PA Health & Wellness Transportation: County MATP Rides, MTM Waiver Trips, and Plan-Paid Ambulances

PA Health & Wellness, a Centene company, runs one of Pennsylvania’s Community HealthChoices plans. The Department of Human Services (DHS) names three Community HealthChoices plans, AmeriHealth Caritas, PA Health & Wellness, and UPMC Community HealthChoices, and says each of the program’s five zones is covered by all three. In May 2026, DHS counted 79,883 PA Health & Wellness participants out of 396,880 in the program: 43,654 classed as nursing facility ineligible, 23,209 in home and community-based services, and 13,020 in long-term care.

Routine medical rides for these participants belong to the county Medical Assistance Transportation Program (MATP), as the Pennsylvania guide explains, and the way the program divides rides among MATP, the plans, and waiver services is laid out on the AmeriHealth Caritas PA CHC page. This page covers what is particular to PA Health & Wellness: which company carries its trips, the standards it holds drivers to, and how your company gets in.

Who arranges each PA Health & Wellness ride

The plan’s own documents send each kind of trip to a different place, as of October 2026:

Ride	Who handles it	How it is booked
Taxi, van, or wheelchair van to a medical visit	County MATP office	The participant registers with MATP; in Philadelphia, calls MATP directly
Trip in a waiver participant’s service plan	MTM	MTM Link, online or in the app
Stretcher or ambulance trip MATP cannot give	PA Health & Wellness	MATP sends the plan a Transportation Referral Form
Medical ride for a nursing home resident	PA Health & Wellness	Through the plan; Participant Services answers ride questions at 1-844-626-6813
Ride for a Wellcare by PA Health & Wellness member	Modivcare	1-877-718-4201

For participants with a Medicare Advantage plan, the 2026 participant handbook says the Medicare plan’s ride benefit should be used before the PA Health & Wellness benefit.

Non-medical waiver trips go through MTM

The plan’s Transportation page tells participants that MTM Link lets them book new rides, change existing ones, and check ride status from a computer or phone. It adds that the program is only for waiver-eligible participants with transportation written into their person-centered service plan. The Community HealthChoices quick reference guide, last updated April 2026, lists MTM as the plan’s contracted transportation network. DHS counted 23,209 PA Health & Wellness participants in home and community-based services in May 2026, the group these waiver trips serve, and an MTM trip assignment is how one of their non-medical rides reaches a van.

The 2026 provider manual describes the service as rides to the long-term services and supports in the service plan, paid as mileage to a driver or as tickets and tokens, billed per one-way trip or per item such as a monthly bus pass. It repeats the program-wide limits the AmeriHealth Caritas page explains, such as the rule that the plan must deliver 86% of the non-medical trips participants request.

One limit matters if your agency also sends home care workers: one person cannot provide Personal Assistance Services and Non-Medical Transportation at the same time. The 2026 Community HealthChoices waiver adds that a personal assistance worker who drives a participant must meet the state’s transportation provider standards and be enrolled in Medical Assistance as a transportation provider or with the plan’s non-medical transportation broker. The waiver’s other standards for drivers and agencies are on the waiver transportation guide.

The plan’s own network is closed to new transportation applicants

On its contract request page, as of October 2026, PA Health & Wellness lists services for which it is not accepting requests or applications to join, judged by the primary or secondary specialty registered in PROMISe. Non-Emergency Transportation (267) is on the list, next to personal care, home-delivered meals, and service coordination. On DHS’s list of transportation specialties, 267 is Non-Emergency, separate from the ambulance specialties 260 to 262, and the plan’s LTSS addendum lists 267 as Non-Medical Transportation, the waiver service.

The plan says it closed those services to match participants’ needs to its existing providers and keep enough volume for each one. It also says the list can change at any time, and that it would reopen a service to providers with enough existing capacity, statewide or in the counties it needs, based on the locations and counties registered in PROMISe.

