Welcome to the Modivcare Facility web site for New Jersey. This site hosts information and forms that medical facilities in NJ can use to schedule transportation for their Medicaid members.
If you have general questions, please review the NJ Facility Brochure and Frequently Asked Questions (FAQs). Also, please be aware that Modivcare is only responsible for certain types of non-emergency medical transportation in the state. Please refer to the document titled “What Modivcare is responsible for in New Jersey” for more information. The remaining documents on this site include forms used to request transportation services as well as informational brochures you can provide to your Medicaid members.
The forms on this site are stored in PDF format. Your computer must have Adobe Acrobat Reader installed for you to be able to read and print the forms. If you do not have a copy of Adobe Acrobat, you can download it for free at www.get.adobe.com/reader/.
Modivcare now offers a Facility Website Service where single trips and standing orders can be booked on-line. The Facility is also able to receive a confirmation number. For more information, please email [email protected].
Facilities can also call 866-527-9945 to book up to a month’s worth of trips.
Ambulatory/Livery – This is a client who is able to walk on their own or with the assistance of a walker or can and able to be picked up and dropped off at the curb. This is curb to curb transportation.
Ambulatory/MAV – These will be clients that are able to ambulate on their own or with a walker or cane to the vehicle and can ride in a normal seat within the vehicle, but due to either physical weakness or mental impairment they must be assisted door through door.
MAV/Wheelchair – These are clients confined to a wheelchair due to either physical weakness or mental impairment and must be accompanied by MAV level staff from inside of the pick-up facility, where the client is handed off to them, to inside of the drop off facility where they are handed off to either staff or family to assure their safety.
MAV/Wheelchair 02 – These will be any clients in a wheelchair that requires Oxygen be PROVIDED and MONITORED by the transportation provider.
BLS – These will be clients who are unable to be transported in any manner other than a stretcher.
BLS with oxygen – This is for ANY patient that requires transportation on a stretcher and need Oxygen to be PROVIDED and MONITORED by the transportation provider.
ALS/SCT – These will be clients who require the care of a critical care nurse during transport to monitor an IV drip medication and/or a cardiac monitor.
Modivcare covers all Medicaid eligible clients in all 21 counties within New Jersey for all levels of service.
Trips for client traveling out of state are booked with Modivcare, using the same process that other trips are booked as long as they are to a Medicaid reimbursable service. Any out of state trips that require travel beyond the next county in a neighboring state will be approved pending authorization from NJ Medicaid.
A copy of the Medical Necessity Form is located on this web site and can be downloaded for your convenience.
A copy of the Standing Order Request Form is located on this web site and can be downloaded for your convenience.
Modivcare maintains a facility department dedicated to handling the needs of nursing homes, hospitals, dialysis, mental health and substance abuse clinics. A dedicated staff and phone number is available to book transportation needs from these facilities. The phone number is 866-527-9945. It is suggested that you fax your trip requests in to save time on the phone and make the most efficient use of your time. The fax number is 866-457-3316. Another option available to facilities for making non-emergency medical transportation reservations is the Facility Web Portal. You will find instructions and forms for arranging a standing order or single trips included in the answers found below.
Hospitals contact the Facility Line at 866-527-9945 and select the discharge prompt. No Medical Necessity Form is needed for hospital discharges. Dedicated call takers are assigned to handle discharges. Once the discharge is arranged, the transportation provider has three (3) hours to respond and pick up the patient.
The client or Dr.’s Office will call the “Where’s My Ride” phone number 866-527-9934 and request that transportation be sent to pick up the client. The transportation provider will be dispatched and will have up to ninety (90) minutes to pick up the client.
Urgent/same day trips can be booked through Modivcare. Such trips should be for true urgent conditions where a physician is requiring the client be seen the same day or next day. All urgent/same day trips will be verified with physician’s office for medical necessity. If it is a case where the trip was just not called in timely, then in those cases, the appointment should be rescheduled so that transportation can be booked providing the two business day notice.
Modivcare has an Outreach Coordinator whose job it is to educate facilities on Modivcare’s policies and procedures and to work with facilities to resolve any ongoing issues they may have with transportation.
The Medical Necessity Form needs to be updated every six months, with the exception of dialysis and nursing homes.
Two business days’ notice prior to the date of the scheduled appointment is necessary.
Sudden life threatening medical situations, significant trauma, coma shock, uncontrolled bleeding, respiratory distress, poisoning, drug overdose and any situation where immediate medical relief or treatment is necessary.
Examples of such trips are doctor appointments deemed urgent by the physician, Dialysis, Wound Care, Chemotherapy, and Radiation.
Modivcare maintains a staff to resolve any issues when a transportation provider is late or fails to show at the scheduled time. A dedicated phone line is available to call and find out the status of the ride. This line is called “Where’s My Ride” and the phone number is 866-527-9934.
Emergency ambulance trips are not arranged through Modivcare. If an emergency ambulance trip is needed, 911 should be called.
Medical Necessity Forms are completed for any client who requires a level of service of Ambulatory/MAV, Wheelchair/MAV, BLS ambulance or SCT ambulance. A physician completes the Medical Necessity Form and determines the Level of Service by which the client will travel. The Medical Necessity Form should accompany a Standing Order or Single trip request form and is faxed to Modivcare’s Facility Department at 866-457-3316.
To eliminate the need to arrange trips for clients who have three or more trips to the same facility, the same days of the week and the same appointment times, a standing order form and process has been created. This allows a facility to arrange trips in advance for a client scheduled for trips three days or more a week to the same location. Examples are: Dialysis, Mental Health and Substance Abuse. A Standing Order for a client is good for three months and will be recertified by the Modivcare staff to make sure the trip continues to be necessary. The facility will be asked to provide information at that time, but the facility will not have to submit a new standing order.
The Standing Order Request From should be faxed to Modivcare at 866-457-3316.
Standing orders must come from the Facility representatives where the treatment is being administered. Examples: Dialysis Clinics, Mental Health and Substance Abuse Clinics. Nursing homes may book the first three trips for a client in need of Dialysis. The Facility Department will then contact the Dialysis Clinic to secure a Standing Order for the client for future trips.
Yes, trips to a Veteran’s Hospital will be covered for Medicaid eligible clients.