Non-Emergency Medical Transportation (NEMT) Attestation of Medical Necessity
Form Template
Because Medicaid only pays for health care and medical services that are a medical necessity, physicians are required to attest that Medicaid enrollees need medical services and/or transportation services.
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The Non-Emergency Medical Transportation (NEMT) Attestation of Medical Necessity app allows users to provide physician certification for non-emergency medical transportation (that will be Medicaid-funded). This form constitutes a prescription and attestation of the medical necessity for transportation services. Users must submit the app at least 48 hours prior notice for all standard requests. The Non-Emergency Medical Transportation (NEMT) Attestation of Medical Necessity app is quick and simple to fill out for submission and review.
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