The United States General Services Administration announced an increase for the rate of Transportation Mile reimbursement rate, procedure code W7271, beginning January 1, 2019. The new rate is $0.58 per mile. This communication provides notice of the rate increase, as well as instruction for Supports Coordination Organizations (SCOs) on how to add transportation mileage to the vendor screen. It also instructs direct service providers on how to submit claim adjustments, if applicable.
Provider Types (PT) 54 with specialties 540 (Agency with Choice [AWC]) and 541 (Vendor Fiscal [VF]) and PT 55 (Vendor) with specialty 267 are able to receive payment from the Department for the Transportation Mile service authorized through base funding or the Consolidated, Community Living, or Person/Family-Directed Support (P/FDS) waivers.
Supports Coordinators (SCs) should ensure that individuals who receive the Transportation Mile service, procedure code W7271, are made aware of the change in the reimbursement rate. When applicable, SCs should complete a critical revision on Individual Support Plans (ISPs) that contain Transportation Mile, procedure code W7271, per ODP Bulletin 00-17-03, “Individual Support Plan Manual for Individuals Receiving Targeted Support Management, Base Funded Services, Consolidated or P/FDS Waiver Services, or Who Reside in an ICF/ID.” ODP Announcement 19-016 provides detailed instructions for making changes to reflect the new rate.
- Providers should ensure that individuals whom they reimburse for Transportation Mile service, procedure code W7271, are made aware of the change in the reimbursement rate.
- Providers who submitted claims for Transportation Mile (procedure code W7271), with dates of service January 1, 2019 and forward, using the old rate ($0.55) should submit claim adjustments using the appropriate rate to obtain the correct payment amount.
- NOTE: Only paid claim detail lines can be adjusted.
- When submitting a claim adjustment, bill the way the claim should have originally been submitted. Do not bill for the difference in rate. Include all claim lines that were originally submitted on the claim, including denied lines. Do not add or remove any claim lines when doing an adjustment.
- Use claim frequency “7” for an adjustment.
- Insert the last paid claim internal control number (ICN) in the “Original Claim #” field.
- For inquiries regarding billing/claims, please contact the ODP Claims Resolution Section via email or phone at 866-386-8880, Mon–Thurs 8:30 am–12:00 pm and 1:00 pm–3:30 pm.
Upon release of this announcement, Announcement 013-18 will be archived. Questions regarding this announcement should be addressed to the appropriate ODP Regional Program Managers.