Medi-Cal TAR for NEMT: The Treatment Authorization Request for Van Rides

Fee-for-service Medi-Cal pays for a wheelchair or litter van ride only after it has approved that ride. You ask for the approval on a Treatment Authorization Request, or TAR, and its number travels with your claim. This page covers getting the TAR, reading the answer, and billing so the claim matches it. For how ride approvals work in other states, see prior authorization.

Which Medi-Cal rides need a TAR

Every non-emergency medical ride for a fee-for-service rider needs a TAR. The codes page of the ground transportation manual (updated September 2023) lists the wheelchair van and litter van codes, including A0130, A0380, T2001, T2005, and T2007, under “the following services require a TAR.” The rider must also be eligible for Medi-Cal on the date of the ride, so run an eligibility check before you send the request.

Medi-Cal approves only the lowest cost type of ride that meets the rider’s medical needs, and only to the nearest facility that can meet them (22 CCR 51323(b)). A request to drive past a closer clinic that offers the same care may not be approved.

There is one exception. A ride from an acute care hospital, right after an inpatient stay, to a nursing facility at level A or B needs no TAR, prescription, or clinician signature. You bill it with modifiers HN and QN at the same maximums as a TAR trip, such as $20.30 for A0130 (codes page updated March 2024). Medi-Cal does not cover waiting time or night calls on a transfer to level A care.

Health plan members are different. Their plan approves rides with a PCS form, and Medi-Cal denies a fee-for-service TAR for a plan member unless the plan has denied the ride. A few plans also want their own TAR, sent to the plan: Partnership HealthPlan requires one with its PCS for rides that carry a TAR requirement (policy last reviewed January 14, 2026). The Medi-Cal PCS form guide covers how plans approve rides and what the prescription for a fee-for-service TAR must say.

How to send a TAR: eTAR or paper

Both routes go to the TAR Processing Center, which handles every NEMT TAR. On either one you list the procedure codes with their modifiers, up to four per code, and write the medical justification. Modifier 99 is not allowed on NEMT codes. Send a legible prescription with it, or for a rider who lives in a facility, an order sheet signed by the physician.

What differs	eTAR	Paper TAR (form 50-1)
Where you send it	Online, under Transactions, then Online TAR Applications, on the Medi-Cal Providers website	820 Stillwater Road, West Sacramento, CA 95605-1630, or P.O. Box 13029, Sacramento, CA 95813-4029
Where modifiers go	The Modifiers box of the Transportation Service Codes and Total Units field	After the code in box 11
Attachments	Upload them, or fax 1-877-270-8779 with a TAR 3 Attachment form on top	Mail them with the TAR
How you get the answer	Check the TAR online; no Adjudication Response is mailed	An Adjudication Response by mail, or by fax if you put a fax number in box 1B

For a paper TAR, you can also check status on the Provider Telecommunications Network at 1-800-786-4346, 7 a.m. to 8 p.m., seven days a week.

What the answer means

The consultant decides each service line four ways: approved as requested, approved as modified, denied, or deferred. The Adjudication Response shows the decision, the reason, the approved units, the “from-through” dates, and the pricing indicator.

1. Approved. Run the rides inside the approved dates, which can cover up to a year when treatment warrants it. Keep the Adjudication Response on file.
2. Approved as modified. Read the units and dates closely. They may be fewer or shorter than you asked for, and only what was approved gets paid. You can appeal a modification the same way as a denial.
3. Deferred. Send the missing information within 30 days, or the TAR is denied. On an eTAR, upload it or fax it with the TAR 3 Attachment form; on paper, mail it with the Adjudication Response as the cover sheet.
4. Denied. You may appeal in writing within 180 calendar days of the TAR action date. Mail it to TAR Processing Center Appeals at either address above, never by fax, with a copy of the Adjudication Response, the dates in dispute, why it should be granted, the medical records, and a new completed paper TAR (appeals page, September 2024).

For rides after the approved dates end, send a reauthorization TAR by eTAR or mail before the old one runs out.

How the claim must match the TAR

Each TAR has a 10-digit TAR control number, and the last column of the Adjudication Response gives a pricing indicator. Add the indicator as the 11th digit, and put all 11 digits in box 23 of the CMS-1500. A claim without the pricing indicator as the 11th digit is denied. You do not attach a copy of the TAR.

Medi-Cal’s TAR Overview and claim form instructions name the common mismatches that cost you the payment:

• Units. The units you bill must not exceed the units approved.
• Codes and modifiers. The procedure code and every modifier must be the ones on the TAR.
• Provider. Your provider number or NPI must be the one the TAR approved.
• Dates. Every ride must fall inside the approved period.
• Mixed claims. Bill TAR rides and services that need no TAR on separate claims.
• One TAR per claim. Only one TAR control number can cover a claim, so rides on two TARs go on two claims.

A billing example

Say a fee-for-service rider goes from home to a dialysis clinic 9 miles away, three times a week, in your wheelchair van. The nephrologist’s prescription gives the purpose, the schedule, and the condition that rules out a car or bus, and because the rides are ongoing, it shows the condition is chronic and comes with a treatment plan. Your TAR asks for A0130 and A0380 for October 1 through December 31, and the consultant approves 78 trip units and 702 mileage units: 39 dialysis days, two legs a day, 9 miles a leg.

For each dialysis day you bill A0130 with 2 units and A0380 with 18 units. The prescribing doctor goes in box 17 with the NPI in 17B, both pickup times and the full addresses with city and ZIP go in box 19, the addresses also go in box 32, and the 11-digit TAR number goes in box 23. At the maximums on the codes page (updated September 2023), each day pays up to 2 × $20.30 plus 18 × $1.50, or $67.60. Medi-Cal pays your usual charge to the public, up to those maximums, which come from California’s state plan amendment 22-0039, effective July 1, 2022.

If the rider’s schedule grows, the extra legs come out of the same 78 units, and rides past the approved units are not paid on that TAR. Send a new TAR for the extra rides, with a copy of the first Adjudication Response, before you run them. If you run two round trips for the rider on one day, list both times and places in box 19 and add modifier 76, or the second trip can deny as a duplicate.

TARs for riders who share a van

When you take more than one rider from the same pickup point to the same place in one van, each rider needs a TAR. Each TAR lists the names and TAR control numbers of all the riders in its medical justification field. If there is not room, write “see attached” and attach a sheet.

A single TAR may also be approved for a trip with several riders, with the number of riders in box 8C. If it is approved for three or more and fewer ride on the day, you need no new TAR as long as more than one rides. If only one rider goes, you need a new TAR. How the shared trip is billed, with modifiers UN through US and mileage on the first rider’s claim only, is on the A0380 page.

For enrollment, vehicle rules, and how health plan rides work in the state, see the California guide.