471 Neb. Admin. Code, ch. 27, § 003 - COVERED SERVICES

Medicaid covers the most appropriate nonemergency medical transportation (NEMT) services necessary to obtain Nebraska Medicaid reimbursed services when one of the following criteria is met:

(A) Client does not own or does not have access to a working licensed vehicle;
(B) Client does not have a current valid driver's license;
(C) Client is unable to drive due to a documented physical, cognitive, or developmental limitation;
(D) Client is unable to travel or wait by himself or herself due to a documented physical, cognitive, or developmental limitation; or
(E) Client is unable to secure free transportation as defined in this chapter.
003.01 NON-EMERGENCY MEDICAL TRANSPORTATION (NEMT) SERVICES PROVIDED FOR CLIENTS RESIDING IN NURSING FACILITIES OR INTERMEDIATE CARE FACILIITIES FOR PERSONS WITH DEVELOPMENTAL DISABILITIES (ICF/DD'S) WHEN MEDICAID IS THE PRIMARY INSURANCE. Non-emergency medical transportation (NEMT) services for clients residing in nursing facilities or intermediate care facilities for persons with developmental disabilities (ICF/DD) may be covered under this chapter for facility discharge transportation to a private residence within boundaries of the State of Nebraska.
003.02 EARLY AND PERIODIC SCREENING, DIAGNOSIS AND TREATMENT (EPSDT) SERVICES. All transportation services for medically necessary early and periodic screening, diagnosis, and treatment (EPSDT) covered services will be provided without regard to service limitations defined within this chapter, and with prior authorization.
003.03 PROVIDER LOCATION. Non-emergency medical transportation (NEMT) services are available to the nearest Nebraska Medicaid coverable services within a 20-mile radius of the client's residence, able to meet the client's medical needs, and willing to accept the client as a patient, unless otherwise exempted or approved by the Department.

Notes

471 Neb. Admin. Code, ch. 27, § 003
Amended effective 7/12/2021 Amended effective 11/12/2024

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