Florida Medicaid transportation fee schedule: ambulance fees, negotiated van rates, and fee-for-service riders

The schedule lists ambulance service only

AHCA, the Agency for Health Care Administration, sets Florida’s Medicaid fees in reference documents adopted through rule 59G-4.002 of the Florida Administrative Code. The Transportation Services Fee Schedule in force is the January 1, 2025 edition, incorporated in that rule as amended effective January 18, 2026. Every line on it is an ambulance line, in three groups: ground emergency, ground non-emergency, and air.

The ground non-emergency lines are these:

The emergency group lists $152.73 for basic life support (A0429), $213.37 for advanced life support (A0427), $280.74 for advanced life support level 2 (A0433), and $331.28 for specialty care transport (A0434), plus its own A0999-QN negotiated line. Air ambulance pays $1,116.61 for a fixed-wing or rotary-wing transport (A0430, A0431) and $4.47 per air mile (A0435, A0436).

No wheelchair van, stretcher van, sedan, or multi-load passenger van code appears anywhere on the schedule.

Where van and sedan rates come from

The NET coverage policy, adopted by reference in rule 59G-4.330, explains the gap. Its rate section pays ambulance trips that are not emergencies, by ground or air, at the Florida Medicaid rates on the fee schedule. Every other NET service is paid at a “mutually agreed upon negotiated rate,” set by the provider and the broker AHCA contracts with. The same policy sets how those trips move:

• Authorization. Every NET service is coordinated and authorized through the AHCA-contracted transportation broker.
• Claims. All claims for NET services go to that broker, as professional claims.
• Codes. Providers report the current billing codes, modifiers, and units incorporated in rule 59G-4.002.

The law behind this is section 409.908(18), Florida Statutes. It pays a transportation provider the lesser of its billed amount or the Medicaid maximum fee, except where AHCA has a direct contract or a negotiated agreement. It also lets the agency buy rides through a prepaid capitation rate, negotiated fees, competitive bidding, or prior authorization. For a wheelchair van or sedan company, the figure that matters is the rate in the vendor agreement. The guide to NEMT broker rates covers how those agreements are usually built.

Who rides fee-for-service

Florida runs two delivery systems for Medicaid rides. Members enrolled in a Managed Medical Assistance (MMA) plan get rides from that plan. Members outside MMA get rides from one of AHCA’s NEMT vendors under a 1915(b) waiver covering July 1, 2025 through June 30, 2027. The waiver names the groups in the fee-for-service system:

• Excluded from MMA. Women enrolled through the Breast and Cervical Cancer program, presumptively eligible pregnant women, and recipients in the Medically Needy program.
• Eligible for MMA but not enrolled. People with other credible health coverage (not Medicare), children who attend a PPEC (prescribed pediatric extended care) center, people in the iBudget waiver or on its waiting list who are not in an MMA plan, and residents of licensed group homes serving people with developmental disabilities.

Several groups are left out of the waiver: Medicare dual eligibles, residents of intermediate care facilities, Long-Term Care waiver enrollees (who get services through MMA), Title XXI children, and residents of institutions such as statewide inpatient psychiatric program facilities. The coverage policy separately excludes NET for recipients in the QMB, QMBR, SLMB, QI1, WD, ALIEN, FP, and PACE program codes.

The two vendors and how AHCA pays them

AHCA contracts with two vendors for fee-for-service NEMT, each with its own regions:

• Modivcare. Region A, plus Regions G through I.
• Medical Transportation Management (MTM Health). Regions B, C, D, E, and F.

Each vendor receives a fixed capitation payment for every member, every month. The waiver sets that capitation in two rate groups, one for PPEC recipients and one for everyone else, and reports average annual increases from calendar 2023 to 2025 of about 30.67 percent for the non-PPEC group and 9.87 percent for the PPEC group. The vendors handle centralized call intake, eligibility checks, trip authorization, scheduling and dispatch, and monitoring of transportation providers, and may provide trips themselves or subcontract them. Each vendor keeps its own list of providers for its regions and assigns the most appropriate one for the rider’s needs. When a rider calls, the vendor screens for ambulatory, wheelchair, or stretcher travel, oxygen, and an attendant.

So AHCA pays each vendor a fixed amount per member, and the vendor pays transportation companies what its own agreements say.

Policy rules that move what a ride pays

Several coverage policy rules never show up as a dollar amount, yet they still decide what a ride brings in:

• Most cost-effective mode. Florida Medicaid covers the most cost-effective mode when the recipient has no other means of transportation, needs help during transport, and the mode is medically appropriate as determined by a licensed health care professional.
• No waiting time. Time spent waiting while the recipient receives a service is not covered.
• Escorts ride free. An escort has to be allowed along, with no charge to the recipient or family, when the recipient has an intellectual disability or mental health disease, is blind or deaf, is under 21, or needs personal assistance due to a medical condition. Drivers and other employees of the company cannot serve as the escort.
• Extra riders. Companions “in excess of one child and one escort” can be billed to the recipient.
• Lodging and meals. Overnight trips for covered care include lodging and a meal per diem at the Florida government rate in section 112.061.

The policy’s service standards, such as the three-business-day limit on advance booking, the ban on trip caps and zones, and the $1.00 copayment under section 409.9081, are laid out in the Florida NEMT guide.

PPEC trips carry one more rule. When an escort is medically necessary, the provider picks up the escort at the PPEC center or an agreed spot before collecting the child, and takes the child back to the starting point before dropping off the escort.

Plan members are priced by the plan

The coverage policy binds MMA plans too. Plans must meet its service coverage requirements unless their AHCA contract says otherwise, and they cannot set stricter coverage limits than Florida Medicaid policy. The policy’s rate section covers trips through AHCA’s contracted broker. Plans, and the ride vendors they hire, pay transportation companies under their own agreements, not from the AHCA fee schedule. Which ride vendor each plan uses is in the state guide, along with licensing and insurance.

The January 1, 2026 schedule in rulemaking

AHCA published a proposed amendment to rule 59G-4.002 in the Florida Administrative Register on August 31, 2026 (Vol. 52/169), to incorporate the Medicaid fee schedules and billing codes dated January 1, 2026. Comments ran from August 31 to September 21, 2026. The proposed Transportation Services Fee Schedule dated January 1, 2026 carries the same codes and amounts as the 2025 edition, including $137.96 for A0428 and $192.73 for A0426. Until the amendment takes effect, the January 1, 2025 edition is the schedule the rule incorporates. For what each A-code means across payers, see the billing codes guide.

Trip records for vendor invoices

Because Florida van and sedan rates live in each vendor agreement, disputes come down to what the trip record shows: clock times at pickup and at drop-off, loaded miles, and who signed. In HealthRide, each completed leg carries its GPS-recorded miles, actual times, and on-screen signatures. Any date range can be exported from the trip log report as a spreadsheet or PDF.