If you have full‑scope Medi‑Cal and you cannot get to an appointment, your plan is required to get you there. Not as a courtesy — as a covered benefit, written into state law and into every managed care plan’s contract. The benefit comes in two forms with two very different sets of rules, and knowing which one you are asking for is usually the difference between a ride and a runaround.
This article covers what each benefit pays for, who qualifies, exactly what your doctor has to write down, the timing standards your plan has to meet, and what to do when the ride does not show up. Figures and rules were verified against California statute, regulation, and current Department of Health Care Services guidance in August 2026.
The short version
- Two benefits, not one. NMT is a regular car. NEMT is a medical vehicle. Asking for the wrong one is a common reason requests stall.
- Both cover the pharmacy. Not just doctor visits — dental, mental health, substance use appointments, and picking up prescriptions and medical supplies.
- NMT needs no prescription. NEMT needs a Physician Certification Statement and prior authorization.
- Your plan must get you there within 15 minutes of your appointment time.
- Denied? Appeal within 60 days. State Fair Hearing within 90 days.
The two benefits at a glance
California Medi‑Cal covers two separate transportation benefits. They are not interchangeable, and the paperwork is different.
| NMT | NEMT | |
|---|---|---|
| What it is | A ride in a regular vehicle | A ride in a medical vehicle |
| Vehicles | Passenger car, taxi, rideshare, bus pass, taxi voucher, train ticket, mileage reimbursement | Ambulance, litter van, wheelchair van, air transport |
| Who it’s for | You have no other way to get to the appointment | Ordinary transportation is medically contraindicated |
| Prescription | Not required | Required — physician, dentist, or podiatrist |
| Prior authorization | Not required by law; plans may add one, renewed no more than every 12 months | Required in advance, with limited exceptions |
| Legal basis | Welf. & Inst. Code §14132(ad) | 22 CCR §51323 |
Non‑Medical Transportation (NMT)
A ride in a regular vehicle for someone who simply has no other way to get to an appointment. State law (Welfare and Institutions Code §14132(ad)) defines it as round‑trip transportation by passenger car, taxicab, or any other form of public or private conveyance, plus mileage reimbursement, bus passes, taxi vouchers, and train tickets.
Non‑Emergency Medical Transportation (NEMT)
A ride in a medical vehicle for someone whose condition makes an ordinary car unsafe or impossible. Title 22 of the California Code of Regulations, §51323, covers it when transport by ordinary means of public or private conveyance is medically contraindicated. That means ambulance, litter van, wheelchair van, or in rare cases air transport.
Both benefits cover the same destinations: medical, dental, mental health, and substance use disorder appointments — and trips to pick up prescriptions and medical supplies.
The pharmacy counts. A lot of people assume this benefit only applies to doctor visits, so they never ask for a ride to pick up a prescription. Both NMT and NEMT cover it — including medications carved out under Medi-Cal Rx, and including dental and behavioral health appointments your medical plan does not otherwise manage. If a prescription cannot be mailed to you, the trip to get it is covered.
Who qualifies
You qualify for NMT if
A ride in a regular vehicle
- You have full-scope Medi-Cal, or
- You are pregnant, or were pregnant — coverage runs through the end of the month containing the 365th day after the pregnancy ends
- You attest that other currently available transportation has been reasonably exhausted
You qualify for NEMT if
A ride in a medical vehicle
- Your medical or physical condition makes ordinary transportation medically contraindicated
- A physician, dentist, or podiatrist has written a prescription
- The transportation has been authorized in advance
For NMT
- You have full‑scope Medi‑Cal, or
- You are pregnant, or were pregnant — coverage runs through the end of the month containing the 365th day after the pregnancy ends
- You attest that other currently available transportation resources have been reasonably exhausted
For NEMT
- You are a Medi‑Cal member whose medical or physical condition makes ordinary transportation medically contraindicated, and
- A physician, dentist, or podiatrist has written a prescription for it, and
- The transportation has been authorized in advance
The regulation gives specific grounds for a wheelchair van: you cannot sit in a private vehicle, taxi, or public transportation for the length of the trip; you need to be transported in a wheelchair or need assistance getting to and from a location because of a physical or mental limitation; you need safety equipment beyond what an ordinary vehicle has; or you are stable enough that you do not need ambulance‑level staff and equipment.
