Non-Emergency Medical Transportation in Medicaid, 2018–2020
Evidence | Publications

Non-Emergency Medical Transportation in Medicaid, 2018–2020

Report to Congress
Published: Jul 21, 2022
Publisher: Centers for Medicare and Medicaid Services
Health Medicaid and CHIP Federal
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Key Findings
  • Overall, between 4 and 5 percent of Medicaid beneficiaries used NEMT in each study year (2018 – 2020). However, certain subgroups of Medicaid beneficiaries with substantial health care needs used NEMT at higher rates than the average. These subgroups included Money Follows the Person (MFP) participants, participants receiving home and community based services through Section 1915(c) waivers, Program of All-Inclusive Care for the Elderly (PACE) enrollees, and dually eligible beneficiaries. Beneficiaries eligible for Medicaid on the basis of a disability and those eligible on the basis of age (65+) also used NEMT at rates higher than the average.
  • NEMT played a key role in enabling access to care for beneficiaries with certain types of physical health conditions, mental health conditions, and substance use disorders (SUDs). Beneficiaries who used NEMT at higher rates than the average included those with chronic kidney disease (CKD) with end-stage renal disease (ESRD), beneficiaries with CKD without ESRD, beneficiaries with intellectual disabilities or developmental delays, beneficiaries with any SUD, beneficiaries with opioid use disorder, and beneficiaries with a mental health condition. These results suggest that NEMT plays an important role in enabling beneficiaries with chronic physical and mental health conditions, and substance use disorders to access medically necessary care.
  • Beneficiaries most often used NEMT to access preventive health care services, behavioral health services, and lab and imaging services.
  • Rates of NEMT use changed dramatically at the start of the COVID-19 Public Health Emergency (PHE). At the start of the COVID-19 PHE, NEMT use dropped sharply. Between February and April 2020, the number of monthly NEMT ride days decreased by 63 percent and the number of beneficiaries using NEMT decreased by 60 percent as many services shifted to telehealth and providers and beneficiaries delayed non-urgent medical care. Use of NEMT gradually increased in May through October 2020, but the total number of ride days remained 33 percent below pre-PHE levels, and the number of beneficiaries using NEMT remained 26 percent below those levels as of October 2020.

This Report to Congress presents an analysis of Medicaid beneficiaries’ use of Non-Emergency Medical Transportation (NEMT). Specifically, the report presents insights about overall number and percentage of Medicaid beneficiaries who used NEMT annually and monthly in 2018 – 2020. The report also examined the relative frequency and volume of NEMT service use across different beneficiary subgroups, including beneficiaries in each major Medicaid eligibility category (children, adults, adult expansion beneficiaries, beneficiaries eligible for Medicaid on the basis of a disability, and beneficiaries eligible on the basis of age [65 and older]), beneficiaries living in different geographic areas, and among beneficiaries with different physical and behavioral health conditions. The report also examined the types of medical services Medicaid beneficiaries accessed when using NEMT. The report leveraged T-MSIS data covering calendar years 2018-2020.

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