How to Charge for NEMT Services

If you plan to start a NEMT service, the first thing you need to decide is how much you want to charge for your services. This is important because most of your business will come from brokers, so they’ll set the price. However, if a broker has special requests that are outside of your normal service area, you can negotiate with them and increase your prices to cover these costs.

You may also want to adjust your pricing depending on when you’re delivering your services. For instance, you can charge more during the weekend than on holidays. This is because holiday trips are likely to be slow and weekends can be less profitable. But it’s important to consider that the demand for NEMT services is seasonal and may vary greatly.

In addition to providing transportation services, NEMT providers can provide specialized equipment to patients with medical needs. Typically, this service is used for transportation to medical appointments or for patients to go to dialysis. However, the level of care offered and the coverage vary widely. Because of these factors, it’s important to thoroughly research the services before providing them.

NEMT services can include meal and lodging costs if needed. However, it’s important to contact the NEMT brokerage to review and approve all costs. Remember that NEMT benefits do not cover the cost of an inpatient attendant. These attendants must be accompanied by their parents or caregivers.

NEMT providers are required to keep records. To be eligible for NEMT benefits, the provider must be enrolled with the Minnesota Health Care Programs (MHCP). They must be affiliated with a transportation provider organization or an ambulance service. Once a provider is certified by the MHCP, they will be listed as a provider on claims.

In addition to NEMT certification, providers should also have certification through a state-administered program. Often, the NEMT program will require providers to verify a member’s eligibility through a LOS assessment process. This process takes about 60 days and is conducted by a medical review agent.

If you provide NEMT services for members of an OHP plan, you need to follow the guidelines set out by the state or a private company. For example, if a member has a medical condition that requires non-emergency transportation, the provider must be certified through a state or federal agency. Once this process has been completed, you can bill NEMT services with the same code as the stretcher.

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