Prior Auth Required

51323 - Regulations, Title 22, Section . Such transportation is approved when the member has a medical

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceRegulations, Title 22, Section . Such transportation is approved when the member has a medical
Procedure / Service Description

Section 6. Alliance Covered Benefits and Services - Non-Emergency Medical Transportation: Medi-Cal The Alliance covers Non-Emergency Medical Transportation (NEMT) as specified in the California Code of Regulations, Title 22, Section 51323. Such transportation is approved when the member has a medical condition that prevents them from traveling by another form of conveyance without jeopardizing the member’s health.

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.