Apple Health – Ground Emergency Medical Transportation (GEMT) supplemental reimbursement deadline November 30, 2018

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Apple Health (Medicaid) Provider Alert

Ground Emergency Medical Transportation (GEMT) providers who want to receive supplemental payments for the 2020 state fiscal year service period must submit their cost reports to the Health Care Authority (HCA) by November 30, 2018.

What is the GEMT Program?

The Washington State Legislature created the GEMT program through House Bill 2007. The GEMT program makes supplemental payments to qualified publicly owned or operated GEMT providers.

The supplemental payments cover the funding gap between a provider’s actual costs per transport and the allowable amount received from Washington Apple Health (Medicaid), and any other sources of reimbursement.

Providers voluntarily participate in the GEMT program.

Who can participate?

Publicly owned or operated ground emergency medical transportation providers can participate in the GEMT program.

Eligibility requirements

To be eligible for the GEMT program, you must:

  • Provide GEMT services to Medicaid clients
  • Be enrolled as a Medicaid provider, with an active Core Provider Agreement (CPA), for the service period being claimed
  • Be owned or operated by a governmental entity, such as a state, city, county, special purpose district, or other governmental unit in the state that has taxing authority, has direct access to tax revenues, or is an Indian tribe 

How do I enroll as a provider in the GEMT program?

To enroll in the GEMT program, eligible providers who choose to participate in the 2020 state fiscal year service period must:

  • Obtain an HCA ProviderOne ID number (if you don’t already have one)
  • Agree to reimburse HCA administrative costs associated with the administration and management of the GEMT program
  • Complete and submit the entire annual GEMT application packet to HCA no later than November 30, 2018. The application packet consists of the following:

    • Provider Participation Agreement (PPA)
    • Annual cost report certifying public expenditures

You must complete the annual participation agreement and cost report, print both documents in their entirety, and sign the agreement and cost report certification page. Scan and email both the signed PDF and Excel versions, in their entirety, to by November 30, 2018.

What do I need to do once I am enrolled, or if I am already enrolled?

Once enrolled in the GEMT supplemental reimbursement program, you must:

  • Complete a Provider Participation Agreement (PPA) and cost report certifying public expenditures for this program each year; and
  • Maintain current provider contact information with HCA by submitting Point of Contact information with the required documentation.

 When are cost reports due?

Cost reports are due five months after the end of each state fiscal year. The state fiscal year ends each June 30. Cost reports are due November 30 each year.

The due date for the state fiscal year 2020 claiming period is November 30, 2018.

HCA will notify you when your cost report has been accepted. HCA will establish the average cost per transport. Interim payment rates will be effective July 1, 2019.

HCA will send you notification of calculated average cost per transport at least 15 days before the effective date.

Where can I go for more information?

Electronic versions of the participation agreement, cost report, cost report instructions, and other program related documents and information can be found at the Ground Emergency Medical Transportation (GEMT) webpage.

If you have any questions regarding the GEMT supplemental reimbursement program, please contact us at