The Title XIX Non-Emergency Medical Transportation (NEMT) Program provides assistance for non-emergency medical transportation needs for eligible recipients.
The NEMT Program provides assistance for non-emergency medical transportation needs for eligible recipients. A recipient may be reimbursed for mileage, meals and lodging at the current rate of payment.
Transportation must be to the closest medical facility or medical provider capable of providing the necessary services, unless the recipient has received a Prior Authorization from Medical Services. Click here to be transferred to Medical Services for more information on how to get a Prior Authorization.
In order for the recipient to receive transportation reimbursement, a NEMT Out-of-State Travel Approval Request form must be completed by the medical provider in South Dakota that referred the recipient out of state when:
The completed form and any required medical documentation are to be submitted by fax 605.773.8461 or email DSS.EBTSTATEOFFICE@state.sd.us for approval.
NOTE: THIS INFORMATION IS FOR NEMT SERVICES FOR THE MEDICAL RECEIPIENT ONLY AND DOES NOT REPLACE PRIOR AUTHORIZATIONS NEEDED FOR MEDICAL SERVICES.
No more worrying about lost or stolen checks. NEMT travel reimbursements can be made to you by either Direct Deposit into your bank account or by electing to receive a VISA branded debit card (US Bank Reliacard)..
Direct Deposit features:
* Successful identity verification required. To help the government fight the funding of terrorism and money laundering activities, Federal Law requires all financial institutions to obtain, verify and record information that identifies each person who opens an account. If necessary, we may also ask to see your driver’s license or other identifying documents.
** Visa’s Zero Liability Policy protects you against unauthorized transactions processed by Visa. You must notify U.S. Bank immediately of any unauthorized use. Other conditions may apply. See your Cardholder Agreement for details The ReliaCard® is issued by U.S. Bank National Association pursuant to a license from Visa U.S.A. Inc. © 2015 U.S. Bank. Member FDIC
How do I sign up for electronic payments?
Division of Social Services
Office of the Secretary
700 Governors Drive
Pierre, SD 57501
When will I receive my reimbursement?
Reimbursements will be received either in your bank account or in the card account within 2 to 3 business days after the program applies the payment. Direct Deposits show up as SD DSS on your bank statement.
Q. What can I be reimbursed for?
A. The Title XIX Non-Emergency Medical Transportation program may reimburse you for mileage, lodging and meals at the current rate of payment.
A recipient may not receive reimbursement for lodging and meals for days the recipient is an inpatient in a hospital or medical facility.
Q. How do I know if I qualify for non-emergency medical transportation reimbursement?
A. In order for you to be reimbursed for your transportation you must be on a medical assistance program that provides Title XIX (Medicaid) transportation coverage.
Transportation must be to the closest medical facility or medical provider capable of providing the necessary services. The service must be a Medicaid covered service that is provided by a medical provider who is enrolled in the medical assistance program.
Q. If I have a medical appointment within the city I live, can I get reimbursed?
A. No. Mileage is limited to the actual miles between two cities and does not include miles driven within the city.
Q. Can I get reimbursed to travel to my Primary Care Provider (PCP) or Health Home Provider (HHP)?
A. Transportation to the closest PCP or HHP is reimbursable. If travel is not to the closest PCP or HHP, transportation will only be reimbursed if a "good cause" exception has been approved by Medical Services. Lodging and meals are not reimbursable when travel is to a PCP or HHP.
Q. Do I need a referral, if my Primary Care Provider (PCP) or Health Home Provider (HHP) refers me to a medical specialty provider?
A. Yes. Trips to medical specialty providers other than your PCP or HHP require a referral.
Q. What do I need to do to get travel reimbursement to and from my medical appointment?
A. The Title XIX Medical Transportation Reimbursement Form must be completed and signed by the recipient, parent or guardian. The Medical Provider section of the form must be completed and signed by the receptionist, nurse or medical provider.
A NEMT Payment Authorization Form must also be completed to have your payments either direct deposited into your checking or savings account or onto a U.S. Bank Reliacard®.
The form, along with any necessary documentation, may be turned in at your local Department of Social Services’ office, mailed directly to: Department of Social Services, Office of Finance/EBT, 700 Governors Drive, Pierre, SD, 57501, emailed to firstname.lastname@example.org, or faxed to 605.773.8461.
Q. If I have already completed the NEMT Payment Authorization form, do I need to complete the form again?
A. Yes, but only when you are notifying NEMT of a change to how you want to receive your reimbursement, or a name change, and /or address change.
A. Yes. A motel receipt is required for lodging reimbursement. Lodging is reimbursable when the provider is at least 150 miles from the recipient's city of residence and travel is to obtain specialty care or treatment that result in an overnight stay.
Q. When will I receive my reimbursement?
A. You will receive your reimbursement when all required forms and verifications have been received in our office and processed. Claims are processed in the order they are received in our office. Please allow 6-8 weeks from the date your claim was received in our office to be processed. You will receive a Paid Claims Statement showing specific travel dates and amounts in the mail once your claim has been paid.
A. You can obtain the Title XIX Medical Transportation Reimbursement Form at your local Department of Social Services Office, on the DSS online Forms and Publications page or by calling 1.866.403.1433.
Q. After my appointment I realized that I forgot to have the medical provider sign the reimbursement form verifying my appointment, what can I do?
A. Mail or fax the reimbursement form to the medical provider to complete the Medical Provider section. The medical provider can fax the completed form to our office.
Q. Will I be reimbursed for meals for a same day medical trip?
A. No. Meals will be reimbursed only if an overnight stay is medically necessary and the overnight meets the lodging requirement criteria.
Q. Can I get reimbursed to travel to medical appointments out-of-state?
A. Medicaid covered services received more than 50 miles outside of the state of South Dakota, except Bismarck, ND, will require prior authorization by South Dakota Medicaid. This applies to all Medicaid recipients, including those not on managed care.
If your doctor recommends you see a doctor out-of-state, please ask your doctor if prior authorization is needed before you make the appointment. If approval is not given, you will be responsible for the medical bill and transportation costs.
Prior authorization by South Dakota Medicaid must be approved before transportation expenses can be approved or paid.
NOTE: If you are on managed care and traveling to Bismarck, ND, a referral from your PCP is still required. If you are not on managed care, travel will only be reimbursed if Bismarck, ND, is the closest provider capable of providing the services.
Department of Social Services
700 Governors Drive
Pierre, SD 57501