AmeriHealth Caritas Ohio Transportation: No-Limit Rides for Wheelchair Users and the Facility Direct Option

AmeriHealth Caritas Ohio is one of the seven health plans in Ohio Medicaid. The state’s annual managed care report counts an average of 167,324 members a month from July 2024 to June 2025, about 5.5 percent of everyone on Ohio Medicaid. MTM Health books and assigns its rides. Ohio makes every plan cover wheelchair van and ambulance trips at any distance and car trips to care 30 or more miles from home, and county job and family services offices handle many shorter rides; the Ohio guide explains both.

The MTM side of AmeriHealth work, such as the 48-hour booking request, the approval needed before a trip of 75 miles or more, and the consent form that lets a 16 or 17 year old ride alone, is on MTM Health in Ohio. This page covers what AmeriHealth’s own documents add: who never runs out of rides, a way for hospitals to call your company directly, and the free transit the plan pays for in Athens County.

Which AmeriHealth members ride without a yearly limit

AmeriHealth’s member handbook, issued August 1, 2026, puts three groups of rides outside any annual count:

• Every necessary ambulance and wheelchair van trip, at any distance.
• Treatment that repeats: chemotherapy, radiation, and dialysis, plus prenatal and postpartum visits.
• Medical visits for members who use a wheelchair. A member who rides in a wheelchair does not use up an allowance on trips to the doctor.

Ohio’s 2027 plan comparison, updated July 1, 2026, lists the same groups for AmeriHealth, wheelchair users included. Molina lists members who use a wheelchair outside its cap, and CareSource keeps wheelchair van trips outside its yearly maximum, so in all three plans that work does not run out partway through the year.

These riders are the steady base of AmeriHealth work. A dialysis patient’s runs never hit a ceiling, and a member in a wheelchair keeps riding to every covered visit. Run them as standing orders, and see dialysis transportation for how to win and keep those runs.

The 60 short trips and what counts against them

Most other rides under 30 miles come out of an allowance. The handbook gives up to 60 one-way trips a year to visits under 30 miles. AmeriHealth’s January 2026 provider manual builds that figure as 30 added one-way trips, for a total of 60 one-way or 30 round trips, and sets two rules a dispatcher should know:

• A ride to an out-of-network provider, arranged because AmeriHealth could not offer one in network, does not count against the allowance.
• The allowance covers medical and non-medical trips under 30 miles when the member cannot get a ride through the county job and family services office, pharmacy stops included.

Ohio’s 2027 comparison names the non-medical places members can go: county caseworker meetings to keep their coverage, WIC appointments, grocery stores, food banks, and work or job training. It adds that members in AmeriHealth’s care management programs may get more rides, and that members can choose Uber or Lyft. When a member uses up the allowance, the comparison has the plan help the member move to the county’s ride program; see Ohio county NET contracts.

The facility direct option for ambulance and wheelchair trips

AmeriHealth posts a second door into its trips, open only to wheelchair van and ambulance companies. Its Facility Direct Scheduling Option, effective February 1, 2023 and still listed under transportation forms on the plan’s provider forms page in October 2026, lets a hospital or other medical facility call an MTM-approved ambulance or wheelchair company directly for an AmeriHealth Caritas Ohio Medicaid member, without going through MTM’s call center.

Either side can pass. The facility may book through MTM or with any MTM-approved provider, and MTM gives facilities its approved list on request. You are not obliged to take a facility’s request when you have no van free. If you decline and the facility then calls MTM, MTM still asks for two business days’ notice unless the plan deems the visit urgent.

