Overview of Travel

Simple Guidelines

The simple guideline for billable travel is this: Mental Health Travel Time is a billable health care service when the travel is to recipient's homes and to places in the community that the recipient would naturally access on his or her own, where you are providing services.

Travel time to services provided at our corporate offices is not allowed, nor is travel between agency offices, even if it is to provide a billable service there. It will not appear as an option if a corporate office is selected as the location of service.

Non-billable travel is travel to locations for tasks and activities that you have been asked to do, where travel is required, but is not reimbursable as a healthcare service. As a rule, non-billable travel requires prior-authorization: you must receive approval for expenses occurred for non-billable travel in advance. When you receive prior-authorization for non-billable travel, you will be paid for your time and mileage.

Medically Necessary Travel

Medically necessary travel is a billable service in community-based mental health services. Medically-necessary travel is defined as follows:

• Travel to provide a medically necessary service in a person's home or other community location, or
• Travel between medically necessary services, or
• Returning to the corporate office from a medically necessary service, when the need for the service to be delivered in the location other than the office is identified in the Treatment Plan.

Most Direct Route

Minnesota Health Care Program rules for travel also require the following:

• Provider travel time covers only the time the provider is in transit to and from the recipient by the most direct route. It does not include any stops or variations in the route.
• Only variations resulting from posted detours or blocked routes may be included in claims for mental health provider travel time. Detours and traffic delays are acceptable for travel time, but should be desribed in the note, if they  exceed the typical travel time.
• Travel to a service provided in one of our offices is not billable.

Travel During Services

Travel during services is not billable to insurance. However, Accend reimburses providers for travel during services when this travel is medically-necessary. For this purpose, we define medically-necessary travel during a service as follows:

• Travel to a location that an individual would otherwise access naturally, using their own transportation resources (car, public transportation, medical cabs, or walking.)
• to provide a service that is in the individual's treatment plan, for which that location is the most appropriate for providing the service, and
• when the travel includes ridesharing (defined below) and you are in contact with and providing services during the travel.

Ridesharing Defined

Ride-Sharing (transportation of clients) is prohbited by our policy for any service other than Housing Stabilization Services, except in certain circumstances, where prior-authorized. When authorized, ride-sharing might be allowed, with prior-authorization in some circumstances.

With prior-authorization, when a provider travels during a service to an individual, Accend allows ridesharing by offering the individual a ride in your car while continuing the service. Examples of this might include any or all of the following:

• Access to the services at the destination is medically necessary and would not otherwise be possible withoutd transportation.
• While traveling to an appointment together, an individual rehearses a self-advocacy script he or she will use in the meeting.
• While traveling to an appointment together, an individual practices breathing exercises to reduce anxiety about the appointment.
• Others.

When traveling during services, always use the location "Various Locations" as the place of services.

Alternatives to Rideshaing

• Meet the client at the designated location.
• Use the transportation service the client uses (example bus or other transit) to travel with them, while traveling with them, while providing coaching, teaching, symptom management related to using public transportation, or other services as defined by the Service/Treatment plan.
• When all other alternatives are not available and travel is neceseary to the destination, seek authorization from your Program Manager for ride-sharing (transporting clients).

Travel To/From Home to Services

Travel from home directly to your first home- or community-based service of the day/shift, and from your last of each day/shift is billable. However, you must not bill travel that is longer/farther than it would take to travel to/from the same location as from the office. To bill your first/last travels from/to your home do this: use a reliable tool such as google maps or you own experience to determinsfe the shortest distance to/from your home or to/from the office. Bill time and mileage for the shorter distance.

If any part of your travel from or to your home includes transporting your family members or friends, that portion of the trip cannot be documented as work or billable travel time. Travel must begin after the family members or friends are dropped off, or end when they are picked up. Travel that includes personal errands must exclude the personal errands in the documented work and travel time.

