23-1024m Reminder: Sign This Form for NEMT for Medi-Cal Members

Date: 09/14/23

Make copies of the attached Physician Certification Statement form.

Download the Provider Update here. (PDF)

 

This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, Ancillary providers, Community Supports (CS) Providers, and Enhanced Care Management (ECM) Providers.

For Medi-Cal, this information applies to Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties.