Transportation services are not covered for Category 07 TA clients if provided by a hospital.
HFS pays for transportation for a client, and if necessary an attendant, to go to a provider to get care that is covered under the medical program. HFS pays for transportation to get to and from medical care even if the medical care is free, such as
care at a VA hospital. HFS will not pay if transportation is available at no cost. The client has to use the cheapest type of transportation that meets their needs.
An employee attendant is a person, other than the driver, who is an employee of a Medicar company. An employee attendant is a covered service when the mode of transportation is a Medicar and the circumstances constitute a medical necessity.
A non-employee attendant is a family member or other person who may accompany the client when there is a medical need for an attendant. A non-employee attendant is a covered service when the mode of transportation is a Medicar, service car, bus, or
taxicab and the circumstances constitute a medical necessity.
HFS will pay for an employee attendant, non-employee attendant, or both to accompany an eligible client to and from the source of a covered medical service, in the following circumstances:
- to go with the client to a medical provider when needed, such as a parent going with a young child to the doctor, or an attendant needed to assist the client;
- to participate in the client's treatment when medically necessary; or
- to learn to care for the client after getting out of the hospital.
HFS does not pay for transportation of family members or an attendant to visit a hospitalized client for other purposes.
DPA's authorized prior approval agent may require documentation of medical necessity.
NOTE: The Crisis Assistance Program (see PM 06-03-01) may pay for lodging and food for family members who have to travel
long distances to be with a client who is in the hospital.
The types of transportation HFS pays for include:
There are 2 types of ambulance transportation: emergency and nonemergency. Emergency ambulance service is to take a client who needs immediate transportation to a hospital emergency room or a physician's office. Nonemergency ambulance service is to
take a client who needs a stretcher, medical supervision, or who may need oxygen or drugs.
Medicars transport clients who need a lift or ramp to get into a vehicle or who need a stretcher, but do not need medical supervision, oxygen, or drugs.
- Service Car, Taxi, or Private Auto
A service car, taxi, or private auto may be used to take a client who can walk, when their medical condition does not require a specialized mode, but they cannot use other transportation, such as a bus or train.
- Other Transportation
Transportation by bus, train, or commercial airplane, etc.