# Health Plan of San Mateo Transportation: American Logistics Car Rides and HPSM-Approved NEMT

Canonical URL: https://nemtguide.com/health-plans/health-plan-of-san-mateo/ · Updated 2026-10-02

Health Plan of San Mateo transportation is free for Medi-Cal and CareAdvantage members with no other way to a covered visit. American Logistics books car and taxi rides at 1-844-856-4389 for Medi-Cal or 1-877-356-1080 for CareAdvantage, two business days ahead. Wheelchair van, gurney van, and ambulance trips need a provider's prescription and HPSM approval, and HPSM or a facility books them with HPSM's own network.

- HPSM splits its ride benefit: American Logistics books car and taxi rides, and HPSM itself approves and books wheelchair van, gurney van, and ambulance trips.
- A wheelchair or gurney company gets HPSM trips by joining HPSM's own network, not American Logistics'.
- Nearly every HPSM NEMT trip needs the combined approval form before you bill, except hospital discharges to a home, a facility, or another hospital.
- The approval number goes on every claim, and the modifiers on the claim must match the ones HPSM approved.
- HPSM pays Medi-Cal claims in full only when you bill within six months of the ride.

## Health Plan of San Mateo (HPSM) rides at a glance

| Fact | Details |
| --- | --- |
| Who it serves | San Mateo County's Medi-Cal plan, with nearly 130,000 Medi-Cal members (October 2026), plus CareAdvantage, its plan for members with Medicare and Medi-Cal |
| Car and taxi rides | American Logistics: 1-844-856-4389 for Medi-Cal, 1-877-356-1080 for CareAdvantage, weekdays 8 a.m. to 5 p.m., at least two business days ahead |
| Wheelchair, gurney, ambulance | Booked by HPSM's Integrated Care Management team (650-616-2060) or by a hospital, nursing facility, or dialysis center, using HPSM's network companies |
| Approval form | One combined prior authorization and physician certification form for nearly every trip, faxed to 650-829-2079 |
| No approval needed | Hospital discharges to a nursing facility, a custodial facility, a home, or another hospital (modifiers HN, HE, HR, and HH) |
| Standing orders | Up to 12 months on one form. A hemodialysis standing order covers 12 months with unlimited trips. |
| Not eligible | HPSM HealthWorx HMO members and ACE program participants |
| Gym rides | CareAdvantage members get 12 one-way rides a month to a YMCA under the Fitness Membership Program, since January 1, 2025 |
| Full payment | Medi-Cal claims sent within six months of the ride. Later claims are paid at 75% or 50%, and nothing after a year. |
| Other county plan | Kaiser Permanente also serves Medi-Cal members in San Mateo County and arranges their rides separately |

The Health Plan of San Mateo (HPSM) is San Mateo County's Medi-Cal plan, and its network page counted nearly 130,000 Medi-Cal members in October 2026. It also runs CareAdvantage, its [dual special needs plan](https://nemtguide.com/glossary/dual-special-needs-plan/) for members who have both Medicare and Medi-Cal. HPSM splits its ride benefit in two: a contracted vendor, American Logistics, books the car and taxi rides, and HPSM approves and books wheelchair van, gurney van, and ambulance trips itself. Statewide, every Medi-Cal plan follows DHCS All Plan Letter 22-008 (May 18, 2022), and every transportation company in a plan network must enroll in Medi-Cal. The [California guide](https://nemtguide.com/states/california/) covers those rules and the permits, so this page sticks to how HPSM's rides work and how your company gets them.

## Who books each HPSM ride

HPSM's Ride Benefit FAQ, its NEMT provider FAQ updated February 2025, and its 2026 Medi-Cal member handbook divide the rides this way.

| Ride | Who books it (October 2026) | Notice or approval |
|---|---|---|
| Car, taxi, bus, or similar ride to a covered visit | American Logistics | At least two business days |
| Wheelchair van, gurney van, ambulance, or air | HPSM's Integrated Care Management team, with an HPSM network company | At least five business days, after the provider's form |
| Discharge from a hospital to a home, facility, or hospital | The hospital, with an HPSM network company | None. No prior authorization |
| Other trips from a hospital, nursing facility, or dialysis center | The facility, with an HPSM network company | The approval form still applies |
| YMCA rides for CareAdvantage members | American Logistics | At least two business days, 12 one-way rides a month |
| Emergency | 911 | None |

HPSM tells members not to call American Logistics for wheelchair, gurney, or ambulance rides. It also tells NEMT companies that they may not schedule rides directly with members. A wheelchair or gurney company gets HPSM trips from HPSM's care team or from a facility, never from a member's call. See [NEMT vs. NMT](https://nemtguide.com/glossary/nemt-vs-nmt/) for the difference between the two ride types.

