This transmittal supersedes Transmittal 21-48: Medicaid and Alliance MCO Emergency Medical Transportation. This transmittal corrects the prior issuance by removing reference to two procedure codes that were included in error: A0430 and A0999.

The purpose of this transmittal is to inform providers that effective for dates of service beginning October 1, 2021, the Department of Health Care Finance (DHCF) established a new payment policy for Medicaid reimbursable Emergency Medical Transportation services and, as well, for the Alliance program. Under this new policy, Emergency Medical Transportation services remain as a benefit available to beneficiaries enrolled in the Medicaid Managed Care program and in the DC Health Care Alliance program, but service providers will be reimbursed by DHCF instead of Managed Care Organizations. Network providers and hospitals should submit applicable claims for Emergency Transportation service (see chart below) for either Medicaid or Alliance enrollees directly to DHCF for reimbursement.

All remaining currently Medicaid and Alliance MCO reimbursable services remain the responsibility of the assigned MCO, and network providers and hospitals should continue to bill the MCO for those services.