SECTION 380.202. Program Services

Transportation services prior authorized by the Medical Transportation Program (MTP) or transportation providers include:

(1) Demand response transportation services provided when fixed route services are either unavailable or do not meet the health care needs of clients. Services must be timely and provided by qualified, courteous, knowledgeable, and trained personnel;

(2) Mass transit tickets when determined to be the appropriate mode of transportation for the client, ensuring the client does not live more than a quarter (1/4) mile from a public fixed route stop, the appointment is not more than a quarter (1/4) mile from a public fixed route stop, and that mass transit tickets are received by the client before the client's appointment;

(3) Individual transportation participant services provided by volunteers who enter into an agreement and are reimbursed for mileage if they are prior authorized to drive a client to a covered health care service in a personal car;

(4) Meal and lodging services for clients and an attendant when a covered health care service requires an overnight stay outside the client's county of residence or beyond adjacent counties. Clients and attendants must receive the same quality of services provided to other guests and the lodging services must be equivalent or better than those listed in the Office of the Texas Comptroller's State Travel Management Program;

(5) Transportation to and from renal dialysis services for clients enrolled in the Medicaid program who are residing in a nursing facility, as required by the Human Resources Code;

(6) Advance funds disbursed before the covered health care service to clients when a lack of transportation funds will prevent a child from traveling to the service. Advance funds are for clients through age 20 and Children with Special Health Care Needs services program clients 21 and over who have been diagnosed with cystic fibrosis. Advanced funds may be issued to cover meals, lodging, and/or mileage;

(7) Out-of-state transport to contiguous counties or bordering counties in adjoining states (Louisiana, Arkansas, Oklahoma, and New Mexico) that are within 50 miles of the Texas border, if services are medically necessary and it is the customary or general practice of clients in a particular locality within Texas to obtain services from an out-of-state provider that is enrolled as a Texas Medicaid provider; and

(8) Commercial airline transportation services for a client and attendant to a covered health care service, when it is the most cost effective option or when necessary to meet the client's medical needs.

Source Note: The provisions of this §380.202 adopted to be effective September 1, 2014, 39 TexReg 5731