Page 4

Medical Services – Appendix B, Transportation Procedures 01/01/19 Appendix B Page 3 of 4 Therapeutic Visits A therapeutic visit is defined as a meeting of a child with his parents, guardian or foster parents as a part of a treatment plan to help reunite a family whose members have been separated due to the necessity of inpatient psychiatric care for the child. Three (3) therapeutic visits (either for the child to visit the parents or for the non-Medicaid eligible parents, etc. to visit the child) in a calendar year may be authorized by the Division of Medical Services (DMS) Utilization Review Section for a family whose child is in an out-of-state facility when a psychologist or psychiatrist has recommended in writing that the visits are medically necessary as a part of the recipient’s therapeutic treatment plan (See section below for out-of-state travel). NET should be contacted for information and for transportation arrangement. If the facility is in Arkansas, a parent, foster parent or guardian is eligible for transportation by NET to visit a minor Medicaid recipient. There is a limit of one (1) trip to and from the facility per episode of care. The parent, foster parent, or guardian contacts NET to schedule the appointment. Only one (1) round transportation trip will be authorized by the DMS Utilization Review Section for parents who take their child home from a facility (e.g., weekend visit) and later return the child back to the facility. Emergency Transportation When an emergency occurs and the attending doctor advises the client to obtain medical care immediately, the doctor will call the NET transportation broker and inform the broker that the client has an “urgent medical situation.” The broker will provide transportation without 48 hour notice. Emergency ambulance services may be covered only when provided by an ambulance company that is licensed by the Arkansas State Ambulance Board and is an enrolled provider in the Arkansas Medicaid Program. Medicaid will cover the ambulance transportation only when the Medicaid recipient is admitted to the hospital or when the patient’s condition is an emergency. Visits for Prolonged Treatment When it is necessary for a client to see the doctor at the same time each week (e.g., for dialysis or radiation therapy), the client should contact the broker and ask if a regular schedule can be setup for that time period. Out-of-State Transportation The Division of Medical Services (DMS) Utilization Review Section authorizes all out of state transportation including air travel. The provider must obtain prior authorization from the DMS Utilization Review Section for ground ambulance trips to a medical facility outside the State of Arkansas, unless the medical facility is within a 50-mile trade area and is the nearest hospital or nursing home from the point of pick-up.