The Connecticut Mileage Worksheet for Medical Treatment Examinationio— - Physical Therapy - Laboratory Test is a form used by Connecticut Medicaid recipients to calculate the cost of medical transportation. It can be used to determine the reimbursement for eligible medical transportation expenses to and from a medical provider. This worksheet is available in two versions: the standard and the extended. The Standard version of the Connecticut Mileage Worksheet for Medical Treatment Examinationio— - Physical Therapy - Laboratory Test covers transportation for medical treatment, examination, physical therapy, and laboratory testing. It includes calculations for both round-trip and one-way mileage, as well as items such as tolls, parking fees, and ferry tickets. The Extended version of the Connecticut Mileage Worksheet for Medical Treatment Examinationio— - Physical Therapy - Laboratory Test covers transportation for medical treatment, examination, physical therapy, and laboratory testing, as well as prescription drugs, medical supplies, durable medical equipment, and other medically necessary items. This version also includes calculations for round-trip and one-way mileage, as well as items such as tolls, parking fees, and ferry tickets. Both versions of the Connecticut Mileage Worksheet for Medical Treatment Examinationio— - Physical Therapy - Laboratory Test must be completed and submitted to the Connecticut Department of Social Services for reimbursement.