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Healthcare Facility Frequently Asked Questions

Many common questions can be answered by reviewing the frequently asked questions below. Clicking the link for the question will display its answer.

If you need to print out the frequently asked questions, click on the Convert FAQs to PDF link below and follow the directions.

What is a Standing Order Request Form?

A Standing Order Request Form is document used by facilities to request reoccurring transportation to programs such as Supported Employment, Day Support, and Dialysis.

Instructions and the Standing Order Request Form are located on the Download navigation section of this website.

The Standing Order Request Form must be completed by a Facility representative such as a dialysis clinician, social worker, case manager or other healthcare professional.

FFS Medicaid transportation services are identified as non-emergency, medically necessary transportation provided to eligible members to ensure reasonable access to and from FFS Medicaid and FAMIS covered services. Non-Emergency Medicaid Transportation is pre-scheduled, pre-authorized and medically necessary transportation to Medicaid-paid services such as medical appointments, waiver programs and dialysis.

You may be entitled to transportation from your MCO. Some of the information on this website does not apply to MCO transportation. Refer to your MCO benefit handbook or contact your MCO plan for an explanation of transportation benefits. Click here for MCO transportation contact telephone numbers.  https://www.dmas.virginia.gov/for-providers/transportation/non-emergency-transport/   and look under the heading “Information” and click on “Transportation Contacts for Reservations and Ride Assist/Customer Service”
Non-Emergency Medical Transportation is pre-scheduled, pre-authorized and medically necessary transportation to Medicaid-paid services such as medical appointments, waiver programs and dialysis.
The level of service describes the type of service required to transport a member. A member can travel by one of several levels of service based on the medical necessity and plan coverage.
Ambulatory (Taxi or Van) Wheelchair Ambulance  Strecher-Van
 Virginia Medicaid  Virginia Medicaid  Virginia Medicaid  Virginia Medicaid
Don’t forget you can ride with a friend or family member for mileage reimbursement. If you have a bus service in your area, you can ride the bus.  Please discuss your level of service needed for your transportation needs with Modivcare’s customer service representative at 866-386-8331.
Medically necessary transportation is defined as the most appropriate level or type of vehicle that can safely be provided to the member. NEMT levels of service include taxi (including sedans and mini-vans), non-emergency ambulance, stretcher van and wheelchair van. You may also have three alternatives: fixed-route public transportation, mileage reimbursement or Volunteer Driver. Modivcare manages different levels of service in all of Virginia’s Medicaid programs. Please see level of service table listed below for levels of service provided to each program. All transports must be preauthorized and prescheduled by Modivcare.
Ambulatory is defined as
  • able to walk , or
  • able to walk with the assistance of a walker or other device; or
  • able to transfer from a wheelchair to a vehicle without assistance, and able to stand and pivot without assistance

Standing Orders are recurring trips for treatment that are scheduled at least one (1) day per week  to programs such as Supported Employment, Day Support and Dialysis. Members must attend at least 1 day per week for a duration of 90 days going to the same place at the same times.

Facilities who would like to arrange a standing order appointment for Medicaid members should contact an Exceptions Specialist, submit by fax a Transportation Request Form at least five (5) days in advance for routine appointments and two (2) day notice for standing orders, or utilize the Modivcare TripCare website.  Please see Facility information on this website. The phone number is 866-679-6330 and the fax number is 866-907-1491.  The Exceptions Team is available 8:00 AM – 5:00 PM, Monday – Friday.
Yes, a member in a Waiver program may also be enrolled in an MCO Plan. Transportation to the Waiver service is covered by Modivcare’s FFS contract. Transportation to a routine medical appointment is covered by the MCO Plan or its transportation broker. Modivcare is the transportation broker for several MCOs. When you call Modivcare for transportation arrangements, transportation will be set up accordingly.
A wheelchair van is a motorized vehicle equipped specifically with a certified wheelchair lift and wheelchair securement system designed or adapted to safely carry passengers in manual or electric wheelchairs and other mobility devices. Wheelchair van services can only be used in non-emergency transportation. They are limited to use by members who can sit upright, to members without acute medical problems that require them to remain in a horizontal position and by members who use a mobility device.
Ambulance, as defined by Code of Virginia §32.1-111.1, means any vehicle, vessel or craft that holds a valid permit issued by the Virginia Department of Health, Office of Emergency Medical Services (OEMS) and that is specially constructed, equipped, maintained and operated, and intended to be used for emergency medical care and the transportation of patients who are sick, injured, wounded, or otherwise incapacitated or helpless. The word “ambulance” may not appear on any vehicle, vessel or aircraft that does not hold a valid EMS vehicle permit. Modivcare only provides non-emergency ambulance transportation. 
A Stretcher-van is similar to a wheelchair van but it is designed to transport a passenger on a stretcher.  It is used when a passenger must be transported in a prone position but does not need the medical services of an ambulance. Stretcher-van service does not provide emergency medical transport and does not include any medical monitoring, medical aid, medical care or medical treatment during transport.  It requires a crew of two people on board to safely load and unload the stretcher.

