Phone: (410) 548-5142
Fax: (410) 219-2885
Office Hours: Monday - Friday - 8:00 AM - 5:00 PM
Main Office: 801 North Salisbury Blvd., Salisbury, MD 28101
Medical Transportation can distribute bus tickets to eligible clients ONLY if they have three or more appointments per week. All appointments must be documented by the provider and received by our office prior to issuing bus tickets.See links above for the form.
PLEASE NOTE: Beginning July 1, 2018 please utilize the new forms below. There will now be only one certifcation form for all mobility – ambulatory, wheelchair, and stretcher. For transfers or discharges from a facility, please use the seperate Transfer & Discharge form.
Below are the forms required for Medicaid Transportation. The Provider Certification Form (PCF) is required for every client, and the Distant Transport Form is required for every out of area referral. Frequency of forms may vary, contact our office for more information.
- Medical Assistance Statewide Transportation Certification Form w/ Instruction Sheet
- Medical Assistance Statewide Transfer & Discharge Form w/ Instruction Sheet
- Medical Assistance Statewide Distant Transport & Referral Form – Distant Transport
The bus ticket appointment verification form is to be completed by a medical provider, and used for clients who have three or more medical appointments per week. See form for further instructions.