Medical rides: MATP first, then the plan

PA Health & Wellness does not cover non-emergency medical transportation for most participants, its 2026 handbook says; it helps them arrange rides through programs such as MATP. It does cover two kinds:

1. Nursing home residents, to any medical appointment, an urgent care center, or a pharmacy for a Medical Assistance service, equipment, or medicine.
2. Medically necessary specialized trips, such as a stretcher or ambulance.

When the county MATP cannot give a stretcher or ambulance trip after looking for local options, it completes a Transportation Referral Form and sends it to PA Health & Wellness. If the plan approves the referral, it tells the participant to schedule the trip and tells MATP the referral was accepted. The handbook’s prior authorization list includes emergent ambulance and non-emergent transportation, fixed-wing air ambulance, and non-medical transportation.

The standards your drivers meet

The 2026 provider manual sets a timing rule for medically necessary non-emergent trips. The transportation provider schedules the ride so the participant arrives on time but no sooner than one hour before the appointment, and the participant waits no more than one hour after treatment ends for the ride home. The plan asks its participating providers, including the transportation vendor, to tell Participant Services when a participant misses a ride, so it can follow up with the participant.

For MATP van and wheelchair work, the county sets its own contract terms. County pages such as Philadelphia, Allegheny, and York, where rabbittransit runs the program, explain how each one buys rides.

How PA Health & Wellness pays

Claims go electronically to payer ID 68069 through Centene EDI, or on paper to PA Health & Wellness, Attn: Claims, P.O. Box 5070, Farmington, MO 63640. The plan takes no handwritten, faxed, or copied claim forms. Its billing manual, dated August 20, 2025, sets the deadlines:

• New claims within 180 calendar days of the date of service.
• When it pays second, within 90 days of the primary payer’s explanation of payment, or the original deadline if that is later.
• Corrected claims and reconsiderations within 365 calendar days of the date of service.

Ambulance claims carry one rule of their own. Every ambulance line needs at least one modifier, and HCPCS A0425 (ground mileage) and A0430 (fixed-wing air transport) must carry modifier U8, or the line denies. For where stretcher vans end and ambulances begin, see NEMT vs. ambulance.

How a ride company gets PA Health & Wellness trips

1. Get Public Utility Commission authority and Medical Assistance enrollment. The Pennsylvania guide covers both.
2. For van and wheelchair riders, contract with your county MATP. That is where these participants’ medical trips are booked.
3. For waiver non-medical trips, join MTM. With specialty 267 closed at the plan, MTM’s network is the open door; see becoming an MTM provider.
4. For ambulance work, ask for a contract. Send the Contract Initiation Form from the contract request page, and the plan’s Network Development team says it replies within two weeks, followed by a credentialing packet. A facility or ancillary provider sends the signed agreement with documents that include a valid Medicaid ID, the credentialing application, its state license, proof of general liability coverage, a Disclosure of Ownership and Controlling Interest Statement, and a W-9.
5. If the plan reopens specialty 267, expect its LTSS addendum: one per service location, sent to PHWproviderdata@pahealthwellness.com, with your PROMISe ID, the counties you will serve, staff counts by county, and an attestation that every employed and contracted worker has a criminal background check, a child abuse registry check where it applies, and other state-required clearances.
6. For Wellcare Medicare riders, join Modivcare. See Wellcare transportation.

After the plan contracts and credentials you, it assigns a Provider Network Specialist and schedules an orientation that must be done within 30 days of the contract date. It re-credentials every three years. Questions go to Provider Relations at PHWProviderRelations@PAHealthWellness.com or to Provider Services at 1-844-626-6813.

The Wellcare dual plan’s rides

Wellcare by PA Health & Wellness is the company’s Medicare dual special needs plan for people who have both Medicare and Medicaid. Its 2026 benefits page lists 60 one-way rides to approved health care locations, by sedan or taxi, rideshare, or wheelchair van, to places such as dialysis, the pharmacy, specialists, and primary care. Its January 2026 provider guide names Modivcare as the transportation network, at 1-877-718-4201. UPMC for You and the other Pennsylvania plans each pick their own vendors, so check every rider’s cards before you plan a schedule around one.