Kaiser Permanente is the other Medi-Cal plan in San Mateo County, according to the Medi-Cal provider manual's list of County Organized Health System plans. Its members ride through Kaiser's own lines. See the [Kaiser Permanente Medi-Cal page](https://nemtguide.com/health-plans/kaiser-permanente-medi-cal/).

## Who can use the HPSM ride benefit

Only Medi-Cal and CareAdvantage members. HPSM HealthWorx HMO members and participants in HPSM's ACE program are not eligible. A member also needs to have no other way to the visit, which HPSM defines as three things at once: no driver's license or no vehicle, no ride from a family member, friend, or neighbor, and no way to get there by bus or train.

There is no limit on rides to approved visits. HPSM's list of approved visits includes dialysis, dental visits, outpatient behavioral health therapy, sleep studies, medication-assisted treatment such as methadone, Diabetes Prevention Program sessions, and pharmacy pickups. Rides to schools, government offices, grocery stores, shopping malls, and other people's homes are not covered. A member who misuses the benefit goes on an appointment verification list and must get HPSM's approval to schedule rides.

### Curb-to-curb or door-to-door

HPSM's car rides come in two levels, and the dividing line is unusual. A member who can wait at the curb, get in and out of the car alone, and has a cell phone that receives text messages gets [curb-to-curb](https://nemtguide.com/glossary/curb-to-curb/) service. A member who can get in and out alone but has no phone that receives texts gets [door-to-door](https://nemtguide.com/glossary/door-to-door/) service. A member who needs the driver's help to and from home, the vehicle, or the place of treatment because of a physical or mental disability moves to NEMT, as does anyone whose medical needs rule out a car, bus, or taxi. HPSM requires door-to-door service on every NEMT ride.

### Rides that need HPSM's approval first

American Logistics will not book a car ride until HPSM Member Services approves it, at least two business days ahead, when the ride starts or ends outside San Mateo, San Francisco, and Santa Clara counties, runs more than 50 miles one way, or has both addresses outside San Mateo County. For NEMT, the 2026 handbook says HPSM does not cover trips outside its network or service area unless it approves them first. The [American Logistics guide](https://nemtguide.com/brokers/american-logistics/) lists the pickup, waiting, and late-ride rules drivers follow on HPSM car rides.

## How HPSM approves wheelchair, gurney, and ambulance trips

HPSM requires its combined Prior Authorization and Physician Certification Statement form, called the PA-PCS form, for nearly every NEMT trip. Two parts of it matter to your company: who fills it out, and how the trips and miles are counted.

### Who fills out the form

The member's treating provider decides the ride type and signs the certification. The form lists physicians, physician assistants, nurse practitioners, certified nurse midwives, physical, speech, and occupational therapists, and mental health and substance use disorder providers who know the patient's condition. Office staff may sign for the clinician with the clinician's approval. Everything except the signature must be typed, and missing diagnosis codes, procedure codes, NPIs, or dates can get the form rejected.

Either your company or the signing provider may fax the form to HPSM Health Services at 650-829-2079. Its line for authorization questions is 650-616-2070. See the [Medi-Cal PCS form guide](https://nemtguide.com/guides/medi-cal-pcs-form/) for how this form compares with other plans'.

### How to count trips and miles

Each one-way trip goes on its own line with an origin and destination [modifier](https://nemtguide.com/glossary/origin-destination-modifiers/), such as RP for home to a doctor's office and PR for the ride back. The mileage line leaves its modifier blank on the form and carries one total for all legs. HPSM's February 2025 FAQ uses A0380 for van mileage, and its April 29, 2020 notice gives A0425 for ambulance mileage. HPSM's own dialysis example shows the math: a member 20 miles from the center, three treatments a week, needs 6,240 miles for a year (20 miles times two legs times three visits times 52 weeks). If your claims later exceed the units approved, they deny, and you file an authorization correction request for more units.

