PURPOSE: This rule establishes the criteria by which the medical assistance program (Medicaid) reimburses expenses for nonemergency medically necessary transportation if a recipient does not have access to transportation services that are available free of charge. (1) The Missouri Medical Assistance program (Medicaid) or its contractor reimburses eligible recipients or nonemergency medical transportation (NEMT) providers for medically necessary transportation only if a recipient does not have access to transportation services that are available free of charge.

1. (A) The recipient must have an appointment for any medical treatment that is approved by the Division of Medical Services.
2. (B) Alternative transportation services that may be provided free of charge include volunteers, relatives, designated legal representative, individual involved in the resident’s care, or transportation services provided by nursing facilities or other residential centers. Recipients must certify in writing that they do not have access to free transportation.
3. (2) Nonemergency medical transportation is not available to a pharmacy.
4. (3) Medicaid reimburses the most appropriate and least costly transportation alternative suitable for the recipient’s medical condition. If a recipient can use private vehicles or less costly public transportation, those alternatives must be used before recipients can use more expensive transportation alternatives. AUTHORITY: section 208.201, RSMo 2000.* Original rule filed May 16, 2005, effective Oct. 30, 2005. *Original authority: 208.201, RSMo 1987.