Types of Travel That Are Prohibited

The following types of travel are prohibited:

• Travel that is strictly for the purpose of providing transportation, for example:
• Picking up an individual and transporting them to the office for services.
• Running errands unrelated to the treatment plan.
• Giving a ride strictly for the convenience of the person served unrelated to the treatment plan. An exception to this being that you might offer a ride to a recipient when his or her destination is directly on your route to your next service location, and does not add time or mileage to the trip.
• Others
• Transporting a child under the age of eight who requires a carseat, or anyone who needs or other safety accommodations.
• Riding in the vehicle of recipient of services, or a family member of a recipient, except with permission from the Program Director for a legitimate treatment purpose.
• No portion of a trip that is travel to services or travel from services may be billed as billable travel or documented as work time if the provider who is traveling is also transporting his or her family members (for example to school, day care, etc.)

Clock Out When Traveling Home

When traveling from home to the office after starting your day at home, or to home from the office or a home- or community-based service with the intention of working from home, you must clock out, regardless of the duration of the trip. You may only include, as work time, that portion of the trip home that is billable under the guidelines for Travel To/From Home, above.

Documenting Travel

Travel time and mileage is added on to the service with which it is associated. This means that for any service or work activity for which travel is allowed in the location where it occurs, you may add on time and mileage at the end of the progress note. To add travel to, during, or from a service, check the corresponding box and you will be offered options for time and/or mileage.

If this option is not available to you, travel is either not allowed to this service, or to this location. (For example, travel is not allowed to a service provided at one of our offices.)

When Travel is Separated In Time From a Service

Unless you are estimating travel, document travel at the exact time that it occurred, even if separated in time from the service by other non-client-related activities. Consider the examples below:

• You travel from 1:45 to 2:00 PM to a community location to meet someone for a billable service, arriving at 2:00 PM. They arrive 25 minutes late, so you use the extra time to complete progress notes. In the associated service note, mark the travel time when it occurred (1:45 to 2:00 PM) even if you have documented Timecard and Note Writing from 2:00 to 2:25 PM.
• After your appointment, you return to your car at 3:50 PM, but before you leave to return to the office, you take 5 minutes to put finishing touches on the Progress Note you wrote during the session, and scheduling the next appointment you had set up with the person you saw. Mark the travel from start time as the time you actually began traveling, at 3:55 PM. (In this case, there is no need to document the 5 minutes of Timecard and Notewriting because it was less than 20 minutes.)

Estimating Travel

When Estimating Is Necessary

Travel time should be estimated only rarely. These are four examples of times when estimating is necessary:

1. When traveling from home to the first client of the day, but using travel from the office because it would have been the shorter of the two trips. (Required.)
2. When traveling to home from the last client of the day, but using travel to the office because it would have been the shorter of the two trips. (Required.)
3. When not traveling the most direct route because you need to go somewhere else during the trip.
4. When traveling between clients when you have had a no-show cancellation between them. (Example, you travel from client A to client B, who does not answer her door, then go onward to client C who agrees to see you early. Travel here to client C should be estimated from client A.)

When estimating travel, indicate this and how you arrived at the estimate in the location description. Example: "Estimated based on previous trips," or "Estimated using Google Maps," etc.

When Estimating Is Not Necessary

Estimating travel is never necessary in the following circumstances:

• You are delayed by road construction (delays and longer travel for this purpose are valid as travel time). Document your full direct trip with exceptions for the above.
• You are delayed by heavy traffic (delays and longer travel for this purpose are valid as travel time). Document your full direct trip with exceptions for the above.

Non-Billable Travel

At times, you may be asked to travel to other locations for work activities other than direct services. With prior-authorization, you may use Non-Billable Travel to document your time and mileage to these activities.

Non-Billable Travel exists for this purpose only and will be authorized only when the service or activity with which it is associated was prior-authorized.

When using Non-Billable Travel request mileage using Travel During. Do not add on Travel To or Travel From.

Travel to Cancellations

Travel to cancellations is not reimbursable. If you have billable travel during the route that includes cancellations, do not use CCN travel, instead use estimated travel as described below.

Avoid non-billable CCN travel by confirming appointments before traveling whenever possible.

