MassHealth Transportation Services
NOTE: Glossary words are highlighted. Click on any glossary word to see its definition.
 MassHealth rules about non-emergency transportation services changed July 1, 2010. You will no longer be reimbursed for private transportation if you use your own car or arrange your own ride for a MassHealth appointment except in special cases. MassHealth will still arrange curb-to-curb transportation for members who qualify, and will reimburse members for public transportation costs. |
What are MassHealth transportation services?
MassHealth members who need non-emergency transportation to and from medical appointments may be eligible for free transportation services. Eligible members who use public transportation can get reimbursement for their transportation expenses. Eligible members who need dial-a-ride services can get van or taxi service free of charge.
Am I eligible?
You can get free non-emergency transportation services from MassHealth if your MassHealth coverage type includes transportation services (MassHealth Standard or CommonHealth), and the medical appointment you are going to is covered by MassHealth.
You cannot get MassHealth transportation services to pick up prescription medicine at a pharmacy.
Note: All MassHealth members are covered for emergency ambulance services.
What benefits will I get?
Travel costs reimbursement:
If you use public transportation, you can get reimbursement for transportation costs. You will get paid for the least expensive means of travel from your home to your medical appointment and back, even if your actual costs are higher. You will get paid only if your travel costs are $5 or more. Note: For urgent care, you do not have to use the least expensive means of travel.
Dial-a-ride services:
If you need dial-a-ride van/taxi service, you will get curb-to-curb transportation services from your home to your MassHealth appointment and back. The service will be provided by your local Regional Transit Authority (RTA). You will get free transportation for the number of trips approved by MassHealth. You will be given a toll-free RTA phone number to call to schedule your trips.
How do I get reimbursement for travel costs?
To get reimbursed for your travel costs:
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You must get a letter from the health provider who treated you, stating your name, address, and Social Security number; and the date, time, and type of treatment. If you see the same doctor for several visits, you only need one letter listing all the dates.
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You must send the letter and a record of your transportations expenses to:
MassHealth Transportation Authorization Unit
P.O. Box 45
Boston, MA 02112-0045
Fax: 617-988-2925
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Your transportation costs must be $5 or more to be reimbursed. Include any transportation receipts that you have. Keep a copy of the letter and your receipts for your records.
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You must submit your reimbursement request within 90 days of the date your transportation expenses reached $5.00.
If you have questions, call MassHealth Customer Service at 1-800-841-2900 (TTY: 1-800-497-4648).
How do I apply for dial-a-ride service?
Your health care provider must fill out a Prescription for Transportation (PT-1) authorizing your need for transportation services. Your health care provider can fill out the PT-1 online, or send or fax a paper form. The form must be submitted by someone who is authorized to prescribe medications. For urgent requests, your health care provider can call MassHealth for verbal authorization.
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To submit an online PT-1:
Your health care provider should go to the MassHealth web site: Request Transportation for a Member. To use the online PT-1, your prescriber must have a MassHealth Customer Service Web Account.
For complete instructions, see How to Complete and Submit the PT-1 Online on the MassHealth web site.
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To submit a paper PT-1:
Your health care provider should call MassHealth at 1-800-841-2900 and ask for a copy of the form, or download the form: MassHealth PT-1 Form (rev. 05/09).
Mail or fax the PT-1 to:
MassHealth Transportation Authorization Unit
P.O. Box 45
Boston, MA 02112-0045
Fax: 617-988-2925
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For urgent requests:
Your health care provider should call MassHealth at 1-800-841-2900 and ask for a verbal PT-1 authorization. Your provider must follow up by submitting an online or paper PT-1.
For more information about the PT-1 form, see MassHealth Provider Bulletin 192.
What information is needed for the PT-1 form?
The PT-1 form requires this information:
- MassHealth member's name, birth date, home address, pick-up address, telephone number, and member ID
- prescriber's name, address, telephone, MassHealth provider number, and National Provider Identifier (NPI)
- name, address, and provider numbers for the health care provider who is providing treatment
- type, frequency, and duration of treatment
- reason the patient cannot use public transportation
- special transportation requirements, if any (for example, wheelchair van or alternate pickup address)
- if the medical appointment is not local, the reason why the service cannot be provided locally
You must have a separate PT-1 for each health care provider you will see and for each type of treatment. A PT-1 authorization is good for up to 6 months for an acute illness and up to a year for a chronic illness. Your prescriber will tell you the number of trips that are covered.
How long does it take?
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Travel costs reimbursement:
MassHealth will review your request and make a decision within 30 days. If they decide you are eligible, they will send you a check. If they decide you are not eligible, they will send you a letter telling you why. You may appeal their decision. The letter will include instructions on how to appeal.
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Prescription for Transportation (PT-1):
MassHealth will process your PT-1 within 5 days. You will usually get a decision within a week. Forms that are submitted online have a shorter response time. Urgent requests by phone are approved or denied immediately.
If you are approved for transportation services, you will get an approval letter from MassHealth. You will also get information from your Regional Transit Authority (RTA) about how to set up your rides.
If your request is denied, you will get a notice from MassHealth explaining why. If the PT-1 was submitted online, your health care provider can check the reason for the denial online. If MassHealth denied the request because it needed more information, your health care provider can add the information and resubmit the form. You also have the right to appeal the denial within 30 days. Your denial letter will include instructions on how to appeal.
Note: If you are not eligible for MassHealth transportation services and you are a senior or disabled, you can get low cost transportation services from the Paratransit and Elder Van Service.
Useful links
These links are external links to web sites that are not part of MassResources.org. When you click on these links, you will leave our site. Click "Back" on your browser to return.
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MassHealth Transportation
Overview and answers to frequently asked questions about MassHealth transportation services.
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MassHealth Transportation Regulations 130 CMR 407.000
Regulations regarding authorization of MassHealth transportation services, the Prescription for Transportation form, reimbursement of members for transportation expenses, and dial-a-ride services (requires Adobe Reader).
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SEIU Local 509 - MassHealth
Collective bargaining agreement between the Commonwealth of Massachusetts and MassHeath workers in the Alliance, including per mile reimbursement rates.
MassHealth Transportation Services section last updated on 7/07/10
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