# How to Provide NEMT Rides for PrimeWest Health in 2027

Canonical URL: https://nemtguide.com/brokers/primewest-health/ · Updated 2026-10-02

PrimeWest transportation is the ride benefit PrimeWest Health runs itself for Medical Assistance members in 24 rural Minnesota counties. Members book through its Transportation Contact Center at 1-888-814-6643 at least two business days ahead, and PrimeWest staff call contracted companies with each ride. To get those trips you need a MnDOT special transportation service certificate, MHCP enrollment, and a signed PrimeWest Provider Participation Agreement.

- PrimeWest schedules its members' rides itself and calls contracted companies directly. A company may not take a ride request straight from a member.
- Since January 1, 2026, PrimeWest is the only Families and Children (PMAP) plan in its 24 counties, after Blue Plus members there moved over.
- Send a driver roster through the PrimeWest web portal on the first of every month. Put the driver's license number on every Mode 3 to 7 claim and the driver's UMPI on every Mode 4 to 7 claim.
- From April 1, 2026, the Mode 4 mileage rate (S0215) is $1.48, and rural and super-rural trips earn RUCA add-ons.
- Claims are due within 180 days of the ride, on the 837P, with both the pickup and drop-off address.

PrimeWest Health is a Medical Assistance and MinnesotaCare health plan owned by 24 rural Minnesota counties. Two commissioners from each county sit on its Joint Powers Board, and its About Us page, updated April 11, 2025, counts more than 17,000 contracted health care and human services providers in its network.

As a county-owned plan, PrimeWest pays for its members' rides and runs the scheduling with its own staff. Its transportation coordinators take each request and phone a contracted company to drive it, so the contract you need is with PrimeWest itself.

Minnesota law sets the floor for every ride company: an STS certificate from MnDOT, enrollment with Minnesota Health Care Programs (MHCP), and trip records that meet Minnesota Statutes 256B.0625, subdivision 17b. The [Minnesota guide](https://nemtguide.com/states/minnesota/) walks through each one. The statewide or regional NEMT administrator the legislature ordered in 2025 cannot take over PrimeWest's rides until DHS gives health plans, including county-based plans, six months' notice, a condition Laws 2026, chapter 121 added ([the delay report](https://nemtguide.com/news/minnesota-nemt-administrator-delay/)).

## Where PrimeWest members live and who can ride

PrimeWest serves Beltrami, Big Stone, Chippewa, Clearwater, Cottonwood, Douglas, Grant, Hubbard, Jackson, Kandiyohi, Lac qui Parle, Lincoln, Lyon, McLeod, Meeker, Nobles, Pipestone, Pope, Redwood, Renville, Stevens, Swift, Traverse, and Yellow Medicine counties.

On December 11, 2025, PrimeWest told providers that from January 1, 2026 it would be the single plan option for Prepaid Medical Assistance Program (PMAP) Families and Children enrollees under 65 in all 24 counties, and that Blue Plus enrollees there would move to PrimeWest automatically. A December 30, 2025 update said PrimeWest honors existing Blue Plus authorizations for services it also authorizes. Families and Children rides in these counties now come through PrimeWest rather than [BlueRide](https://nemtguide.com/brokers/blue-plus-blueride/).

PrimeWest-administered NEMT covers members with no transportation of their own in these programs:

- **Families and Children,** Medical Assistance for pregnant people, children under 21, and adults under 65.
- **Minnesota Senior Care Plus (MSC+).**
- **Special Needs BasicCare (SNBC).**
- **Prime Health Complete and PrimeWest Senior Health Complete,** its two HMO special needs plans.
- **MinnesotaCare,** for enrollees under 19 and pregnant enrollees only.

Rides to waiver services are the waiver program's job. Members may ride up to 30 miles to a primary care provider or 60 miles to a specialty provider, and PrimeWest denies out-of-state NEMT. For the costs of long rural runs, see [rural NEMT](https://nemtguide.com/guides/rural-nemt/).

## How PrimeWest schedules rides

Members call the Transportation Contact Center at 1-888-814-6643 at least two business days before the ride. With less notice, scheduling depends on which companies can take it. The rules on your side:

- **Wait for the call.** PrimeWest staff contact companies directly and expect a quick answer so rides get set up in time.
- **Send members back.** Do not accept a ride request from a member. Give any member who calls you the contact center number.
- **Medical necessity comes first.** NEMT needs a statement of medical necessity. The coordinator gathers the details, asks the treating provider for the statement, and passes it to PrimeWest's Appeal and Grievance staff for review.
- **Recurring trips.** Members can book a series up to 30 days at a time, or longer for dialysis, child day treatment programs, chemotherapy, and dialectical behavior therapy.
- **Opioid treatment programs.** PrimeWest picks providers and drivers at random, when feasible, for rides to these clinics. See [methadone clinic rides](https://nemtguide.com/guides/methadone-clinic-rides/).
- **Pharmacy-only trips.** Allowed only when the member has no other way to get the prescription, with every prescription picked up on one date and no repeat trips that week or month.
- **A parent or helper.** One responsible person, such as a family member or guardian, may ride with the member, and that person is included in your payment.