Check the date on anything you read about this benefit. Disability Rights California’s publication on Medi-Cal transportation (#F120.01) is dated December 1, 2022 and still states the postpartum window as 60 days. DHCS updated its transportation page on May 28, 2026 and states 365 days.
The DHCS figure is current. Legal-aid explainers age quietly — the underlying advice stays sound, but the numbers drift.
NEMT: what your provider actually has to write down
The document is the Physician Certification Statement, usually called the PCS form. Every managed care plan uses its own DHCS‑approved version, so ask your plan for theirs rather than downloading a generic one. Under All Plan Letter 22‑008, the completed PCS must include:
- The functional limitations that justify the transportation
- The dates of service — up to a maximum of 12 months per authorization
- The mode of transportation you need
- The provider’s certification that the transportation is medically necessary
Your plan cannot downgrade the mode your provider prescribed. All Plan Letter 22-008 states that once a provider prescribes the transportation mode, the plan cannot modify the authorization. If your doctor wrote wheelchair van and the plan sends a sedan, that is not a scheduling mix-up you have to live with — it is grounds for a grievance.
One caveat that cuts the other way: 22 CCR §51323 requires authorization only for the lowest cost type of medical transportation that is adequate for the patient’s medical needs. Your provider’s job is to document why a cheaper mode is not adequate. Vague forms get denied.
Door-to-door is required, not optional. Plans must have processes ensuring door-to-door assistance for every member receiving NEMT, including help with a wheelchair or walker.
If you live in a building that is not ADA compliant and you need help getting from inside your unit to the front door, the plan must arrange a different mode of transportation that can provide it. Curb-to-curb is not the standard.
Two situations skip prior authorization: transfers between acute care hospitals after an emergency department visit, and urgent cases where a PCS form could not reasonably be submitted first — those can be authorized by telephone, with the form submitted afterward.
NMT: no prescription, but there is a catch
NMT does not require a provider’s authorization. Plans are permitted to build their own prior authorization process, with reauthorization no more often than every 12 months, but the benefit itself is not gated behind a doctor’s signature. Covered modes include a passenger car, taxi, rideshare, bus pass, taxi voucher, train ticket, or mileage reimbursement for a private vehicle.
Mileage is reimbursed at the IRS standard mileage rate for medical transportation in effect on the date you traveled. Rideshare drivers are not eligible for mileage reimbursement — that is priced into the fare. A private driver must have a valid California driver’s license, valid vehicle registration, and valid insurance.
Agency guidance is narrower than the statute here, and it matters
Welfare and Institutions Code §14132(ad) authorizes mileage reimbursement when the trip is:
“in a private vehicle arranged by the beneficiary and not through a transportation broker”
The statute does not say who has to be behind the wheel. But DHCS’s guidance to health plans states that the plan reimburses the driver, and that the member cannot be the driver for NMT. So if you drive yourself, managed care will not reimburse your mileage. Fee-for-service members are treated differently and can seek mileage reimbursement after other options are exhausted.
This is a gap between agency guidance and statutory text — not a plan breaking the law — and plans will follow the guidance. If you are denied for driving yourself and you think the statute reads otherwise, that is a point worth raising in a written grievance and worth taking to a legal aid attorney. It is not something to argue with a call center about.
How to request a ride: managed care members
- 1
Call member services on your health plan card
Not the county, not your doctor’s office. Your plan is responsible for arranging and paying for this.
- 2
Name the benefit you want
“I need non-medical transportation to an appointment” gets you a different queue than “I need a wheelchair van.”
