Non-Emergency Medical Transportation

Non-Emergency Medical Transportation (NEMT): Medicaid provides transportation to appointments for covered services to members who don't have access to their own transportation.

Manual

Non-Emergency Medical Transportation (NEMT) Manual   (Last updated on 01/01/2019)

Contacts

As of 7/1/17 all calls should be directed to Vermont Public Transportation Association (VPTA): Toll free 1-833-387-7200.

Tools

Transportation Needs Assessment Tool (09/28/2020) This is a tool that should be utilized by providers to help determine what forms, listed below, are necessary for providing a member with transportation. This tool should not be used in lieu of the actual forms. One of the below forms should be submitted if determined necessary by this tool.

Forms

  • Child Accompaniment Exception Application (05/01/2015) Form to be used if member is requesting that a child under the age of 6 accompany the member to a scheduled appointment. 

  • Hardship Mileage Waiver Form (01/01/2020) Form to be handed out by sub-contractor and filled out by member if requesting hardship mileage reimbursement under the Hardship Mileage Program guidelines. Member needs to go through sub-contractor to be eligible for this program.

  • NEMT Rule and Guidelines Document (01/01/2019) Form to be handed out by sub-contractor and filled out by member prior to the initial utilization of the DVHA NEMT program. 
  • Out-of-Area/Out-of-State Transportation Physician Referral Form (01/01/2019) Referral form necessary for transportation request over 60 miles from members residence to a participating provider.
  • Personal Choice Driver Waiver Form (01/01/2019) Form to be used in specific situations where an individual has been allowed to select their own driver.
  • Public Transportation Medical Exemption Form (01/01/2019) Form to be filled out by provider’s office if medical conditions warrant the use of any specific mode of transport, or if medical conditions limit which modes may be utilized by the transportation provider.   
  • Transportation Employment Exception Verification Form (01/01/2019) Form to be filled out by the employer of the member of the household who is unable to transport the member to scheduled appointments.
  • Vehicle Exception Form (01/01/2019) Form to be filled out by member if vehicle(s) in household are not available for the transport of members to scheduled appointments.

Department of Vermont Health Access

280 State Drive
Waterbury, Vermont 05671-1010
Phone: 802-879-5900
Fax: 802-241-0260

Department Contact List for customer service, program telephone and fax numbers, and staff email

Hours of Operation: Monday-Friday (Excluding Holidays) 7:45am - 4:30pm

Public Record Requests
Kelly Provost
DVHA Public Records Officer
AHS.DVHALegal@Vermont.gov
Visit the Agency of Administration site for the Public Records Database

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