To get paid for driving a Medicaid patient to a medical appointment in Texas, you use Form H3017, the Individual Transportation Participant Service Record, and the Texas Medicaid gas mileage reimbursement process built around it. You do not download the form. The Medical Transportation Program (MTP) mails a preprinted H3017 to the Medicaid client after each ride is authorized, you complete it and get a provider signature after the trip, and you mail it to TMHP within 95 days of the ride.
Register as an ITP Before You Drive
Anyone who drives a Medicaid client in their own vehicle for reimbursement is called an Individual Transportation Participant, or ITP. You can be a relative, friend, or neighbor, but you have to be registered with TMHP before any trip can be paid.1TMHP. Medical Transportation Program Handbook
Registration starts with the client, not you. The Medicaid client calls MTP and asks for you specifically as their ITP. TMHP will not accept an application that comes in without that initial request on file. After the call, TMHP mails a registration packet to you containing the Individual Transportation Participant Application and an Electronic Funds Transfer (EFT) Agreement form. You fill out the application, identify which MTP clients you will be transporting, say whether you are related to them, and mail everything back.
Once approved, TMHP sends a letter with two numbers: your Atypical Provider Identifier (API) and your Taxonomy Code. Both go on every claim. Until that letter arrives, you cannot file for payment, so get registered before the first trip rather than after.
Getting Each Ride Authorized
Every trip has to be authorized in advance, and the client places the call, not you. Timing is set in rule:2Texas Administrative Code. Texas Administrative Code Title 1 Part 15 Chapter 380 Section 380.205 – Program Processes
- Routine trips: request at least two working days before the appointment.
- Long-distance trips: request at least five working days before the appointment.
- Late requests may be granted when circumstances were beyond the client’s control, with the exception documented in the client’s record.
After authorization, MTP mails a preprinted H3017 directly to the Medicaid client.3TMHP. Medical Transportation Program Handbook – Section 2.2 Prior Authorization for ITPs Only authorized claims will be considered for payment, so there is no way to drive first and arrange paperwork later.
Completing the H3017 After the Trip
When the H3017 arrives, most of the trip detail is already filled in: date of the ride, number of miles authorized, MTP Authorization Number, client’s name, your name, your API, and your Taxonomy Code.4TMHP. Medical Transportation Program Handbook – Section 2.3 Claims Filing for ITPs
Two signatures turn the preprinted form into a payable claim. The doctor, dentist, or pharmacy representative who provided the covered service signs the H3017 to confirm the client actually showed up. Then you sign the form and verify that the API and Taxonomy Code printed on it are correct.
Check every field before you leave the provider’s office. A blank signature line, a wrong API, or a missing authorization number is enough to kill the claim. Going back a week later for a forgotten signature is possible, but it eats into your 95-day filing window.
Where to Mail the Claim and the 95-Day Deadline
Mail the completed H3017 to TMHP:4TMHP. Medical Transportation Program Handbook – Section 2.3 Claims Filing for ITPs
Texas Medicaid & Healthcare Partnership
Claims
PO Box 200555
Austin, TX 78720-0555
Mail is the designated submission method; the handbook does not list a fax number or online portal for ITP claims. The H3017 must reach TMHP no later than 95 days from the date of the ride. Anything received after that is denied, with no exceptions mentioned in the handbook. Count on a few days for delivery rather than relying on your postmark.
How You Get Paid
If you returned the EFT Agreement with your registration packet, approved payments go straight into your bank account. TMHP notes that electronic deposit results in faster payments.1TMHP. Medical Transportation Program Handbook Without EFT, a paper check arrives by mail and takes longer.
The per-mile rate is set by HHSC and has been adjusted periodically. TMHP published a change effective July 1, 2022, but the current rate is not posted in a single easy-to-find spot on TMHP’s website.5TMHP. ITP Mileage Reimbursement Rate Change Effective July 1, 2022 Call TMHP’s provider line or ask during registration if you need to confirm it. Payment is calculated from the authorized miles printed on your H3017, not from your odometer, so the amount is set before you drive.
You cannot charge the Medicaid client a fee for completing claim forms, for denied claims, or for any amount above the approved reimbursement rate, and you cannot bill TMHP for the cost of filing claims either.4TMHP. Medical Transportation Program Handbook – Section 2.3 Claims Filing for ITPs
Why ITP Claims Get Denied
Most denials trace back to the same handful of paperwork problems:
- No provider signature on the H3017, so there is no proof the appointment happened.
- No ITP signature.
- Wrong or missing API or Taxonomy Code, which prevents the claim from matching your registered account.
- No prior authorization because the trip was never called in before it happened. Retroactive authorization is not available for routine trips.
- Received by TMHP more than 95 days after the date of the ride.
These are hard denials in most cases, not fix-and-resubmit situations. Review the form carefully before it goes in the envelope.
If a Claim Is Denied
Medicaid participants and providers can appeal denials. Texas HHSC allows a fair hearing request within 90 calendar days of the denial, and contact information is typically included in the denial notice. If the denial looks like a data-entry mistake on MTP’s end rather than something missing from your form, request the hearing promptly rather than waiting it out.
A Note on Regional Brokers
HHSC does not coordinate every MTP ride directly. Under 2013 legislation, HHSC contracted with Managed Transportation Organizations to handle nonemergency transportation across groups of counties, and in the Dallas-Fort Worth and Houston-Beaumont service areas, full-risk brokers Medical Transportation Management Inc. and LogistiCare Solutions, LLC coordinate rides through their own networks.6Texas Health and Human Services Provider Finance Department. Medical Transportation Program (MTP) For an ITP, this is mostly invisible: you still receive the preprinted H3017, and claims still go to TMHP at the Austin PO Box regardless of which organization authorized the trip.