The form offers a one-time date or an ongoing request of up to 12 months, using the first and last scheduled ride dates. A hemodialysis standing order covers 12 months with unlimited trips. The form names the code for each mode:

| Mode | Code on HPSM's form |
|---|---|
| Wheelchair van | [A0130](https://nemtguide.com/glossary/a0130/) |
| Litter (gurney) van | [T2005](https://nemtguide.com/glossary/t2005/) |
| Ground ambulance | A0426 or A0428 |
| Air | A0430 or A0431 |

### How long approval takes

HPSM answers requests sent before the ride within five business days, or 72 hours when urgent. It allows approval after the ride, but those requests can be denied for lack of medical necessity and take up to 30 business days. When an HPSM case manager or treating provider sends an urgent ride, HPSM tells NEMT companies not to delay the trip and to send the PA-PCS form afterward so the ride can be billed.

No prior authorization is needed for a hospital discharge billed with HN (hospital to nursing facility), HE (hospital to custodial facility), HR (hospital to home), or HH (hospital to hospital). Some of those discharges also fall under the statewide three-hour rule in the [California guide](https://nemtguide.com/states/california/), which lets a hospital use an out-of-network company when the ride does not come in time. See [hospital discharge transportation](https://nemtguide.com/guides/hospital-discharge-transportation/).

## How to bill HPSM for a NEMT trip

HPSM pays NEMT on the [CMS-1500](https://nemtguide.com/guides/cms-1500-for-nemt/), on paper or electronically. Its February 2025 FAQ sets these rules:

1. **Wait for the approval number.** It must be on the claim, so do not bill until HPSM sends it.
2. **One line per leg.** Each one-way trip goes on its own service line, and each mileage line carries the same origin and destination modifiers as its leg.
3. **Match the approval.** A claim whose modifiers differ from the ones approved on the transport code is denied.
4. **Put both addresses in box 19.** Include the full pickup and drop-off addresses with city and ZIP code.
5. **Mark night rides.** For a ride between 7 p.m. and 7 a.m., put modifier UJ in the primary position and list the start and stop times in box 19.

HPSM's claims manual cuts payment for late Medi-Cal claims, so its [timely filing limit](https://nemtguide.com/glossary/timely-filing-limit/) works like a sliding scale. CareAdvantage claims are due within one year of the ride.

| Medi-Cal claim sent after the ride | HPSM pays |
|---|---|
| Within 6 months | 100% of the approved amount |
| 7 to 9 months | 75% |
| 10 to 12 months | 50% |
| More than a year | Nothing, without written justification |

Check a member's eligibility before each ride on HPSM's automated line, 1-800-696-4776, which runs around the clock, because the form warns that an authorization does not guarantee payment. Claims Services is 650-616-2106.

## How a transportation company joins HPSM

1. **Choose your rides.** Car and taxi rides come through American Logistics, which asks for its own contract, employee drivers, and commercial auto, general liability, and workers' compensation insurance. Wheelchair van, gurney van, and ambulance rides come through HPSM's network.
2. **Enroll in Medi-Cal.** Apply through the DHCS PAVE portal. The [California guide](https://nemtguide.com/states/california/) explains how long a plan may use your company while the application is pending.
3. **Send HPSM's provider intake form.** It is linked from the Join Our Provider Network page. It asks for a W-9, proof of Medi-Cal enrollment, your NPI, tax ID, and taxonomy code, and a credentialing email address, and proof of Medicare enrollment speeds the review. It also asks about your staff's cultural and language access training and whether you would take HPSM's.
4. **Finish credentialing and sign.** HPSM emails its online credentialing application, and you sign its Medical Services Agreement. HPSM typically re-credentials providers every three years.
5. **Take the training.** New HPSM providers complete HPSM's new provider training within 30 calendar days of contracting.
6. **Meet the facilities.** Hospitals, nursing and long-term care facilities, and dialysis centers can book HPSM's network companies themselves, so introduce your company to their discharge planners and social workers. See [dialysis transportation](https://nemtguide.com/guides/dialysis-transportation/).