Always document the start/end time for the CCN record as the originally-planned service.

Do not use Non-Billable Travel for travel to cancellations.

Route	Bill Travel
Billable service...travel to cancellation...travel to office:	Estimate travel from the billable service that preceded the cancellation back to the office.
Billable service or office...travel to cancellation...travel to billable service:	Estimate travel to the billable service that followed the cancellation from the location that preceded the cancellation.
Office...travel to cancellation...travel to office:	No travel allowed.

DHS Guidelines

MHCP Manual Guidance	Simple Interpretation	Guidance
Mental health provider travel time allows providers to bill for traveling to the recipient to provide covered mental health services in a place other than the provider’s usual place of business. To be eligible, recipients must have an individual treatment plan (ITP) specifying why the provider must travel to the recipient’s home, place of work or other setting to provide services.	ARMHS, Case Management, CTSS are by definition home and community-based services. Psychotherapy may be provided in the home or other community location when the methods identify the need for this.	We encourage home-based psychotherapy and other clinical professional services when a person needs this. Identify the need to go to the person in the objective methods.
Provider travel time covers only the time the provider is in transit to and from the recipient by the most direct route. It does not include any stops or variations in the route. Only variations resulting from posted detours or blocked routes may be included in claims for mental health provider travel time.	Examples of stops or variations along the route: Stopping for gas, lunch, or other personal errands or business A cancellation in between two billable services A cancellation that is the first service after leaving the office/home or last service before returning to the office/home	In TimeTravelTM, use the pause function when stopping for personal reasons during travel. Estimate travel time and mileage from the location previous to the cancellation (office or previous service) as if you traveled directly to the next billable service.
Beginning Location For mental health provider travel time, if the provider begins the trip at his or her home, MHCP fee for service (FFS) will reimburse the lesser of the following: The distance between the provider’s home and the recipient The distance between the provider’s usual place of business or office and the recipient For example, if the provider’s home is further away from the recipient than the provider’s usual place of business, then MHCP will reimburse only the time for the provider to travel from the usual place of business to the recipient. This policy applies for the return trip as well.	You may bill travel from/to your home to/from the first/last person of the day instead of the office, but not if it is longer than a trip from/to the office.	When leaving from home to see the first person of the day, or returning home from the last person of the day, identify which trip is shorter: From/to your home From/to the office Estimate travel from/to the office if that distance is shorter.
Multiple Visits When traveling to consecutive recipients’ locations on the same day, only count the accrued travel time from the beginning location to the first recipient in the first recipient’s progress note, and then travel time from the first recipient location to the second recipient location in the second recipient’s progress notes.	When traveling from person to person, travel is always billed to the person you seen next.	See guidance above when a trip between two billable services is interrupted by personal business or cancellations.
The return trip to the provider’s place of business is billable to and from the last recipient if the provider returns to the usual place of business at the end of the day.	Travel from is billable only when returning to the office from a service.	See guidance above that allows travel from when going home at the end of the day.
Documentation Requirements Documentation (progress note) must be in English and legible, and must include the following: Start and stop time (with a.m. and p.m. notations) Origination site and destination site The electronic source used to calculate driving directions and distance between locations	Document travel time accurately, and identify location	When estimating travel, identify how you estimated in the location section of the note, for example: “Estimated previous trips” “Estimated Google maps”

Read About Mental Health Travel Time

Read more about billable Mental Health Travel Time in the Minnesota Healthcare Programs Manual:

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Driving Policy

The following policy applies to all employees who drive during work time while operating a vehicle owned by, or when driving a vehicle not owned by the company during work time for reimbursable or non-reimbursable travel.

Conditions

Vehicles must be operated in a safe operating condition. Drivers must be physically and mentally able to drive safely. Drivers must conform to all traffic laws with allowances made for adverse weather and traffic conditions. Respect the rights of other drivers and pedestrians. Drivers may not use drugs or alcohol, or be under the influence of drugs or alcohol. Vehicles driven by employees during work time must have insurance at the minimum level required by the state in which the vehicle is operated.