After-hours rides, before 7 a.m. or after 6 p.m. on weekdays and all day on weekends and holidays, are covered, but PrimeWest does not require you to run then. If a member, a hospital discharge planner, or a nursing home asks you directly for a ride at night, on a weekend, or on a holiday, secure email transportation@primewest.org within one business day with the member's name, PrimeWest member ID, and ride date. A late or incomplete report lets PrimeWest deny the claim.

A member under 18 riding without a parent or guardian needs PrimeWest's Unaccompanied Minor Transport Form, signed by the parent and received by PrimeWest before the trip is scheduled. It is good for one year, and you keep a signed copy in your records. Minors going to family planning services need no form. The [children in NEMT guide](https://nemtguide.com/guides/children-in-nemt/) covers riding with minors.

## What PrimeWest requires of your company and drivers

PrimeWest's NEMT page, updated December 8, 2025, lists the standing requirements:

- **STS certificate.** Send proof of your MnDOT STS certificate with the Provider Participation Agreement, and proof of each renewal within 30 days of the MnDOT renewal date.
- **Vehicle markings.** Both sides of every vehicle show your business name and USDOT number, or "STS" followed by your MnDOT certificate number, in a contrasting color readable from 50 feet in daylight. Removable signs count if they meet the same test. See [NEMT vehicle signage](https://nemtguide.com/guides/nemt-vehicle-signage/).
- **Wheelchair vans.** A lift or ramp ride (Mode 5) is for a member who cannot walk without a wheelchair, cannot transfer alone to a regular seat, and needs a lift or ramp. A member who transfers alone counts as ambulatory. Your van must run under MnDOT authority, and PrimeWest pays the wheelchair codes only when the member's file shows wheelchair certification and your provider record carries the wheelchair code indicator.
- **Protected rides.** A [protected transport](https://nemtguide.com/glossary/protected-transport/) vehicle, never an ambulance or police car, has safety locks, a video recorder, and a clear thermoplastic partition, and your company holds MnDOT protected transport certification. A crisis team or hospital completes the DHS-6715 assessment and sends it to PrimeWest within 48 hours, and each certification covers one trip leg on one date. A driver and an attendant ride along, unless the member was stabilized in an emergency department just before a trip under 100 miles.
- **Monthly driver roster.** Submit the NEMT Driver Roster through the PrimeWest provider web portal on the first of every month, with each driver's name, license number, state, and expiration date, UMPI, and hire and end dates. PrimeWest accepts no paper copies and may deny claims when a roster is missing.
- **Exclusion checks.** Check every driver against the OIG exclusion list, SAM, and the MHCP excluded provider list at hire and every month, and tell PrimeWest at once about anyone under investigation, excluded, or fired for fraud. Minnesota Statutes 256B.064, subdivision 3 also makes you record the date, time, and checker's name and title. The [exclusion screening log](https://nemtguide.com/templates/exclusion-screening-log/) fits this routine.
- **Changes.** Report new or dropped counties, locations, and dispatch offices right away, and any ownership change on PrimeWest's Disclosure of Ownership and Control Interest Statement.

Contracted providers also carry general liability of $1 million per occurrence and $3 million aggregate, which PrimeWest checks at assessment and every 36 months, and complete cultural competency learning every year. Drivers and companies may not offer or accept anything of value from members, other providers, or PrimeWest staff, and may not steer members to a particular company or driver.

## How to join PrimeWest's network

1. **Earn your MnDOT STS certificate.** The [Minnesota guide](https://nemtguide.com/states/minnesota/) explains the application and inspection.
2. **Enroll with MHCP.** Federal rules (42 CFR 438.602) make the state screen and enroll every network provider of a Medicaid health plan. Enroll the company through the Minnesota Provider Screening and Enrollment portal, and make sure each driver who will drive Modes 4 to 7 has a UMPI, because those claims list the driver's UMPI as the rendering provider.
3. **Send the Participation Request.** PrimeWest's Participation Request for a contracted facility (form PW_10-19_440R_11-21) asks for provider type Medical Transportation 82, the modes you run from volunteer (Mode 2) to stretcher (Mode 7), every Minnesota county you serve, your NPI and UMPI, and whether you are enrolled as a Minnesota Medicaid provider. Attach your general liability certificate, W-9, ownership disclosure, and EFT and ERA forms. Leave nothing blank, because incomplete forms come back.
4. **Wait for the decision.** PrimeWest staff review the request and notify your contact person. Approval is not guaranteed, and nothing is final until the contract is executed.
5. **Sign the Provider Participation Agreement.** Include your STS certificate proof, and keep the renewal proof coming each year.

