Lynne A. Valenti
Cabinet Secretary

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Recipient Information

Title XIX Non-Emergency Medical Transportation

The Title XIX Non-Emergency Medical Transportation (NEMT) Program provides assistance for non-emergency medical transportation needs for eligible recipients.

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Mileage, Meals and Lodging:

  • A recipient may be reimbursed for mileage, meals and lodging at the current rate of payment.
  • Transportation is from an eligible recipient’s city of residence to a medical provider located in another city, between medical providers located in difference cities, or from a medical provider located in one city to the recipient’s city of residence.  Mileage is limited to the actual miles between the two cities and does not include miles driven within the city.
    • Transportation to the closest Primary Care Provider (PCP) or Health Home Provider (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.
  • Lodging and meals are 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. Meals and lodging are limited to the recipient and, if medically necessary, one escort or volunteer driver.
  • Meals will be reimbursed only if an overnight stay is medically necessary and the overnight meets the lodging requirement criteria.
  • A recipient may not receive reimbursement for lodging and meals for days the recipient is an inpatient in a hospital or medical facility.
  • The Department of Social Services reserves the right to deny coverage for any requests made outside the general coverage guidelines to these rules.

Program Requirements:

  • A recipient must be on a medical assistance program that provides Title XIX (Medicaid) coverage.
  • Transportation must be to the closest medical facility or medical provider capable of providing the necessary services, unless the recipient has a written referral or a written authorization from the recipient’s medical provider.
  • The service must be a Medicaid covered service provided by a medical provider who is enrolled in the medical assistance program.
  • Trips prior to your eligibility date cannot be reimbursed.
  • Trips to medical specialty providers other than your Primary Care Provider (PCP) or Health Home Provider (HHP) require a referral card.
  • A Title XIX Medical Transportation Reimbursement Form must be completed and submitted for each medical trip.  This 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, faxed to 605.773.8461 or emailed to DSS.EBTSTATEOFFICE@state.sd.us.
  • The TXIX 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 recipient will received reimbursement when all requested forms and verifications have been received in our office and processed.
  • The NEMT program must receive a completed claim form within six months following the month the service was provided.

Out of State Travel Requirements

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 Medicaid recipient is traveling out-of-state and also has Medicare; or
  • The Medicaid recipient has been referred to an out-of-state provider that is not currently enrolled or does not expect reimbursement for the medical services provided.

NEMT Out-of-State Travel Approval Request form

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.

NEMT Electronic Payments

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:

  • Cash benefits or payments can be deposited into your current checking or savings account.
  • You can avoid trips to the bank to deposit paper checks.
  • You can be sure your payments will arrive on time, every time.
  • You can withdraw cash benefits or payments by writing checks against your checking account, withdrawing money from your savings account, or withdrawing cash at your ATM

RELIACARD features:

  • Easy to get – there is no cost to enroll, no credit checks* and no bank accounts required
  • Widely accepted – make purchases anywhere debit cards are accepted (in stores, restaurants, online, over the phone, etc.
  • Save time and money – no expensive check cashing fees or trips to the bank
  • Safe – you don’t need to carry cash with you. If you lose your card, it can be replaced. Your funds are protected by Visa Zero Liability** and are FDIC insured
  • 24/7 access – call Cardholder Services

About the ReliaCard®

  • It is a reloadable Visa® prepaid debit card issued by U.S. Bank that provides an electronic option for receiving your NEMT warrants. It is not a credit card, but works similarly to other debit cards. Once funds are added to the card account, it may be used to make purchases everywhere debit cards are accepted. The card can be used for online, phone and mail order purchases. You can also withdraw cash at ATMs, banks or credit unions or by getting cash back with purchases at participating merchants. The amounts of purchases or cash withdrawals are automatically deducted from the available balance on the card.
  • RELIACARD FAQs

SD-NEMT

 

 

 

 

* 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?

  • Complete the NEMT Payment Authorization Form and select either Direct Deposit or EPC
  • Provide all of the necessary information as requested on the form
  • When choosing direct deposit provide a copy of a voided check blank or obtain a letter from the bank to verify the routing and account number
  • When selecting the electronic payment card, it will be received in the mail within 7-10 business days
  • Return the Form and any necessary documentation to:

Division of Social Services
Office of the Secretary
EBT/NEMT
700 Governors Drive
Pierre, SD 57501
FAX:  605.773.8461
Email:  dss.ebtstateoffice@state.sd.us

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. 

NEMT Frequently Asked Questions:

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 dss.ebtstateoffice@state.sd.us, 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.  

Q. If I had to stay overnight due to my medical appointment, do you need a copy of my motel receipt?

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.

Q. How or where can I get the Title XIX Medical Transportation Reimbursement Form?

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.

NEMT Forms:

Contact us:

Mail:   
Department of Social Services
Finance/EBT
700 Governors Drive
Pierre, SD  57501

Phone:
Local: 605.773.6527
Toll-free: 1.866.403.1433
Fax: 605.773.8461

Email:  DSS.EBTSTATEOFFICE@state.sd.us