How to take facility direct trips

1. Sign the affidavit. AmeriHealth’s Ohio Facility Direct Scheduling Option Affidavit confirms you comply with your Transportation Provider (Ambulance) Letter of Agreement with MTM. Signing also lets MTM share your service area and phone number with the facilities that take part.
2. Check eligibility before each trip. The affidavit makes it your job to confirm the member is eligible on the date of service, and MTM strongly encourages checking in ODM’s Provider Network Management (PNM) portal. See eligibility verification.
3. Keep the medical necessity form on file. Hold a signed Certification of Medical Necessity for each rider, and send it within 30 days when MTM asks. Ohio’s form ODM 03452 is for riders outside a health plan, and rule 5160-15-27 says a health plan is not obliged to use it, so ask MTM which form it takes for AmeriHealth riders. See the Ohio wheelchair van certification and medical necessity forms.
4. Send the trip to MTM within 90 days. Submit the trip data no later than 90 calendar days after the ride, as an 837 electronic claim, which needs a connection set up with MTM, or as a CMS-1500 by secure file share, email, fax, or mail.
5. Watch for payment within 90 days. Approved trips are paid at the Medicaid fee schedule or at your contracted MTM rate.

MTM may refuse payment when the trip data arrives after 90 days, the member was not eligible that day, the ride is not a covered service, or the certification has not arrived within 30 days of MTM’s request. Questions go to ohioinquiry@mtm-inc.net.

The option pays off for companies that hospitals already know. Visit the discharge planners and dialysis social workers near you, tell them you are an MTM-approved wheelchair or ambulance provider for AmeriHealth members, and leave a number that answers. The hospital discharge guide and facility contracts cover that outreach.

Free transit the plan pays for in Athens County

Some of AmeriHealth’s ride money goes outside MTM. HAPCAP, the Hocking Athens Perry Community Action agency that runs transit in Athens County, credits AmeriHealth Caritas Ohio for free rides on Athens Public Transit and Athens On Demand Transit through April 2027. The free fares are open to anyone in the county, not only plan members.

Athens On Demand is shared, door-to-door service across the county. Its 2026 rules have riders call at least 24 hours ahead and no more than a week out, pick riders up within an hour of the requested time, allow two stops a day, and offer no recurring rides. So it can take some short errands off an Athens County van company’s schedule, but with no recurring rides, standing runs such as dialysis still need a van.

How to get AmeriHealth Caritas Ohio trips

Ride companies join through MTM, not AmeriHealth. The January 2026 provider manual sends companies that are not under contract to MTM’s network page, and companies already under contract to MTM at 1-888-597-1180 or their MTM vendor account manager for claim submission. The same manual says MTM books each ride in the most cost-effective mode available, so a member who can use a bus day pass or family mileage may get that instead of a van.

1. Get your Ohio licenses. You need a PUCO certificate for for-hire passenger service, and for wheelchair vans an ambulette license and an Ohio Medicaid provider ID; the Ohio guide has the steps.
2. Apply to MTM and name the counties you serve on a consistent basis. MTM Health in Ohio covers the application and the Ohio rule for wheelchair applicants.
3. Ask about the facility direct affidavit once MTM approves you, if you run wheelchair vans or ambulances.
4. Plan for children. AmeriHealth members bring their own car seats and must be able to install and remove them, so your driver does not supply one; see children in NEMT.
5. Know what sets your price. Under Ohio rule 5160-15-28, effective August 1, 2026, a ride arranged through a Medicaid health plan is paid under the provider agreement, so your MTM agreement sets the rate.

Who to call

For	Contact
Booking, changing, or canceling a member’s ride	MTM, 1-833-664-6368
Coverage questions and ride complaints, any hour	Member Services, 1-833-764-7700 (TTY 1-833-889-6446)
Contracted companies with claim questions	MTM, 1-888-597-1180, or your vendor account manager
Facility direct questions	ohioinquiry@mtm-inc.net
Member and family mileage reimbursement questions	1-888-513-0703
Athens On Demand Transit	HAPCAP, 740-597-2404
Joining MTM’s network	mtm-inc.net/service-providers

The other MTM plans in Ohio set different limits. Humana Healthy Horizons in Ohio splits its short trips between medical and non-medical rides, and Anthem books dialysis 90 days at a time. For AmeriHealth’s rides in another state, see AmeriHealth Caritas North Carolina.