting address, click the green button with the words ‘I’m Leaving.’ You must click this button to begin your trip.

When you arrive at your doctor, click the green button with the words ‘I’m Here’. This will collect your location information. You must end the trip using the same mobile device you used to start the trip. If you use a different device, you will receive an error message that says we cannot process your request.

MTM Link will make sure your location matches your doctor’s address. You will see a message that says ‘Location Verified.’ If your location does not match, you will see a message that says we could not verify your location.

Click the ‘Submit Reimbursement’ button after the location has been verified for all legs of your ride.

You will see a message that your claim was submitted.

To see the status and details of your claim, click on the Details View from your Daily View.

Click the “i” icon next to Reimbursement Status. This will show more details about your claim.

Please note, you must submit your claim the day of your trip. You cannot submit it via the mobile app after that day. You will need to complete a paper trip log.