Connecticut invalid coach rates: the DPH maximum charges, company schedules, and Medicaid trips

A price ceiling set by the health department

Connecticut law puts invalid coach prices under the Department of Public Health (DPH). CGS 19a-177(9)(A) tells the commissioner to “establish rates for the conveyance and treatment of patients by licensed ambulance services and invalid coaches.” CGS 19a-175 defines an invalid coach as “a vehicle used exclusively for the transportation of nonambulatory patients, who are not confined to stretchers,” going to or from a medical facility or the patient’s home in nonemergency situations, or serving as backup in an emergency when emergency vehicles are short. In plain terms, it is a wheelchair van run by a DPH-licensed service.

DPH’s rate regulation, Regs. Conn. State Agencies 19a-179-21, turns that duty into a ceiling. It defines an invalid coach response as a nonemergency request to transport a wheelchair patient, and a maximum allowable rate as the highest amount a provider may charge a patient. Three rules follow:

• Your schedule is your own. The commissioner sets maximum allowable rates for each licensed or certified provider every year, by December 15, effective the next January 1.
• You may charge less. Providers may bill below their maximums.
• You may not add charges. A provider may not charge for any service its rate schedule does not list.

Wheelchair accessible livery, which runs under Department of Transportation authority, is a separate business with its own rules, covered in the Connecticut NEMT guide. This page covers DPH invalid coach charges and how Medicaid pays for the same rides.

The 2026 maximums, company ranges, and the 2027 proposal

The statewide schedule for calendar year 2026 caps the invalid coach base rate at $172, while approved company schedules for 2026 run from $109 to $238. The schedule DPH proposed in May 2026 for 2027 raises each statewide line by about 3 percent.

The statewide column is the schedule a provider accepts by signing Waiver A, which the 2026 form describes as approved by the commissioner for calendar 2026. The company range comes from DPH’s June 2026 workbook of maximum allowable rates by organization, which lists each licensed service’s approved invalid coach charges. The 2027 column is from the 2027 short-form package, where the schedule is still labeled proposed.

A company’s own schedule is the one that binds it, whether it sits above or below the statewide figures. The statute keeps a provider’s present rates in effect until the commissioner sets new ones, so a service that skips a year’s application keeps its last approved schedule. The June 2026 workbook flags organizations that did not file a 2026 application.

How miles, waiting, and a second patient are charged

DPH’s rule and the schedule’s notes decide how each line is billed:

• Mileage only across a town line. Section 19a-179-21(d)(1) allows a mileage charge from the point of origin in the patient’s town to a final destination outside that town. A ride that begins and finishes inside one town carries no mileage charge. Distances come from the state utility regulator’s official town-to-town mileage docket.
• Waiting starts at one hour. Waiting time is charged on a minimum of one hour. Past the first hour, more time is charged in quarter-hour increments.
• Two patients have their own rate. The schedule lists a two-patient charge ($217 statewide for 2026) for carrying two patients together.
• A second attendant is a separate line. It is $100 at the 2026 statewide maximum.

Here is an example at the 2026 statewide maximums: a one-way private-pay trip from a home in one town to a clinic 9 docket miles away in another town. The base of $172 plus 9 miles at $14.78 ($133.02) comes to $305.02. The same ride between two addresses in one town could carry only the $172 base. A company with its own approved schedule uses its own figures in place of these. The wheelchair transportation cost guide compares these private charges with what Medicaid programs in other states pay.

