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  • Transportation
  • Form

There is significant evidence that inability to access transportation can represent a major barrier to accessing medical care, particularly for low-income individuals, racial/ethnic minorities, people living with disabilities, and older adults who have chronic conditions that require frequent medical visits. The Non-Emergency Medical Transportation (NEMT) program was launched by Medicaid and has been shown to increase attendance at appointments for preventive care and chronic disease management in both urban and rural areas while reducing the need for inpatient medical treatment. 

MTM manages non-emergency medical transportation for Medicaid and Medicare recipients to attend medical appointments. This Level of Need Assessment Form can be filled out by providers to advocate for patients who experience transportation difficulties and would benefit from the use of MTM.


  1. Level of Need Assessment Form

Next steps

The completed form should be faxed to MTM (the phone number is on the form).