Payment setup may take longer for a new company. Since September 4, 2026, PrimeWest has put new EFT enrollment requests on hold while it moves EFT enrollment to a new payment management system, while existing EFT payments continue. After you sign, give PrimeWest written notice at least 45 days before any change to the details on your Participation Request. A company without a contract must register as a non-participating provider before it bills, and it cannot bill wait time. The [health plan contracting guide](https://nemtguide.com/guides/contract-with-medicaid-health-plans/) covers what any plan contract asks for.

## How to bill PrimeWest for rides

Every claim goes in electronically on the 837P with place of service 99. Use the code for the level of service you gave, not the vehicle you drove, and put the same origin and destination modifiers on the pickup line and its mileage line. Each leg of a round trip goes on its own lines. PrimeWest's billing guide shows a round trip from home to a doctor's office and back this way, with R for residence and P for physician's office:

| Leg | Code | Modifier | Units |
|---|---|---|---|
| Home to doctor's office, pickup | T2003 | RP | 1 |
| Home to doctor's office, miles | S0215 | RP | 2 |
| Doctor's office to home, pickup | T2003 | PR | 1 |
| Doctor's office to home, miles | S0215 | PR | 2 |

The rules that decide your pay:

- **Mileage.** Bill the most direct route from commercial mapping software, rounded to the nearest mile (0.6 to 0.9 rounds up, 0.1 to 0.5 rounds down), never zone mileage. From April 1, 2026, the Mode 4 rate for [S0215](https://nemtguide.com/glossary/s0215/) is $1.48 a mile, and claims priced at the old rate must be resubmitted as replacements (update of May 8, 2026).
- **RUCA add-ons.** In super-rural areas the base rate is 111.3% of the normal rate. In rural and super-rural areas, mileage pays 125% on trips of 17 miles or less and 112.5% on trips of 18 to 50 miles, with no add-on at 51 miles or more. PrimeWest's NEMT page says the ZIP code of the company doing the ride decides which applies.
- **Wait time.** Contracted companies bill [T2007](https://nemtguide.com/glossary/t2007/) at $10.00 per 30-minute unit after the first 60 minutes of a round trip wait, with the drop-off time, pickup time, and minutes waited on the trip log. The billing guide caps it at 2 units a day, while the NEMT page says 4 units. It is not billable for non-pregnant MinnesotaCare adults, and PrimeWest says wait time should never exceed the mileage back to the garage.
- **Shared rides.** Bill mileage only for the member with the longest trip, and no empty miles after the first pickup. See [multiloading](https://nemtguide.com/guides/nemt-multiloading/).
- **Empty miles.** Bill no-load legs with the TP modifier and odometer readings on the trip sheet. The NEMT page says unloaded miles must match the shortest distance from your garage to the pickup, while the definitions page, updated January 11, 2023, says PrimeWest does not pay garage-to-pickup miles, so confirm with the Provider Contact Center.
- **Driver and addresses.** Put the driver's license number, with every character and no dashes or spaces, in the SV101-7 field on Modes 3 to 7, or the claim denies. Since June 1, 2025, Modes 4 to 7 also list the driver's UMPI as rendering provider, and Mode 3 lists it when the driver has one. Mode 3 to 7 claims received on or after March 1, 2025 need both addresses.
- **Deadlines.** PrimeWest must receive claims within 180 days of the date of service and corrected claims within 180 days of the remittance advice, and it denies dates of service older than 34 months.

PrimeWest does not pay for rides to a Day Training and Habilitation site or adult day program, a higher level of service than the member needs, an emergency room unless it is a scheduled appointment or the entrance to urgent care, an extra stop for a parent or helper, a drop-off changed without the coordinator's approval, or treatment court.

## Trip records PrimeWest can audit

The NEMT page has you keep trip records for five years from the date of service, and the billing guide counts five years from the date the ride is first billed. PrimeWest's general provider requirements, updated August 8, 2025, ask every provider to keep documentation of services and claims for at least 10 years. Keeping trip records for 10 years meets all three.

