MTM Missouri Implements Changes to Authorization Process for Payers

(MISSOURI) March 18, 2025 -

As of March 1, 2025, Medical Transportation Management (MTM) in Missouri has implemented significant changes to the handling of non-emergency medical transportation (NEMT) claims.

MTM has transitioned from a pre-authorization process to a post-authorization process for all payers, except traditional Medicaid.

In a webinar held in early February, MTM leaders explained that "while pre-authorizations are no longer required for non-emergent ALS, BLS, or stretcher trips, the necessity for ambulance transports will continue to be determined by the sending physician at the ordering medical facility." They also noted that the facility ordering the transport "has the responsibility to validate insurance and schedule with an approved contracted provider."

This change could significantly impact EMS agencies, hospitals, and Medicaid recipients.

With the new post-authorization process, payers can submit claims immediately, provided that the Physician Certification Statement (PCS) form is on file. This adjustment is expected to expedite the billing process and reduce appointment cancellations or delays for patients.

It is important to note that this change does not apply to traditional Medicaid. The new post-authorization process applies only to Medicaid Managed Care Organizations (MCD-MCOs).