PL 002 RELATIVE FREQUENCY OF SERVICES.xlsx

This is a relative frequency of services data file for South Carolina's Non-Emergency Medical Transportation (NEMT) program, detailing transportation utilization metrics across enrollment types for State Fiscal Year 2025. The document presents comprehensive service statistics for both NEMT and ambulance transportation encounters, comparing performance across Fee for Service, Managed Care, and PRIME enrollment categories. The data encompasses June membership counts, patient utilization rates, claims volume, and service delivery metrics including total miles traveled and miles per patient, providing baseline operational metrics for the program's medical transportation services.

The NEMT data indicates a grand total of 1,291,492 June members generating 51,944 total patients with 2,204,855 claims and an average of 42 claims per patient, resulting in 37,868,673 total miles of service. Fee for Service enrollment represents the highest utilization with 5.9% of members utilizing services, followed by Managed Care at 2.7%, and PRIME at 13.2%. Ambulance services show 902,109 June members with 49,176 total patients and 105,670 claims at 2 claims per patient, with Managed Care representing the majority at 792,541 members. The data reflects paid claims and encounters stored in the BIS (Business Information System) with unduplicated patient counts where individuals are enrolled across multiple enrollment types, providing critical baseline metrics for capacity planning and service delivery assessment.