- 3
For NEMT, get the PCS form completed
Ask your provider’s office to fill out your plan’s Physician Certification Statement. Request it by phone, email, or in person — and keep a copy for your records.
- 4
Ask for the advance-notice requirement and the transportation liaison
Plans must publish the notification timeframe in their Member Services Guide, along with a direct contact for their transportation liaison. Get that number and write it down.
- 5
Say out loud if you need help reaching the vehicle
If you need assistance from inside your home to the curb, state it when you book and confirm the plan has noted it on the trip.
How to request a ride: fee‑for‑service members
If you are on straight Medi‑Cal without a managed care plan, DHCS handles this directly rather than a plan. Email DHCSNMT@dhcs.ca.gov to request the Transportation Request Form; staff respond by secure email with the form and instructions. For eligibility and billing questions, the Telephone Service Center is (800) 541‑5555.
Fee-for-service Medi-Cal also covers lodging and meals for appointments far enough from home to require an overnight stay. Almost nobody knows this benefit exists.
It runs on a separate form — the Pre-Authorization Request for Medi-Cal Fee-for-Service Lodging and/or Meals Expense. DHCS responds within three business days of receiving a completed form. Submit well before the appointment; late requests may still be considered, but approval is not guaranteed.
Beneficiary Service Center
P.O. Box 138008
Sacramento, CA 95813-8008
The timing standards your plan has to meet
Write down the date, the pickup time you were promised, the time the ride actually arrived, and the name of whoever you spoke with. A grievance with times in it moves differently than one without.
Write down the date, the time you were told the ride would arrive, the time it actually arrived, and the name of whoever you spoke with. A grievance with times in it moves differently than one without.
If you are denied, or the ride does not show
Late and no‑show rides are handled as grievances. Denials are handled as appeals. They are different tracks with different deadlines, and it is worth being precise about which one you are filing.
- File a grievance with your plan. A transportation complaint has to be processed exactly like any other complaint about a plan service or provider. Your plan cannot hand grievance processing off to its transportation broker — DHCS prohibits that delegation specifically.
- If the plan denies or reduces a request, it must send you a Notice of Action letter explaining the decision and your right to appeal. If the denial rests on medical necessity, someone with appropriate clinical expertise must have made the call — not a clerk.
- Appeal to the plan within 60 days of the denial notice.
- Request a State Fair Hearing within 90 days of the Notice of Action. Call (800) 743‑8525, file online at acms.dss.ca.gov, or fax (833) 281‑0905. By mail: California Department of Social Services, State Hearings Division, P.O. Box 944243, Mail Station 9‑17‑37, Sacramento, CA 94244‑2430.
- Independent Medical Review is also available for medical necessity disputes.
- If your plan is not responding at all, call the DHCS Medi‑Cal Managed Care Office of the Ombudsman at (888) 452‑8609, Monday through Friday, 8 a.m. to 5 p.m. Pacific, excluding holidays.
Two deadlines, don’t miss them
- 60 daysTo file an appeal with your health plan, counted from the date you receive the denial notice.
- 90 daysTo request a State Fair Hearing, counted from the Notice of Action. Call (800) 743-8525, file at acms.dss.ca.gov, or fax (833) 281-0905.
If you have a monthly share of cost, NMT interacts with it. DHCS states that share-of-cost requirements apply to the NMT benefit and that these payments count toward reducing your monthly out-of-pocket obligation. In practice, a ride may not feel free in a month when your share of cost has not yet been met. Ask your county eligibility worker how transportation is being applied to your share of cost before you assume a bill is an error.
What this benefit does not do
- It does not help you buy, lease, repair, or own a vehicle. Medi‑Cal transportation is rides only. Programs that help with vehicle costs exist in California, but they run through other agencies entirely.
- It does not cover non‑medical errands. Groceries, banking, and social visits are outside the benefit, regardless of how necessary they are.