HPSM's NEMT FAQ also sets two service rules for network companies. Give door-to-door service, and arrive within 15 minutes of the scheduled time. If you will be late or cannot do a ride, call the member and the Integrated Care Management team at 650-616-2060 right away.

## Who to call

| For | Contact (October 2026) |
|---|---|
| Medi-Cal car and taxi rides | American Logistics, 1-844-856-4389 |
| CareAdvantage car, taxi, and YMCA rides | American Logistics, 1-877-356-1080 |
| Booking NEMT for a member | Integrated Care Management, 650-616-2060 |
| PA-PCS form questions | Health Services, 650-616-2070, fax 650-829-2079 |
| Claims | 650-616-2106 or ClaimsInquiries@hpsm.org |
| Ride benefit questions | transportationprogram@hpsm.org |
| Medi-Cal Member Services | 1-800-750-4776, weekdays 8 a.m. to 6 p.m. |
| CareAdvantage Unit | 1-866-880-0606, every day 8 a.m. to 8 p.m. |

## Frequently asked questions

### What is the Health Plan of San Mateo transportation phone number?

For car, taxi, and similar rides, Medi-Cal members call American Logistics at 1-844-856-4389 and CareAdvantage members call 1-877-356-1080 (TTY 1-800-735-2929 or 711), weekdays 8 a.m. to 5 p.m. For wheelchair, gurney, or ambulance rides, Medi-Cal members call HPSM Member Services at 1-800-750-4776 and CareAdvantage members call 1-866-880-0606. The Integrated Care Management team is 650-616-2060.

### Does HPSM cover wheelchair van rides?

Yes, as non-emergency medical transportation. The member's doctor, dentist, therapist, or other treating provider prescribes it on HPSM's combined prior authorization and physician certification form, and HPSM approves it. Members ask for the ride at least five business days ahead, and an approval can last up to 12 months. American Logistics does not book these rides.

### How do I become a NEMT provider for the Health Plan of San Mateo?

Enroll your company in Medi-Cal through the DHCS PAVE portal, then send the provider intake form linked from HPSM's Join Our Provider Network page. It asks for a W-9, your NPI and tax ID, and proof of Medi-Cal enrollment. HPSM emails its online credentialing application, and you sign its Medical Services Agreement. For car and taxi rides, apply to American Logistics instead.

### Can a hospital book an HPSM wheelchair van without prior authorization?

For discharges, yes. HPSM requires no prior authorization for trips from a hospital to a nursing facility, a custodial facility, a home, or another hospital, billed with modifiers HN, HE, HR, or HH. Hospitals, skilled nursing facilities, long-term care facilities, and dialysis centers may also book NEMT directly with HPSM's in-network companies for other trips, which still need the approval form.

### Does HPSM pay for rides to the gym?

Only for CareAdvantage members, and only to a YMCA in HPSM's Fitness Membership Program. Since January 1, 2025, they get 12 one-way rides a month, or six round trips, booked through American Logistics at 1-877-356-1080 at least two business days ahead. Medi-Cal members get no gym rides.

### Who cannot use the HPSM ride benefit?

HPSM HealthWorx HMO members and ACE program participants. The benefit is for Medi-Cal and CareAdvantage members only, and only when the member has no other way to the visit: no license or no vehicle, no ride from family, friends, or neighbors, and no way to get there by bus or train.

## Official resources

- [Health Plan of San Mateo: Ride Benefit FAQ](https://www.hpsm.org/member/ride-benefit/ride-benefit-faq)
- [Health Plan of San Mateo: NEMT Policies, Procedures and FAQs for providers](https://www.hpsm.org/docs/default-source/provider-services/hpsm-nemt-authorization-faqs.pdf)
- [Health Plan of San Mateo: NEMT prior authorization and physician certification form](https://www.hpsm.org/docs/default-source/provider-forms/hpsm-nemt-authorization-form.pdf)
- [Health Plan of San Mateo: Join Our Provider Network](https://www.hpsm.org/provider/join-the-network)
- [Health Plan of San Mateo: Claims manual and timelines](https://www.hpsm.org/provider/resources/manual/claims)