Dear Case Manager,
Due to many issues with the A0100 taxi Non-Medical Transportation (NMT) procedure code, changes have been made to the rate for this service. The Department is required to pay taxis, the Public Utilities Commission (PUC) approved tariff, and each taxi company has their own set rate. The Department does not have a set rate for this procedure code.
Typically for this procedure code, a Case Manager (CM) puts an estimated unit rate on the PAR, based on the local taxi tariff. A member’s average trip may be $30, with that amount being entered on the PAR for each unit. This has caused issues if a trip unexpectedly costs more than the average cost entered on the PAR.
Already-created PARs with this procedure code have been adjusted by DXC with a max rate of $125.
Do not adjust this rate.
For new PARs, CMs should enter $125 as the unit rate on all new A0100 lines. This will allow the provider to bill up to that amount for the cost of the trip. A provider does not have authority to bill each unit at the max of $125; they may only bill for displayed metered charge. For example, if the metered charge for one trip is $25.52, and the metered charge for the return trip is $28.80, the provider should charge one unit at $25.52 and another unit at $28.80. This process will be clearly communicated to the provider community on how they may bill for this service.
Thank you,
Health First Colorado (Colorado's Medicaid Program)