All changes to a standing order must be made by a facility representative. Changes must be made with Modivcare who will then contact the assigned transportation provider. Do not make changes with the transportation provider or driver directly. The new Standing Order Request Form should be faxed to 866-907-1491.

Transportation should be scheduled five (5) business days in advance of the appointment. The day of the appointment is not being included in this calculation. Please have the member’s name, Medicaid number, name and address to the pick-up facility, or residence, as well as the destination facility, available when making a reservation. Transportation reservations may be taken with less than a 5-day notice if they are of an urgent nature, which will be verified with the physician’s office.
An Urgent Trip is defined as a trip to treat a sudden illness or other medical condition that is not life threatening but the member’s doctor or other healthcare professional wants to see the member in less than five (5)-days. For example, a baby wakes up with a serious cold or an adult has an infection.  Urgent Trip reservations are not for routine appointments or appointments where the member failed to notify Modivcare to arrange transportation.
Examples of such trips are follow-up appointments within five days, appointments deemed “urgent” by the physician, urgent MRI or CT Scan ordered by a physician, wound care, chemotherapy, and radiation therapy. Modivcare will verify the urgency with the physician’s office.
Emergency ambulance trips are not arranged through Modivcare. If an emergency ambulance trip is needed, 9-1-1 should be called.
Yes, all Medicaid-paid services are subject to verification or service authorization prior to transport.
If a member’s transportation is more than 15 minutes late for the scheduled pick-up, call the “Ride Assist” line.  If the provider says he will pick up your member soon, Ride Assist will record a “Provider Late” complaint after the pick-up.  If the provider cannot pick up your member, Ride Assist will record a “Provider No Show” complaint.
Examples are sudden life threatening medical situations, significant trauma, comas, shock, uncontrolled bleeding, respiratory distress, poisoning, drug overdose and any situation where immediate medical treatment is necessary.
The “Ride Assist” phone number is (866) 246-9979
Hospital staff contact the Facility Line at 866-679-6330 and select the appropriate prompt. Modivcare has three hours to assign the trip to a provider and pick up the member. The three hour time frame starts with the call to Modivcare. All hospital discharges should be arranged by hospital staff. The member should not make the transportation request for the discharge. Modivcare will need to verify the discharge with hospital staff.
Out-of-state transportation is covered by Modivcare to the extent that it is general practice for the member in a particular locality to use services in a bordering state.  Examples are travel from Scott County, Virginia to Kingsport, Tennessee or travel from Tazewell County, Virginia to Bluefield, West Virginia, Emporia, Virginia to Durham, NC, from Fairfax County to the District of Columbia or other similar near-by locations in bordering states. All other out-of-state transports are arranged by the Department of Medical Assistance Services (DMAS).  Modivcare will review your out-of-state transportation needs.  You may be instructed to contact DMAS Medical Support if the transportation is to a location outside of those areas immediately bordering the stat.
Your return trip can be scheduled as a “Will Call”. You will use the same “Ride Assist” phone number listed above. Once the appointment is finished, you or someone at the medical facility will call the “Ride Assist” phone number and request transportation to be sent to pick you up. The transportation provider will be dispatched and will have up to 45 minutes to arrive.
Please refer to the chart below. In order to determine the region you are in, find the city or county in which you live and refer to the region number at the top of the column.
The member will use the same “Ride Assist” phone number listed above. Once the appointment is finished, the member or someone at the medical facility must call the “Ride Assist” phone number and request transportation to be sent to pick-up the member. The transportation provider will be dispatched and has up to 45 minutes to pick up the member.
Medicaid members do not have the freedom of choice to choose their transportation provider. A request can be made and will be noted by Modivcare.  However, Modivcare reserves the right to utilize a different transportation provider consistent with the transportation needs of the member.

Minors age 13 to 17 may travel alone; however, a Consent and Release of Liability Form must be on file. For transporting minors 17 and under please contact the Exceptions Department for policy at 866-386-8331.

