Non-Emergency Medical Transportation (NEMT) Physician Certification Statement

January 24, 2024

Thank you for your continued partnership in serving WellCare of Kentucky members. We have some important information to share with you related to Medicaid non-emergency medical transportation (NEMT) via ambulance.

Effective 3/1/24, Medicaid NEMT ambulance providers must attach a Kentucky Physician Certification Statement (PCS) of Medical Necessity for Non-Emergency Ambulance Services to the claim submitted for the service. The PCS form must be completed in entirety, signed by the physician or authorized healthcare professional, dated, and filed with the claim as an attachment.

You can access the form at: wellcareky.com/providers/medicaid/forms.

Concurrent with the above change, WellCare will cease requiring prior authorization for NEMT ambulance transport.

Again, we thank you for your continued partnership in providing quality care to our members. If you have any question regarding this notice, please contact your Provider Relations Representative.

Sincerely,

WellCare Health Plans