NEMT billing in Alaska

Broker for air and ferry, case management for the rest. Alaska's state plan amendment 25-0009, approved by CMS on December 18, 2025 and effective July 1, 2025, keeps a transportation broker under 42 CFR 440.170(a)(4) for air and ferry transportation only and 42 CFR 440.170(a) authority for other transportation-related expenses. The statewide broker is not a government entity and does not provide transportation itself; the plan waives freedom of choice for brokered services, lists air, ferry and transportation network companies among them, and pays the broker a brokerage fee, with the broker making direct payment to individual providers and then submitting a claim to Medicaid.¹ Administrative case management of transportation is performed and overseen by the state or other governmental entities, and vehicles, air and ferry travel, meals and lodging arranged by a government entity other than the state do not have to be bought through the broker contract. The plan's transportation benefit covers wheelchair van, taxi, stretcher car, bus passes, secured transportation, air, ferry, meals, lodging, escort and shuttle services, and EPSDT mileage reimbursement paid to the beneficiary is claimed as an administrative expense.

Alaska runs a travel program: a statewide broker handles air and ferry legs and pays providers directly, tribal health organizations and other governmental entities manage the travel they arrange, and the state pays ground, taxicab and common carrier trips plus food, lodging and escorts as a state plan benefit¹.

Section 1902(a)(87) of the Social Security Act sets federal minimums for every Medicaid transportation provider and driver, which CMS lists as: each provider and driver is not excluded from a federal health care program or listed on the HHS Office of Inspector General's exclusion list, each driver has a valid driver's license, the provider has a process to address any violation of a state drug law, and the provider has a process to disclose each driver's driving history, including traffic violations, to the state Medicaid program.⁴ Alaska's state plan amendment 25-0009 records the agency's assurance that it meets those minimum requirements for 2025 onward. A company that carries air or ferry legs works under the broker's terms, because the broker pays individual providers directly, while ground travel is set up with Alaska Medicaid or with the tribal health organization that manages the trip.

• The beneficiary's name and Medicaid identifier, the pickup and drop-off locations, the date and time, and the miles traveled with the beneficiary in the vehicleCMS states that every state requires at least these, and that drivers document only loaded miles.
• The authorization behind the travel, whether the state, a tribal health organization or the broker arranged itAlaska's state plan places administrative case management of transportation with the state or other governmental entities, and the broker arranges the air and ferry legs.
• Food, lodging and escort costs tied to the authorized travelThe state plan includes the costs of necessary food and lodging for the recipient and an escort to accompany the recipient under transportation services.
• Each driver's license, exclusion check and driving history recordSection 209 of the Consolidated Appropriations Act, 2021 requires a valid driver's license for each driver, no exclusion for provider or driver, a process for state drug law violations and a process to disclose driving histories to the Medicaid program; CMS advises checking exclusions monthly.
• The no-show closed as a no-showCMS says a provider cannot bill Medicaid for a no-show, and that claiming loaded mileage for one is billing for services not rendered.

The state plan describes the benefit by mode, not by code: wheelchair van, taxi, stretcher car, bus passes, secured transportation, air, ferry, meals, lodging, escort and shuttle services, with transportation network companies added for brokered and tribal-managed travel. An air or ferry leg is paid by the broker directly to the provider before the broker claims Medicaid, so that leg follows the broker's terms rather than a state rate sheet. This page lists no procedure codes or rates.¹ For what each transport code and each origin and destination modifier means, in plain language, see the NEMT billing codes page.

Federal rules require every state Medicaid agency to require providers to submit all claims no later than 12 months from the date of service, under 42 CFR 447.45(d)(1). An air or ferry leg the broker arranged is paid by the broker under its own terms, since the broker pays providers directly and then claims Medicaid.⁶ This page quotes no Alaska-specific day count. The biller treats the federal 12-month limit as the outside edge and files each authorized trip as soon as its record is complete.