Adult day care transportation contracts: waiver trip codes, bundled day rates, and per-rider pricing

The money for an adult day ride almost always reaches you through the center. A state aging or disability waiver pays the center for attendance, and depending on the state it pays a separate trip rate, folds the ride into the attendance rate, or pays nothing for the ride at all. Read the center’s program rules before you quote, because they set both the ceiling on your price and the paperwork the center needs from you. This page covers the contract and the money. For winning facility work in general, start with how to get NEMT facility contracts. For planning the morning and afternoon runs, see group trips to adult day programs.

CDC’s 2025 national study of adult day services counted 4,448 centers in the United States, serving about 227,169 participants.

Who pays for the ride to an adult day center

The center pays in most contracts, and the state program decides where the center’s money for the ride comes from. Four patterns cover most of what you will see:

• A separate trip rate. The waiver pays the center a set amount per ride on top of attendance. Illinois and Ohio’s PASSPORT waiver work this way.
• Inside the attendance rate. The ride is folded into the day service and paid through the same units. Missouri’s waivers and Washington’s adult day health service work this way.
• Not paid by the program. Washington’s adult day care rate excludes the ride, so the family or another source pays.
• Medicaid ride programs, case by case. Some leave these trips out. PrimeWest Health in Minnesota lists rides to an adult day program as not covered, and New York will not prior-authorize Medicaid trips for participants of an adult day health care program that arranges its own transportation. Check before you book a participant’s ride as a Medicaid trip.

The table shows what the center receives for the ride in four programs. Your price has to fit under these amounts, unless the center adds money from its own budget.

Illinois: $12.44 for every ride between home and center

Illinois pays adult day centers in its Community Care Program $12.44 for each one-way ride, billed as T2003, in the fee schedule that took effect January 1, 2026. The day service itself pays $16.84 an hour under S5100, and that hour excludes time spent in transit.

The rule text matters more than the rate. Under 89 Ill. Adm. Code 240.1950, one unit is a one-way trip per participant between home and the adult day site. A participant can generate no more than two units in 24 hours, and outings, doctor visits, shopping, and other errands sit outside the unit. If the center wants you for a monthly outing, quote it separately.

The center can drive participants itself or contract the rides out. Either way, section 240.1550(d) requires vehicles carrying participants to have a working two-way communications device and written emergency procedures. A center that subcontracts must write its safe-transportation procedures into the service agreement with you. Section 240.1560 requires drivers to be certified in CPR, trained in first aid, licensed with the right endorsements for the vehicle, and compliant with the Illinois Vehicle Code. Expect the center to ask for proof of all of it before the first run.

Ohio PASSPORT: per trip or per mile, with a household rate

Ohio makes the adult day provider responsible for the ride. Rule 173-39-02.1, effective October 1, 2026, says the center transports each participant under Ohio’s non-medical transportation rule, or subcontracts with another provider that meets that rule, unless the caregiver drives or picks someone else to.

PASSPORT pays the ride separately from attendance, and attendance units exclude transportation time. A transportation unit is a round trip, a one-way trip, or one mile. Distance is set by the case manager’s own calculation of the trip between home and center, not by your odometer. The appendix to rule 5160-1-06.1, effective April 17, 2026, caps the rates at $23.21 per one-way trip, $28.61 per round trip, and $3.12 per mile. When two PASSPORT participants from the same household ride in the same vehicle to the same center, each trip pays 75 percent of the unit rate.

As an example, a participant the case manager places 6 miles from the center and authorizes per mile is worth $18.72 each way at the maximum. A married couple from that household on a round-trip authorization is paid at $21.46 each instead of $28.61.

A subcontractor has to meet rule 173-39-02.18 in full:

• Drivers. First aid and CPR from a trainer approved by Ohio’s EMFTS board, a clean drug test from a CLIA-certified lab, background checks under Chapter 173-9, a license held for at least two years, and a passenger-assistance course within six months of hire.
• Vehicles. A yearly inspection on the Department of Aging form by an ASE-certified or approved mechanic, and a recorded check of belts, fasteners, and the ramp or lift before the first trip of the day in any vehicle that carries wheelchair users.
• Operations. A radio or cell phone so the driver can talk to the office while carrying riders, a back-up plan when a driver or vehicle is out, and help with every transfer between the door and the seat.
• Trip records. Name, date, pickup point and time, destination and drop-off time, the driver’s name, and identifiers from both the driver and the participant.

The center, for its part, keeps each participant’s arrival and departure times and how they got there for every attendance day, so give it your times in a form it can use.

