Proposition 56 Non-Emergency Medical Transportation - Supplemental Payment
This program provides supplemental reimbursement for eligible Non-Emergency Medical Transportation (NEMT) services provided to Medi-Cal beneficiaries. The supplemental reimbursement is a fixed amount provided above the base rates, for qualified NEMT services rendered during the applicable time period. The base rates for NEMT services remains unchanged. Base rates for NEMT services are the rates established by the Department of Health Care Services for each procedure code.
The supplemental payment amounts are equivalent to a 10 percent increase of the current rates for Medi-Cal Fee-for-Service (FFS) NEMT services, except for codes A0130 and A0380, which receive the equivalent of a 25 percent increase. Ground Medical Transportation and Air Medical Transportation providers are eligible for the supplemental payments. The table below reflects the codes eligible for the supplemental payment and the respective reimbursement amount.
| 93005 | $1.64 | A0424 | $1.64 | A0435 | $1.43 |
| 93041 | $0.51 | A0425 | $0.36 | A0436 | $2.21 |
| A0130 | $4.41 | A0426 | $10.72 | T2001 | $0.55 |
| A0380 | $0.33 | A0428 | $10.72 | T2005 | $2.63 |
| A0420 | $1.98 | A0430 | $127.50 | T2007 | $1.13 |
| A0120 | $1.77 | A0390 | $0.13 | | |
| A0422 | $1.00 | A0431 | $180.00 | | |
The Centers for Medicare & Medicaid Services (CMS) approved the time-limited supplemental reimbursement program for eligible services provided to Medi-Cal beneficiaries, effective July 1, 2019.
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