Each trip record, in English and legible, carries the member's name and PrimeWest ID on every page, the trip date, pickup and drop-off times marked a.m. or p.m., both addresses, the vehicle's plate number, odometer readings at the start and end, and the driver's license number, printed name, and NPI or UMPI. Add the mode, the mapping source for the miles, the starting point of any empty miles, any no-show activity, wait minutes, and the extra attendant's name on a stretcher ride. The driver signs a statement that the miles and times are accurate, and the member or the medical provider signs that the ride happened, with the destination signature showing a scheduled appointment. The [trip documentation guide](https://nemtguide.com/guides/nemt-trip-documentation/) and the [trip log template](https://nemtguide.com/templates/nemt-trip-log-template/) cover the same fields.

## Who to call at PrimeWest Health

- **Transportation Contact Center:** 1-888-814-6643 for scheduling, and secure email to transportation@primewest.org for after-hours reports.
- **Provider Contact Center:** 1-866-431-0802, fax 1-320-335-5285, weekdays 8 a.m. to 4:30 p.m., closed noon to 1 p.m. and from 8 to 9 a.m. on the second Thursday of each month.
- **Contracting:** contracting@primewest.org.
- **Claim attachments:** fax 1-320-762-1805 with the cover sheet, within three days of the claim.
- **Mail:** PrimeWest Health, 3905 Dakota St, Alexandria, MN 56308.

[South Country Health Alliance](https://nemtguide.com/brokers/south-country-health-alliance/) is another county-based plan that runs its own ride program, in seven southern Minnesota counties. A PrimeWest contract does not cover its members, so each plan needs its own contract.

## Frequently asked questions

### Does PrimeWest Health use a transportation broker?

No. PrimeWest employs its own transportation coordinators, and members call its Transportation Contact Center at 1-888-814-6643 to set up rides. PrimeWest then contacts a transportation company directly for each one. Its provider manual tells companies not to accept ride requests from members and to send any member who calls them to the contact center.

### How do I become a PrimeWest transportation provider?

Get your MnDOT special transportation service certificate and enroll with Minnesota Health Care Programs. Then send PrimeWest its Participation Request for a contracted facility, choosing provider type Medical Transportation 82, checking each mode you run, and listing every county you serve. If PrimeWest approves, sign the Provider Participation Agreement and include proof of your STS certificate. Approval is not guaranteed.

### Does PrimeWest pay for wait time?

Only to contracted companies, only on a round trip where the driver stays, and only after the first 60 minutes. Bill T2007 at $10.00 per 30-minute unit. The billing guide, updated July 7, 2025, allows 2 units a day, and the NEMT page, updated December 8, 2025, says 4 units, so ask the Provider Contact Center which limit applies before you bill more than 2.

### Which counties does PrimeWest Health cover?

Twenty-four: Beltrami, Big Stone, Chippewa, Clearwater, Cottonwood, Douglas, Grant, Hubbard, Jackson, Kandiyohi, Lac qui Parle, Lincoln, Lyon, McLeod, Meeker, Nobles, Pipestone, Pope, Redwood, Renville, Stevens, Swift, Traverse, and Yellow Medicine. The counties own the plan, and since January 1, 2026 PrimeWest is the only Families and Children plan in all of them.

### How long do I have to bill PrimeWest for a ride?

PrimeWest must receive the claim within 180 days of the date of service. Corrected claims are due within 180 days of the remittance advice, and claims for dates of service older than 34 months are denied. Every claim goes in electronically, and claims for modes 3 to 7 received on or after March 1, 2025 need both the pickup and drop-off address.

### Can I give a PrimeWest member a ride at night or on a weekend?

Yes. PrimeWest covers rides before 7 a.m. or after 6 p.m. on weekdays and all day on weekends and holidays, though it does not require companies to run then. When a member, hospital discharge planner, or nursing home asks you for a ride at those times, email transportation@primewest.org within one business day with the member's name, PrimeWest ID, and ride date, or PrimeWest may deny the claim.

## Official resources

- [PrimeWest Health: Administered NEMT services](https://www.primewest.org/pwh-administered-nemt)
- [PrimeWest Health: Transportation billing](https://www.primewest.org/transportation-billing)
- [PrimeWest Health: Enrollment process and Participation Request form](https://www.primewest.org/join-our-network/enrollment-process)
- [PrimeWest Health: Provider Updates](https://www.primewest.org/provider-updates)
- [Minnesota DHS: Protected Transport Level-of-Service Assessment (DHS-6715)](https://edocs.dhs.state.mn.us/lfserver/Public/DHS-6715-ENG)
- [HHS OIG: List of Excluded Individuals and Entities](https://oig.hhs.gov/exclusions/)