Texas Children’s Health Plan is partnered with Medical Transportation Management (MTM) to provide our members with transportation services at no cost to a doctor’s appointment, a dental visit and/or the pharmacy. In addition, members, or their friends and family, can be reimbursed for mileage when driving to a Medicaid-covered appointment.
Important to note:
Each driver (either the member themselves or a friend or family member) must submit an Individual Transportation Participant (ITP) Registration Form in order to be eligible. You may also call MTM at 888-401-0170 and ask to have this form mailed to you. Missing documents or incorrect information can delay your approval.
Fill out the ITP Registration Form and attach the following documents*:
Then, submit the completed form to MTM by email, fax, or mail:
*ITPs must maintain a valid driver’s license, auto insurance, and registration at all times to remain eligible for the program.
Once you have submitted your driver documents to MTM:
If MTM does not approve your information, they will not notify you. Check the status of your application on the MTM Mobile Link app or call them at 888-401-0170.
On the day or your doctor’s appointment, dental visit, or trip to the pharmacy, you must have the provider sign the Mileage Reimbursement Form.
Trips without a signature will not be reimbursed. Each trip will need to be confirmed with the medical provider before the driver is paid.
You must submit the Mileage Reimbursement Form to MTM within 30 days of your trip. If you have parking or toll receipts from your trip, you should also include these with the form. You can submit the form by:
PLEASE NOTE:MTM will not notify you if your Mileage Reimbursement Form has been approved or denied. You will need to check the status of this form on the MTM Mobile Link app or by calling MTM at 888-401-0170.
Payments are issued only after approval and are processed within 10-14 business days depending on method of payment:
Drivers will be paid $0.70 per mile, round trip. Drivers will only get one payment per trip, even if they drive multiple people on the same trip.
Incorrect bank information, expired forms, or handwritten corrections on a form will delay your payment.
Call MTM at 888-401-0170 Monday through Friday, 8:00 a.m.-5:00 p.m. Or, call Member Services at the phone number found on the back of your Member ID Card.