PT-1 Form: How MassHealth Approves Rides Before a Broker Schedules Them

You never book a brokered MassHealth ride yourself. The member’s medical provider asks MassHealth for it on a PT-1, MassHealth approves it, and the regional broker schedules each trip and assigns it to a company. That makes the PT-1 the start of every broker trip you drive for MassHealth. The Massachusetts guide covers the program as a whole. This page covers the form and what it means for your schedule.

What the PT-1 form is

The PT-1 is the Provider Request for Transportation. Under 130 CMR 407.402, it is the form MassHealth uses to request brokered transportation, and it records both why the ride is medically necessary and who authorized it. Every brokered ride needs one under 130 CMR 407.421, including wheelchair van rides arranged by the broker (130 CMR 407.471). Public transportation is the only mode that needs no authorization.

Approved trips go to one of two regional transit authorities that act as brokers for the state’s human service transportation system: MART or GATRA, depending on the member’s city or town. Members can qualify when their coverage is MassHealth Standard, CommonHealth, or CarePlus. A nonemergency ambulance ride is outside the PT-1 system and needs MassHealth’s Medical Necessity Form.

Who can file one

The rule names four kinds of filers in 130 CMR 407.421(C):

• An authorized provider. A MassHealth-enrolled physician (including interns and residents), physician assistant, psychologist, dentist, nurse midwife, or nurse practitioner, or a registered nurse designated and supervised by an enrolled physician.
• A managed care representative. A clinical employee a MassHealth health plan designates to handle members’ ride requests.
• A day habilitation program representative. A registered nurse, licensed practical nurse, service manager, or program director at the day habilitation provider.
• An early intervention program representative. A registered nurse, occupational or physical therapist, psychologist, licensed clinical social worker, or speech and language pathologist at the early intervention provider.

GATRA and MART tell members that any one of their MassHealth providers can file a PT-1 for travel to another MassHealth provider. Your company cannot file one.

What the form asks and approves

The provider files online in MassHealth’s Customer Web Portal: under PT-1 Request Management, Create New PT-1. MassHealth stopped taking PT-1s by fax or mail. The provider needs the provider number, the member’s MassHealth ID, and the pickup address if it is not the member’s home. The form asks for the condition as an ICD-10 chapter and may ask about trip distance and public transportation.

That last question matters. Under 130 CMR 407.411, MassHealth pays for rides only when public transportation is not available, and it counts transit as available when it suits the member’s condition, runs on a regular schedule, and stops within 0.75 mile of both the home and the destination. A wait of up to an hour and up to two transfers count as reasonable. Rides to a pharmacy to pick up medicine are not covered.

What an approved PT-1 sets for your trip:

• One destination. Each location or service needs its own PT-1.
• The addresses. Rides are authorized only for the addresses on the form, so a regular pickup at a relative’s home must be listed.
• The level of help. PT-1 rides are curb to curb unless the provider requests an enhanced level, such as room to room for a member in a facility.
• Who rides along. An escort must be noted on the form and approved. MART says riding alone, without other passengers, also needs MassHealth’s approval on the PT-1.

How long a PT-1 takes and how long it lasts

As of May 2026, MassHealth’s member page says a PT-1 generally takes one business day to process, and up to three in some cases. When a ride cannot wait, the medical provider can call MassHealth Customer Service at (800) 841-2900 for a verbal approval, which 130 CMR 407.421(A) allows after a PT-1 is filed or when urgent care is needed. The member gets a letter saying whether it was approved, and a denial letter gives the reason and how to appeal. MassHealth asks members to book rides at least 3 business days before the appointment.

For recurring rides, the PT-1 states how long the need lasts, up to these limits in 130 CMR 407.421(C):

• Acute illness: 6 months.
• Chronic illness: 1 year.
• Early intervention: 3 years.
• Day habilitation: 5 years.

A PT-1 can also need replacing early. MassHealth’s provider FAQ says that when a member moves and reports the new address, every active PT-1 needs a new form, and the treating provider must file them within 30 days of the change to avoid a gap.

How a PT-1 becomes a trip on your schedule

1. MassHealth approves the PT-1 and assigns a broker by the member’s town. MART says it receives every PT-1 straight from MassHealth, and the broker sends the member a welcome letter the first time.
2. The member books with the broker by phone, online, or in the broker’s app: MART at (866) 834-9991 from 7 a.m. to 7 p.m. on weekdays, or GATRA at (800) 431-1713 from 7 a.m. to 6 p.m. on weekdays (hours as of May 2026).
3. The broker picks the company. Trips go out on a low-cost, most appropriate basis and on vehicle availability, and members cannot choose their company. MART books a trip only when a valid PT-1 is on file, and a daily eligibility check cancels trips for members who lost MassHealth coverage (quality plan revised July 23, 2025).
4. You run the trip at the approved level. The member page says the driver waits 15 minutes at a scheduled pickup, and a will-call return is picked up within 60 minutes of the call.
5. You are paid for what you complete. MART pays nothing for no-shows or cancellations at the door, and on a trip with several legs it pays only the legs completed. MART asks you to mark any trip you did not run in its Vendor Portal.

A dispatch example: a standing order near its end date

Say your company holds a standing order for a member who rides to dialysis three days a week. If the nephrologist files the PT-1 for a chronic illness, it runs at most one year. MART does not notify members when a PT-1 is about to expire, and once it ends, MART’s system cannot book further trips under it.

1. Ask for the end date early. MART tells members to keep the approval letter MassHealth mails them, because no reminder comes later. Note the date in your dispatch records.
2. Flag it about a month ahead. Tell the member, or the dialysis center’s social worker, that the nephrologist needs to file a new PT-1.
3. Watch for a move. If the member moves, every active PT-1 needs a new form within 30 days, and the new ones must list the new pickup address.
4. Give notice if you cannot keep the order. MART fines a company that stops a standing order with less than 3 business days’ notice.

For more on running recurring dialysis rides, see dialysis transportation. For how other programs approve rides before they happen, see prior authorization.