Welcome to Travel
When and how to bill for travel has some complexities. This is why we have developed a guide to cover this topic. However, you will find that billable travel is easy to understand by applying a few simple rules, Reimbursement for non-billable travel (and how to get authorization for it) is also explained in this guide.
Travel is also a costly item - as we pay out in time and mileage much more than receive in reimbursement for this service. Travel is reimbursed at lower rates than the cost of acutal wages during travel time, and we pay wages plus mileage expenses (at IRS rates) for travel.
That having been said, be a good steward of travel. Plan routes to minimize travel between the people you see, and travel with during services only when you're going together to a place the individual would otherwise access independently.
This plan was most recently updated on May 31, 2022.
Overview of Travel
What You Will Learn
Document travel time accurately
Differentiate between billable, non-billalbe, and prohibited travel
Explain why stewardship is important in the travel benefit
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.
Helpful Tips: Stewardship
Keep travel to a minimum. While travel to many billable community-based mental health services is reimbursed, it costs more than it pays.
Use these strategies:
- As much as possible, schedule appointments in location that are along the same route, or in close geographic proximity.
- Travel to cancellations is not reimbursed. Call to confirm before traveling long distances.
- Always plan multiple appointments when traveling especially long distances.
Consider this math for a one hour trip of 40 miles:
Wage for one hour at $21/hour + taxes , insurance & full-time benefits: $25.80
Mileage reimbursement for 40 miles: $21.80
Total staff reimbursement: $47.60
Rate received for one hour of travel: $27.50
Difference between staff wage and benefits - reimbursement from MHCP: $20.10
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.
- 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
Due to COVID-19, ridesharing is prohibited as of April 1, 2020 until further notice.
When a provider travels during a service to an individual, Accend allows ridesharing, or offering the individual a ride in your car while continuing the service. Examples of this might be as follows:
- 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.
Travel During Services Not Permitted
Travel During services (ride-sharing) is not permitted when the for the travel is strictly for transportation of the individual to an appointment or event, and is not directly-related to an intervention that was required in the location to which you traveled.
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:
- 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.)
- 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.)
- When not traveling the most direct route because you need to go somewhere else during the trip.
- 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
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MHCP Manual Guidance
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Simple Interpretation
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Guidance
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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.
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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.
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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.
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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.
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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
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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.
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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.
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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.
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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.
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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.
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When traveling from person to person, travel is always billed to the person you seen next.
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See guidance above when a trip between two billable services is interrupted by personal business or cancellations.
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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.
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Travel from is billable only when returning to the office from a service.
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See guidance above that allows travel from when going home at the end of the day.
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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
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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:
*We're working on fixing the link above. If the slideshow above does not load tap here to load a pdf version and scroll to view this slideshow.
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.
May 31, 2022:
Typos corrected in instructions for documenting estimated travel.
A link added to a pdf of the Time and Travel Documentation Exercise.
