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Provider Manual

Transportation Services

Last Updated on May 22, 2021

Emergency transportation

Security Health Plan covers ambulance transportation if medically necessary. Ambulance transportation to another facility for member, family or facility preference or convenience is not covered.

To be considered for reimbursement, ambulance claims must be submitted on a CMS 1500 claim form and contain both a diagnosis and appropriate modifiers. Trip modifiers (U1-U6) and origin and destination modifiers are both required on claims.

For detailed information see the Ambulance handbook at https://www.forwardhealth.wi.gov/WIPortal/

  • Click on Online Handbooks
  • Choose the  I Accept radio button and click Submit Agreement
  • Under Choose a user type, select Provider
  • Under Choose a program, select BadgerCare Plus and Medicaid
  • Under Choose a service area, select Ambulance
  • Click on the Covered and Noncovered Services section
  • Choose the  Codes section

Non-emergency transportation

Non-emergency transportation services are not covered by Security Health Plan. The Wisconsin DHS has contracted with MTM, Inc., to provide NEMT management services for Medicaid and BadgerCare Plus members. NEMT includes transportation provided by ambulance, SMV or common carrier to a covered service.

As DHS's transportation manager, MTM, Inc., arranges and pays for rides to covered Medicaid and BadgerCare Plus services for members who have no other way to receive a ride. Rides can include public transportation such as a city bus, rides in SMVs, or rides in other types of vehicles depending on a member's medical and transportation needs.

For more information on MTM, Inc., refer to the MTM, Inc. website.

For detailed information, see the Non-emergency Medical Transportation Handbook at https://www.forwardhealth.wi.gov/WIPortal/

  • Click on Online Handbooks
  • Click the  I Accept radio button and  select Submit Agreement
  • Under Choose a user type, select Provider
  • Under Choose a program, select BadgerCare Plus and Medicaid
  • Under Choose a service area, select Non-emergency Medical Transportation
  • Select appropriate topic to review