The yearly filing that sets next year’s rates

Every service that received a rate schedule for one year files for the next. For 2027 rates, DPH’s memo is dated May 13, 2026, and the package is downloaded from DPH’s rate application page and sent back by email. The steps:

1. Pick a waiver. Waiver A accepts the statewide schedule. Waiver B keeps your own schedule and raises it by no more than the consumer price index figure DPH applies: 2.1 percent for 2026 and 3 percent for 2027. Only providers that filed a long form or a Waiver B the year before may use Waiver B.
2. Or ask for the long form. A provider that wants more than the CPI increase requests the full rate application, which calls for detailed financial information. Under 19a-179-21, that application is a contested case with a hearing unless the provider waives it.
3. Sign the certification. Every charging provider files a notarized certification with the short-form spreadsheet and a checklist.
4. Meet the deadline. For 2027 rates, the paperwork was due at OEMS in Hartford on August 31, 2026, at the close of business. The commissioner then sets each provider’s schedule by December 15 for the year starting January 1.

CGS 19a-177(9)(A) treats a filed increase that stays within the prior year’s Medical Care Services Consumer Price Index as approved. A new service, or one that does not charge, signs the non-charging certification instead. On it, the service commits to charging nothing until DPH grants it an approved schedule, as 19a-179-21(e) requires.

Medicaid pays through the broker, not the DPH schedule

Connecticut Medicaid does not pay invalid coach companies their DPH rates. State Plan Amendment 18-0004, effective January 1, 2018, moved the NEMT broker from fee-for-service payment off a published fee schedule to an at-risk per-member per-month rate, a form of capitation. Non-emergency ambulance stayed outside that rate. Provider Bulletin 2017-84, issued when the broker was Veyo, spelled out the result for companies: livery, taxi, and wheelchair providers are paid by the broker. They still enroll with DSS (the Department of Social Services), but only as performing providers. The same bulletin says ride requests come from the member, a family member, or the member’s health care provider or facility, never from the transportation company.

• The broker today. DSS names MTM as its current broker. Rides are open to members on HUSKY A, C, or D and to Covered CT enrollees who lack any other way to reach care. According to MTM’s Connecticut provider page, rates are agreed with each company separately, no-shows are unpaid, and general and auto liability policies must meet Connecticut’s NEMT requirements and name MTM as certificate holder and additional insured, and workers’ compensation must meet state requirements. The MTM Health guide covers joining its network.
• The modes in the state plan. State Plan Amendment 26-0023, approved August 14, 2026 and effective August 15, 2026, lists the modes the brokerage uses. Invalid coach licensed by DPH is one of them, next to taxi and livery, wheelchair accessible taxi and livery, group or shared ride vehicles, and independent driver-providers.

DSS payment rules for trips it pays itself

Regs. Conn. State Agencies 17-134d-33 sets the payment rules for transportation the department pays directly. For an invalid coach, and for wheelchair accessible livery, which the regulation treats the same way:

• Lowest of four. The department pays the smallest of four amounts: what you usually charge the public, the Medicare rate where one exists, its own fee schedule amount, and what you billed.
• Five payable items. A trip, waiting time, loaded mileage, an additional recipient, and attendant services.
• Waiting. Nothing for the first half hour, then 15-minute increments. A round trip with waiting is paid one base rate plus the wait, never two base rates plus the wait.
• Mileage. Loaded mileage only when the vehicle crosses a town line, from the same mileage docket, with one mileage charge however many recipients ride.
• No-shows and cancelled calls. Not paid.
• Attendant. Paid only when the attendant is an employee other than the driver.
• Records. Daily driver logs showing, for every trip, the patient’s name, the vehicle’s license number, the time and place of pickup and of drop-off, any attendant’s name, and odometer readings on out-of-state trips.

The two waiting rules point in different directions. A private-pay rider can be charged for a full hour once any waiting starts, while the DSS rule pays nothing until the van has waited 30 minutes.

Invoicing inside an approved schedule

A Connecticut private-pay or facility invoice may only carry charges your DPH schedule lists, at or below the approved amounts. HealthRide builds facility and payer invoices from the trips you actually ran, using the rate schedule you keep for each payer, and sends them as secure links that can be paid online. Every completed trip carries its GPS-recorded miles and its pickup and drop-off times, so a questioned charge can be checked against the ride.