New Hampshire Code of Administrative Rules
He - Department of Health and Human Services
Subtitle He-W - Former Division of Human Services
Chapter He-W 500 - MEDICAL ASSISTANCE
Part He-W 574 - GENERAL MEDICAL TRANSPORTATION
Section He-W 574.04 - Covered Services

(a) General medical transportation shall be covered for the purpose of allowing a recipient to access medicaid covered medical or dental services from a medicaid enrolled provider pursuant to 42 CFR 441.62(a) and 42 CFR 440.170.

(b) When general medical transportation is arranged by the department, the covered service shall be the least costly available to meet the recipient's needs.

(c) The costs of tolls and parking fees shall be covered when the total cost for these is $3.00 or more per trip.

(d) Driver reimbursement, except for volunteer or transit company drivers, shall be limited to one trip per day unless as provided for in He-W 574.09.

(e) Only the actual number of miles traveled from point of origin and return to point of origin shall be reimbursable and as described in He-W 574.07(a) .

(f) General medical transportation shall be to the nearest available medicaid enrolled provider of the covered medical or dental service, unless as authorized in accordance with He-W 574.08, via the least costly route, as described in He-W 574.10(d) .