L.A. Care Health Plan is partnered with Call the Car, Inc. to provide high quality transportation services to our members.
You can view a detailed summary of Non-Emergency Medical Transportation (NEMT) & Non-Medical Transportation (NMT) Services.
NEMT
A Physician Certification Form (PCS Form) is required per the Department of Health Care Services (DHCS) and must be submitted to L.A. Care’s Utilization Management Department.
- Fax: 213-438-2201
- Download the Physician Certification Form
- PCS forms should be submitted to L.A. Care’s Utilization Management Department within 24 hours of the NEMT trip being performed to accurately document activity and avoid unnecessary delays.
A Provider signature is required on the PCS form for L.A. Care Utilization Management approval.
Exceptions
A PCS Form is NOT needed per APL 22-008 NEMT when the member is being transferred from an emergency room to an inpatient setting, or from an acute care hospital, immediately following an inpatient stay at the acute level of care, to a skilled nursing facility, an intermediate care facility or imbedded psychiatric units, free standing psychiatric inpatient hospitals, psychiatric health facilities, or any other appropriate inpatient acute psychiatric facilities.
NMT
A Physician Certification Form (PCS Form) is not required, as long as member is ambulatory.