MedicaidDocumentationMedium impact
20-116 Refer to Updated PCS Form to Authorize Transport for Patients
Health Net·CA·Provider News
We identified it
Jun 20, 2026
Summary
CalViva Health requires immediate use of an updated Physician Certification Statement (PCS) form to authorize non-medical transportation (NMT) and non-emergency medical transportation (NEMT) for Medi-Cal members in Fresno, Kings, and Madera counties. The form must document specific medical limitations that prevent patients from using public or private transportation.
Action Required
Immediately: Download the updated PCS form from provider.healthnet.com Provider Library (Operations Manuals > Benefits > Transportation > PCS Form). Providers (MDs, RNs, NPs, PCPs, LVNs, PAs, or discharge planners) must complete this form to document specific medical limitations when requesting transportation for Medi-Cal members who cannot use public/private vehicles. Failure to use proper form may result in compliance issues and transportation authorization delays.