In April 2021, Jefferson Health Plans notified the provider network of the temporary suspension of medical necessity reviews for non-emergent land transportation for our Medicaid members only, which removed the need to obtain an authorization for these services.  We are writing today to advise this suspension has been permanently put into place and will remain unless notified otherwise.

Air and water transport will still require a medical necessity review for Medicaid and an approved authorization is required for payment. Authorization is still required for Health Partners Medicare members for land, air and water non-emergent transport.

Please note the codes impacted are:

1. A0130 - Nonemergency transportation: wheelchair van
2. A0426 - ALS 1
3. A4028 - BLS
4. A0434 - SCT
5. A0420 - Ambulance waiting time (ALS or BLS), one-half (1/2) hour increments
6. A0424 - Extra ambulance attendant, ground (ALS or BLS) or air (fixed or rotary winged); (requires medical review)
7. A0425 - Ground mileage, per statute mile
8. A0100 - Nonemergency transportation: taxi

If you have any questions, please contact our Provider Services Helpline at 1-888-991-9023 (Monday – Friday, 9 a.m. – 5:30 p.m.).