Medicaid MCO Access Standards: Specialty Care
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2013
| Location | Maximum Distance or Travel Time to a Specialist | Maximum Appointment Wait Time (Days): Routine Care | Maximum Appointment Wait Time (Days): Urgent Care | Maximum Enrollees per Specialist |
|---|---|---|---|---|
| Alabama | N/A | N/A | N/A | N/A |
| Alaska | N/A | N/A | N/A | N/A |
| Arizona | No standard | 45 | 3 | No standard |
| Arkansas | N/A | N/A | N/A | N/A |
| California | No standard | 15 | 4 | General standard |
| Colorado | 30 minutes or 30 miles | No standard | No standard | 2000 |
| Connecticut | N/A | N/A | N/A | N/A |
| Delaware | 100 miles | 21 | 2 | No standard |
| District of Columbia | N/A | N/A | N/A | N/A |
| District of Columbia | No standard | 30 | No standard | No standard |
| Florida | 60 minutes | 3 | 1 | No standard |
| Georgia | Urban: 30 minutes or 30 miles; Rural: 45 minutes or 45 miles | 30 | No standard | No standard |
| Hawaii | Urban: 30 minutes; Rural: 60 minutes | 28 | 1 | No standard |
| Idaho | N/A | N/A | N/A | N/A |
| Illinois | No standard | No standard | 1 | General standard |
| Indiana | 60 miles for selected specialists; 90 miles for other specialists | No standard | No standard | No standard |
| Iowa | N/A | N/A | N/A | N/A |
| Kansas | N/A | N/A | N/A | N/A |
| Kentucky | No standard | 30 | 2 | No standard |
| Louisiana | N/A | N/A | N/A | N/A |
| Maine | N/A | N/A | N/A | N/A |
| Maryland | No standard | 30 | 2 | General standard |
| Massachusetts | No standard | 60 | 2 | No standard |
| Michigan | No standard | No standard | No standard | No standard |
| Minnesota | 60 minutes or 60 miles | No standard | No standard | No standard |
| Mississippi | No standard | No standard | No standard | No standard |
| Missouri | Urban: 15 miles for general surgeon and 25 miles for other selected specialists; Basic: 30 miles for general surgeons and 50 miles for other selected specialists; Rural: 60 miles for general surgeons and 100 miles for other selected specialists | 30 | 1 | No standard |
| Montana | N/A | N/A | N/A | N/A |
| Nebraska | 90 miles for high-demand specialists | 30 | 3 | No standard |
| Nevada | No standard | 30 | 3 | 1500 |
| New Hampshire | N/A | N/A | N/A | N/A |
| New Jersey | 60 minutes or 45 miles for 90% of enrollees in each county or approved subcounty services area | 28 | 1 | General Standard |
| New Mexico | No standard | 21 | No standard | No standard |
| New York | 30 minutes or 30 miles | 42 | 1 | No standard |
| North Carolina | N/A | N/A | N/A | N/A |
| North Dakota | N/A | N/A | N/A | N/A |
| Ohio | 30 miles or MCO must provide transportation | No standard | No standard | No standard |
| Oklahoma | N/A | N/A | N/A | N/A |
| Oregon | N/A | N/A | N/A | N/A |
| Pennsylvania | Urban: 30 minutes for selected specialists; Rural: 60 minutes for selected specialists | 15 for selected specialists; 10 for others | 1 | No standard |
| Rhode Island | Varies by plan | 30 | 1 | No standard |
| South Carolina | No standard | No standard | No standard | No standard |
| South Dakota | N/A | N/A | N/A | N/A |
| Tennessee | 60 miles for 75% of enrollees; 90 miles for all enrollees | 30 | 2 | Varies by specialty type |
| Texas | 75 miles | 30 | 1 | No standard |
| Utah | No standard | 30 | 2 | No standard |
| Vermont | N/A | N/A | N/A | N/A |
| Virginia | Urban: 30 miles; Rural: 60 miles | No standard | 1 | No standard |
| Washington | No standard | No standard | No standard | No standard |
| West Virginia | 30 minutes for high-demand specialists and 60 minutes for other specialists | No standard | 2 | No standard |
| Wisconsin | N/A | N/A | N/A | N/A |
| Wisconsin | No standard | No standard | No standard | Varies by specialty type |