Missouri: ride time counted inside the day units

Missouri does not pay a trip rate. Its HCBS manual sections 3.51 (Aged and Disabled Waiver) and 3.31 (Adult Day Care Waiver) make transportation part of adult day care. The center must arrange or provide the ride free to the participant, and up to 120 minutes a day of carrying a participant between home and the center counts toward the authorized units.

The rate table (revised July 2026) pays $3.32 per 15-minute unit, under S5100HC for the Aged and Disabled Waiver and S5100HB for the Adult Day Care Waiver, for up to 10 hours a day on no more than five days a week. No more than eight of those units a day may be ride time.

Ride time is counted per participant, so each rider’s minutes aboard drive the center’s revenue. As an example, a participant aboard 45 minutes each way adds six units, or $19.92, to the center’s day. A participant aboard 75 minutes each way still adds only eight units ($26.56), because the cap is two hours. Your cost runs by the vehicle hour, so price the center per rider-day or per route, not per unit.

Washington: day health includes the ride, day care does not

Washington splits its two adult day services. Under WAC 388-71-0724, the adult day health daily rate includes transportation to and from the program, and adult day health centers must help clients arrange or provide it. The adult day care rate pays nothing for the ride, and rides are arranged with local transportation companies or informal help. Centers get their state contracts through the local Area Agency on Aging, and that agency reviews each center at least annually (see how Area Agencies on Aging buy rides).

The rest of chapter 388-71 shows what a Washington center will ask of you. Each client file must hold a transportation plan naming how the client travels between home and the center and who is responsible (388-71-0744). The center must keep certificates of insurance on file, including business auto if it uses vehicles and certificates for any subcontractor (388-71-0736). A center running its own vans must use drivers with a proper state license, a clean driving history, and training in CPR and first aid (388-71-0752).

Pricing a rider-day

Price the rider-day (the trip in plus the trip home) and check it against what the center earns. Start from your cost per vehicle hour, count the hours each route really takes from yard to yard, and divide by the riders you can count on.

Here is an example with assumed costs for a center in Illinois. The center receives $24.88 per rider-day (two rides at $12.44). One van brings in eight riders, and each run takes 90 minutes from leaving the yard to returning, so the day uses three vehicle hours. At an assumed $45 per vehicle hour, your cost is $135 a day:

• With eight riders attending, your cost is $16.88 per rider-day.
• With six attending, it is $22.50, close to everything the center receives.

That gap is the reason to price per rider-day with a daily minimum. The group trips guide weighs per-rider against per-run pricing in more detail.

Terms to settle with the center

Write these down before the first run. Most of them have a matching clause in the facility transportation agreement template.

1. What counts as a billable ride. Home to center and back, and how outings, early pickups for illness, and doctor trips are priced. Illinois’s trip unit excludes outings and doctor trips.
2. The drop-off window. The earliest time staff can receive riders and the latest pickup time in the afternoon.
3. Absences. How much notice the center gives and what a no-notice absence costs.
4. The center’s billing records. The times, mileage, and signatures the center needs for its own claim. Ohio’s centers log arrival time, departure time, and how each participant traveled for every attendance day.
5. Proof of your qualifications. Driver checks, vehicle inspections, and insurance certificates that match the state rule, delivered before the start date and renewed on schedule.
6. Rate reviews. Tie your price review to the program’s rate changes. Ohio’s current maximums took effect April 17, 2026, and Missouri’s rate table was revised in July 2026.

Bill the center once a month from your trip records; facility billing covers invoices and disputed trips.

Does the adult day center provide transportation?

Usually, yes. In CDC’s 2025 study, about three in four adult day centers (73.7 percent) gave participants a daily ride to and from the center, using their own staff or a carrier they hired. Another 12.9 percent pointed families to outside services, and 10.8 percent offered neither. State rules point the same way. Missouri’s waiver centers must arrange or provide the ride free to the participant, Ohio PASSPORT centers must transport unless the caregiver chooses to, and Illinois Community Care Program centers provide or arrange the ride. In Washington, adult day health includes the ride and adult day care does not. Veterans in VA adult day health care may get help with transportation, and that help differs from one location to the next.

Families should ask the center and the case manager who arranges the ride before the first day, since a Medicaid ride program may not cover it.

Running center contracts in HealthRide

Adult day work repeats the same riders on a fixed weekly pattern for months. In HealthRide, each rider’s schedule is set once with recurring trips, and every ride is saved with its timestamps, signatures, and GPS-recorded miles. The center can request rides, follow vehicles live, and see and pay its invoices from its own portal.