To qualify for a Medicaid-paid ambulette, taxi, livery, or stretcher van in New York, you need a completed New York Medicaid Transportation Form-2015 on file with Medical Answering Services (MAS), the state’s transportation broker. Your medical provider fills out the form, not you. Once MAS approves it, you call to schedule each ride. The same process applies whether you are in a managed care plan or fee-for-service Medicaid.1New York State Department of Health. Enrollee Frequently Asked Questions (FAQs)
When You Need Form-2015
Form-2015, officially the Verification of Medicaid Transportation Abilities, is only required when a medical condition keeps you off ordinary public transit. If you can take a bus, subway, or commuter train to your appointment, MAS will arrange that and no form is needed. The form exists because Medicaid covers several levels of transport beyond public transit, and state regulations require payment only for the least expensive mode that fits your medical situation.2Cornell Law School. New York Code 18 NYCRR 505.10 – Transportation for Medical Care and Services What your provider writes on Form-2015 tells MAS which mode to authorize.
What You Bring to Your Provider
Your job is to get the right information into your provider’s hands so they can complete the form accurately the first time. Bring your Medicaid Client Identification Number (CIN), which appears on your NYS benefit card or managed care plan card. Your provider will also need your full legal name, date of birth, gender, home address, and phone number. Every one of these has to match what Medicaid has on file. Mismatched demographics are one of the easiest ways to slow down a request that would otherwise be routine.
Providers can get blank copies of the form from the MAS website at medanswering.com, from the New York State Department of Health forms library, or by calling MAS at (844) 666-6270.3Amida Care. Amida Care Medicaid Transportation Guide Most offices already know the form.
What Your Provider Documents
The medical necessity section is the part MAS actually reads. Your provider has to name your diagnosis and explain in concrete terms why it prevents you from using public transit.3Amida Care. Amida Care Medicaid Transportation Guide “Patient cannot travel” is not enough. Specifics work: oxygen dependence, severe mobility impairment, a cognitive condition that makes navigating transit unsafe.
The Transportation Mode
Because Medicaid pays only for the cheapest mode that fits your condition, the level your provider selects has to line up with the clinical picture they described.2Cornell Law School. New York Code 18 NYCRR 505.10 – Transportation for Medical Care and Services The choices are:
- Taxi or livery, for people who can walk and sit in a standard vehicle but cannot use public transit. Livery service is a New York City category and requires taxi and limousine commission licensing.4eMedNY. Medicaid Transportation Policy Manual
- Ambulette, a specialized vehicle for wheelchair or stretcher use when a standard car seat is not workable.4eMedNY. Medicaid Transportation Policy Manual
- Stretcher ambulette, for people confined to bed who cannot sit in a wheelchair but do not need medical monitoring during the trip. It is not for anyone who is sedated or needs treatment en route.4eMedNY. Medicaid Transportation Policy Manual
- Non-emergency ambulance, for people who need medical attention during transport in a non-emergency situation.
If your condition changes and you no longer need the mode currently authorized, your provider has to submit a new Form-2015 to adjust it.
Trip Frequency and a Medical Escort
The form should say whether the transport is for a single visit or ongoing treatment. For recurring care like dialysis three times a week, the provider should spell out the frequency and duration so one authorization covers the whole course of treatment.5eMedNY. Medicaid Transportation Guidelines for New York City Medical Practitioners and Facilities If you need someone to ride with you because of cognitive impairment, severe anxiety, or a need for physical help, the provider must check the medical escort box and give a clinical reason. Attendant costs are covered when medically necessary.2Cornell Law School. New York Code 18 NYCRR 505.10 – Transportation for Medical Care and Services
Provider Information
The form needs the provider’s 10-digit National Provider Identifier (NPI), their signature, and the name and address of the treating facility.6Centers for Medicare & Medicaid Services. National Provider Identifier Standard A missing NPI or an unsigned medical necessity section will get the form rejected.
If You Are Traveling Outside Your Area
When treatment requires going outside your Common Medical Marketing Area, the geographic zone where your community normally receives care, your provider has to submit Form 2020-U along with Form-2015. Form 2020-U asks the provider to explain why the care is not available locally, identify the specialist you are being sent to, and note whether multiple visits are expected.7Medical Answering Services. Request for Transportation Outside the Common Medical Marketing Area If local options technically exist but your provider believes they are not appropriate for you, they have to say why.
How the Form Is Submitted
Your provider submits the completed form to MAS one of two ways:
- Online, through the secure provider portal on the MAS website. This is the fastest route.
- By fax, to (315) 299-2786.3Amida Care. Amida Care Medicaid Transportation Guide
For faxed submissions, MAS generally takes five to seven business days to approve or deny once it has everything it needs.3Amida Care. Amida Care Medicaid Transportation Guide Portal submissions can move faster. Ask your provider to keep the fax confirmation or a timestamped receipt. If MAS later questions whether the form was sent, that receipt is your only proof. Submit well before your first ride. Waiting until the week of the appointment leaves no room for error.
Scheduling Rides After Approval
Once Form-2015 is approved and on file, you schedule each trip yourself by calling MAS at least three days before the appointment.3Amida Care. Amida Care Medicaid Transportation Guide The number depends on your region:
- Downstate, including New York City: (844) 666-6270
- Upstate: (866) 932-77408New York State Department of Health. Medicaid Transportation
Have your CIN and the date, time, and address of the appointment ready. MAS confirms the pickup and matches the mode to what your provider certified. Cancel as early as possible if plans change; repeated no-shows can complicate future scheduling.
If something urgent comes up with less than three days’ notice, MAS may still arrange a ride, but that is case by case. For a true emergency, call 911 instead of the NEMT system.
Keeping Your Authorization Current
Form-2015 does not last forever. Your provider has to renew it at least once a year, or sooner if the end date on the current form comes first. A new form is also required whenever your condition changes enough to warrant a different transportation mode.9Medical Answering Services. Verification of Medicaid Transportation Abilities (Form-2015) Policy and Procedure Once the authorization lapses, MAS cannot approve rides until a fresh form is submitted and processed, which means several business days with no covered transportation.
Ask your provider to send the renewal about two weeks before the current one expires. If you have recurring appointments like dialysis, chemotherapy, or physical therapy, that lead time matters. Even a short gap can force you to miss treatment or pay out of pocket.
If MAS Denies the Request
If MAS denies your request outright or approves a lower mode of transport than your provider asked for, you can challenge the decision. Federal Medicaid rules require the state to send written notice explaining the specific reasons and the regulations behind the denial, and how to request a fair hearing.10eCFR. Fair Hearings for Applicants and Beneficiaries (42 CFR Part 431 Subpart E)
Before you file for a hearing, find out why the form was rejected. Sometimes it is a clerical problem, not a substantive one: an outdated form, a missing NPI, a signature that did not come through on the fax. Any of those can be fixed by resubmitting. Call the MAS provider hotline at (866) 371-3881 to find out what happened.
If the denial is substantive, request a fair hearing through the Office of Temporary and Disability Assistance (OTDA) at 1-800-342-3334. At the hearing you have the right to review your case file, bring witnesses, present evidence, and question the state’s witnesses.10eCFR. Fair Hearings for Applicants and Beneficiaries (42 CFR Part 431 Subpart E) A detailed letter from your provider describing your functional limitations and why the denied mode is medically necessary carries weight. Hearing officers respond to specifics.