Accidents

All accidents involving a company vehicle are to be reported immediately to management of Accend Services, Inc.

All accidents involving a company driver during work time must also be reported to the management of Accend Services, Inc., as the accident may require the review of the driver’s eligibility pursuant to the MVR Standards.

All accidents will be reviewed and a determination made as either preventable or non-preventable. A preventable accident is defined as an accident in which the driver failed to do everything reasonably possible to avoid it.

MVR Standards

Motor Vehicle Records (MVRs) will be checked periodically on all employees where driving is a part of their job. The MVR will be reviewed to ascertain the employee holds a valid license and their driving record is within the parameters set by company management.

MVR checks which reveal either of the following my result in termination if driving is required for the employee's role/position:

• Three (3) or more traffic violations¹ and/or at fault accidents over a three (3) year period, or
• one or more of the following type of serious traffic convictions within the past 3 years:

Conviction for an alcohol and/or drug related driving offense	Passing a stopped school bus
Refusal to submit to a Blood Alcohol Content (BAC) test	Possession of a controlled substance
Failure to stop/report an accident and leaving the scene of an accident as defined by state laws	Making a false accident report
Conviction for homicide, manslaughter, or assault arising out of the use of a vehicle	Three or more physical damage claims made against the company in any twelve month period
Suspension, revocation, or administrative restriction of driver’s license within the last three years	Speeding (10+ MPH over posted speed limit)
Conviction for reckless or careless driving	Conviction for attempting to elude a police officer
Racing	Driving any vehicle during paid work time without insurance, whether or not the travel time was reimbursable travel2

¹Violations include seat belt violations, but do not include such non-moving violations as weight violations or improper or inadequately maintained equipment.

²If an MVR that exposes a violation for driving without insurance during personal, not work time you will be asked to provide evidence of past and current insurance, including dates of lapses. If this evidence indicates you have driven the uninsured vehicle during work time, this policy will apply.

Additionally:

• Any unauthorized passengers, other than company employees, are not permitted
• Seat belts must be utilized when the vehicle is in motion
• The use of radar detectors is forbidden in all vehicles owned or used by the company
• Cargo will be secured and all doors locked while en route and while the vehicles are parked
• Driving distractions must be avoided, which includes the use of cell phones unless hands-free via bluetooth.

Motor Vehicle Record Checks

It is the policy of , to obtain and review the Motor Vehicle Record (MVR) on each prospective driverbefore an offer for employment is extended. Management will review the Motor Vehicle Record to ascertain the applicant or employee holds a valid license and their driving record is with the parameters set by company’s driving policy.

A “driver” is someone who could not perform the duties assigned to them without driving a vehicle.

Management will conduct an annual review of each employee’s driving performance where driving is part of his or her job. Based upon the outcome of the annual review, the driving exposure, and the losses experienced during the past year, MVRs may then be ordered and reviewed.

As a company policy, MVRs are checked annually on all employees where driving is part of their job description. If the employee’s driving record does not meet the criteria set by management, driving privileges may be revoked, or other disciplinary action may be taken.

Violations

Violations of any part of this policy will disqualify the employee from driving company operated vehicles or personal vehicles on company time for reimbursable or non-reimbursable travel required for the purpose of completing job duties.

If driving is required for the employee's role/responsibilities, violations of this policy may result in termination or modified duties that might include a reduction of FTE .

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Time and Travel Documentation Exercise

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Feedback or Questions about this Chapter

This guide is a living document. We want to improve it with your help. Do you have questions? Found a typo? Find yourself wanting more information? Please send us your thoughts about anything in this chapter by tapping on the link below.

Review and Updates this Chapter

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May 31, 2022:

Typos corrected in instructions for documenting estimated travel.

A link added to a pdf of the Time and Travel Documentation Exercise.

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June 8, 2024:

Driving Policy added per recommendations from our insurance carrier.

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October 16, 2024:

COVID Restrictions banning transporting clients replaced with a permanent prohibition without prior-authorization on transporting clients in any service other than Housing Stabilization Services.

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