Transportation can be arranged by you, your representatives (such as family, friends, or case manager) or your Medical service provider.
Please refer to the Consent and Acknowledgement Form found on this website on the download navigator.
The Consent and Acknowledgment Form must be signed by the parent or legal guardian of the minor.
An escort is a family member, friend or facility employee who accompanies a member for the entire trip and stays with the member at the destination. Modivcare is not responsible for providing escorts.  However, your escort can ride for free.  When you make your transportation reservations, please make sure and let Modivcare know you have someone riding with you.
An attendant accompanies a member or a group of members during transport only.  The attendant is on the vehicle to ensure the safe operation of the vehicle and the safety of the members. An attendant is an employee of the company that provides transportation services for a member. A transportation attendant is not a personal assistant, an escort, a parent, caretaker, relative or friend. An attendant is not a medical professional, and does not offer professional medical services. A transportation attendant shall be provided for a member or a group of members when it is necessary for the safety of the member(s), to ensure timeliness of the trip and to reduce behavioral problems en route.

Requests for an attendant will be accepted from a qualified assessor, such as the member, member’s parent or guardian, the member’s case manager or social worker.  The request, an Attendant Care Eligibility Assessment Form must be completed and faxed to Modivcare’s Exceptions Department at 866-907-1491.

Cancel the trip immediately by calling the Modivcare “Ride Assist” line for your area. The number to the “Ride Assist” line is listed below. If you do not cancel the trip at least the day before, the provider may show up but will not be paid for the trip. However, the transportation provider can file a “Rider No-Show” complaint against the member if the trip was not cancelled. Frequent “Rider No-Shows” may result in limiting the member’s transportation benefit for a time.
Please refer to the Attendant Pre-Assessment Checklist (APAC) found on this website on the download navigator.
No, attendants are for the safety of members while riding the vehicle only.  However, the member can have an escort ride for free.  Please see definition of escort listed above.  When the transportation reservation is called in, make sure and tell the customer service representative you have an escort riding as well.
  1. You will find the Attendant Care Eligibility Assessment Form on this website on the download navigator.
Modivcare coordinates volunteer drivers to transport Medicaid members to and from their Medicaid covered service anywhere in Virginia. A Volunteer Driver is someone who is willing to share their time and vehicle to help meet the transportation needs of their community. The Volunteer Driver provides non-emergency Medicaid transportation for local and long distance trips.
  1. Reimbursed at a rate of $0.50 per traveled mile, personal satisfaction of helping others, Modivcare driver training, etc.
  1. The requirements are:
    1. At least 18 years of age
    2. Current and valid driver’s license
    3. Good driving record
    4. Criminal background check and drug screen
    5. Liability automobile insurance coverage
    6. Modivcare inspected automobile which is safe and in roadworthy condition (vehicle will have a Modivcare sticker on the passenger side back window)
    7. Modivcare driver training

Note: Volunteer Drivers have the same requirements as regular transportation provider’s drivers.

To become a Volunteer Driver you can contact a Modivcare Volunteer Coordinator at (866) 810-8305 ext. 2615.
Prior to the trip, call Modicare to schedule the transportation. When scheduling mileage reimbursement trips, you will need the name of the person who will be transporting the member as well as their telephone number and mailing address.
  • Mileage Reimbursement pays a member’s friend, neighbor or relative at the IRS business rate from the member’s residence to the Medicaid paid service and the return trip home. Mileage Reimbursement trips must be pre-authorized by Modivcare before transport.  Modivcare assigns a unique trip number to the reservation.  The trip number is needed to receive any reimbursement.
You will find the Mileage Reimbursement Trip Log on this website on the download navigator.  Contact Modivcare before transporting to receive prior approval and a trip number for reimbursement. The trip number is required for reimbursement.
Yes, prior to the trip, call Modivcare to schedule the transportation. When scheduling mileage reimbursement trips, you will need the name of the person who will be transporting the member as well as their telephone number and mailing address.
In order to be reimbursed, a Mileage Reimbursement Trip Log will need to be completed. The physician’s office must sign the trip log. The payee will mail the completed signed trip log to Modivcare’s Claims Department for processing. You still need to call Modivcare before the trip(s) is made to get a trip number for the trip log. If you fail to call in ahead of time, you will not receive reimbursement.

Please refer to the payment schedule listed in downloads.

Yes. Please call Modivcare’s reservation line at 866-386-8331 for information on receiving bus tickets.
Call the Modivcare reservations line at 866-386-8331 at least five (5) days before the scheduled medical appointment. This allows for proper delivery of the bus tokens, tickets, swipe cards or passes. Please tell the customer service representative the member will be using public transportation.
Yes. Please call Modivcare’s reservation line at 866-386-8331 for information on receiving bus tickets.

Please call Modivcare’s Transportation reservations line 866-386-8331

Call the Modivcare reservations line at 866-386-8331 at least five (5) days before the scheduled medical appointment. This allows for proper delivery of the bus tokens, tickets, swipe cards or passes. Please tell the customer service representative the member will be using public transportation.
Yes, for assistance please call Modivcare at 866-386-8331.
Yes.  The FFS DMAS User’s Guide can be found on this website on the download navigator.
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