- NMT does not cover anyone who needs to be transported by ambulance, litter van, or wheelchair van. The statute excludes that explicitly — those members need NEMT, and asking for the wrong one is a common reason requests stall.
Have this ready before you call
- Your Benefits Identification Card (BIC) and your health plan card
- The appointment date, time, and the full address of where you’re going
- The name and phone number of the provider you’re seeing
- Whether you use a wheelchair, walker, oxygen, or need help from your door
- Whether anyone is traveling with you
- For NEMT: your provider’s completed Physician Certification Statement
- A pen — write down the reference number and the name of the person you spoke with
If your ride keeps falling through
Start with your plan. If the plan is not responding, these are the people who can look at your file.
- DHCS Medi-Cal Managed Care Ombudsman Mon–Fri, 8 a.m.–5 p.m. Pacific, excluding holidays (888) 452-8609
- CDSS State Hearings Division To request a State Fair Hearing (800) 743-8525
- Disability Rights California Free legal assistance for people with disabilities (800) 776-5746
- Medi-Cal Telephone Service Center Fee-for-service eligibility and billing questions (800) 541-5555
Sources
- California Welfare and Institutions Code §14132(ad) — the statutory definition of non-medical transportation, covered modes, the reasonably-exhausted requirement, and the exclusion of ambulance, litter van, and wheelchair van transport.
- 22 CCR §51323 — Medical Transportation Services — the medically contraindicated standard, wheelchair and litter van conditions, the prescription and prior authorization requirement, and the lowest-cost adequate mode rule.
- DHCS All Plan Letter 22-008 (May 18, 2022) — PCS form contents and the 12-month limit, the rule that plans cannot modify a prescribed mode, door-to-door assistance, driver requirements, the 15-minute arrival standard, the three-hour transfer standard, and pharmacy coverage. Supersedes APL 17-010.
- DHCS APL 22-008 Frequently Asked Questions — the rule that the member cannot be the driver for NMT, the IRS medical mileage rate, the attestation requirement, the ban on delegating grievances to a transportation broker, and the clinical-expertise requirement for denials.
- DHCS — Transportation Services (updated May 28, 2026) — current NMT eligibility including the 365-day postpartum window, covered destinations including prescription and supply pickup, and the fee-for-service request process.
- DHCS — Transportation FAQ for Beneficiaries — fee-for-service mileage reimbursement, the share-of-cost interaction with NMT, and how managed care members request each benefit.
- DHCS — Pre-Authorization Request for Fee-for-Service Lodging and/or Meals Expense — the lodging and meals benefit, the Beneficiary Service Center address, and the three-business-day response commitment.
- DHCS — MMCD Office of the Ombudsman Contact Information — the ombudsman phone number and hours.
- Disability Rights California — Transportation Services for Medi-Cal Recipients (#F120.01, Dec. 1, 2022) — appeal and State Fair Hearing deadlines and contacts. Note: this publication’s 60-day postpartum figure has been superseded.
DHCS is the primary authority throughout. Where a plan’s member handbook and the All Plan Letter differ, the All Plan Letter governs; where the All Plan Letter and the statute differ, the statute governs.
About this article
IHSS Connect publishes this article for general information and education. It is not legal advice, and reading it does not create an attorney–client relationship. IHSS Connect is not a law firm and is not affiliated with the California Department of Health Care Services, the California Department of Social Services, or any county agency or health plan.
Benefit rules, forms, and deadlines change — sometimes mid-year. Only your health plan or your county can decide what you are eligible for, and only the Department of Health Care Services can answer questions about fee-for-service Medi-Cal.
If a decision on your case looks wrong, or you want advice about your own situation, talk to someone who can look at your file:
- Free and low-cost legal help: LawHelpCA.org
- Disability Rights California: (800) 776-5746
- DHCS Medi-Cal Managed Care Ombudsman: (888) 452-8609
- CDSS State Hearings Division: (800) 743-8525
Rules and contacts verified August 2026.
