How much does Medicaid pay for NEMT? 2026 base and per-mile rates by state

How Medicaid pays for a NEMT trip

Medicaid fee-for-service pays most NEMT trips in two parts: a base rate for each one-way trip and a rate for each loaded mile. The base rate depends on the service level, such as ambulatory, wheelchair, or stretcher. The mileage rate applies only to miles with the rider on board. A few states pay a flat amount per trip instead.

Three rules sit behind every number on this page:

• Each state sets its own rates. CMS guidance says states may adopt Medicare rates or a percentage of them, set their own fee schedule, or pay an interim rate reconciled to cost. There is no federal upper limit for these services.
• Empty miles are not paid on their own. CMS says unloaded miles, including the drive back after a no-show, generally cannot be paid as a direct service. States can build that cost into their payment rates instead.
• You are paid the lower of your charge or the rate. North Dakota and Ohio pay the lesser of your charge or the state rate. Medi-Cal pays your usual charge to the general public, up to its maximum allowance. Bill what you actually charge everyone.

These are fee-for-service rates, paid when the state pays the trip directly. Trips arranged by a broker or a managed care plan pay whatever your contract says. More on that below.

Wheelchair van rates by state

Wheelchair van trips are the core of most NEMT fleets. The table lists the base rate per one-way trip and the mileage rate from each state’s current schedule.

New York sets rates county by county, so check your county’s row. Colorado also pays $63.70 for an XL wheelchair trip (A0130 with modifier U9) that needs two attendants for loading and unloading, effective November 1, 2025.

North Dakota’s schedule lists one amount per code and no unit column. S0209, S0215, and T2049 are per-mile codes by their national definitions, so those amounts appear here per mile. The A0100, A0130, and T2005 amounts appear as per-trip base rates, which is how the other states on this page pay those codes. Confirm the unit with North Dakota Medicaid before you price against it.

Ambulatory, sedan, and taxi rates

Ambulatory trips pay less, and states structure them in more ways than wheelchair trips.

Texas works differently. Its Medical Transportation Program pays fee-for-service demand response providers a flat amount per trip under T2003, with no mileage line: $33.83 with modifier U1, $62.31 with U3, and $79.63 with U2, effective September 1, 2026. Indiana’s taxi rate is also flat, banded by distance.

Stretcher van rates

Stretcher van rates vary more than any other service level.

Indiana’s fee schedule lists the stretcher van codes as not covered, and its transportation module groups stretcher transport with ambulance services.

Attendants, waiting time, and personal mileage

Smaller line items add up over a month of trips.

• Attendants. Ohio pays $15.00 for a wheelchair van attendant (T2001), Illinois $20.00 (T2001, and another $20.00 for an additional attendant with TK), Indiana $6.36 for an accompanying adult or attendant on an ambulatory trip (T2001) and $15.90 on a wheelchair trip (A0130 TK), California $5.52 (T2001), and Minnesota $9 per stretcher trip when an extra attendant is medically necessary.
• Waiting time. Medi-Cal pays $11.30 per half hour (T2007), up to 90 minutes. Indiana pays $7.43 per half hour (T2007 with U3 or U5), but only after the first 30 minutes and only on trips of 50 miles or more one way.
• Night trips. Medi-Cal pays $26.43 for a wheelchair van trip between 7 p.m. and 7 a.m. (A0130 UJ) instead of $20.30.
• Family and volunteer mileage. Colorado pays $0.47 a mile (A0080 or A0090), Indiana $0.53 for a family vehicle (A0090), North Dakota $0.72 for a volunteer driver (A0080), Texas $0.76 for individual transportation participants (effective July 1, 2026), Illinois $0.23 for a private auto, and Minnesota $0.22 for client reimbursement. Minnesota pays volunteer drivers up to 100 percent of the IRS business mileage rate, which is 72.5 cents a mile for 2026.

What one trip pays in different states

Rates are easier to compare as a real trip. Take a hypothetical one-way wheelchair van trip of 12 loaded miles, billed at or above each state’s fee schedule.

The same ride pays about 2.7 times as much in New York City as in Indiana. Minnesota adds more in rural areas: super rural base rates are 111.3 percent of the table, and rural and super rural mileage is 125 percent for trips of 17 miles or less and 112.5 percent for trips of 18 to 50 miles. In any quarter when gasoline tops $3.00 a gallon, Minnesota also raises its per-mile rates 1 percent for every 10 cents above $3.00. A 2026 law keeps these statutory rates in place until the state’s new NEMT administrator starts.

Our trip price calculator runs the same math for your own rates and miles.

Long trips, mileage limits, and unloaded miles

Long trips bring extra rules in several states.

• Overnight trips. CMS requires states to cover related travel expenses, such as meals and lodging, on overnight long-distance trips.
• Paid unloaded miles. CMS lets states pay unloaded miles and wait time separately only in limited circumstances, and only after a state plan amendment. North Dakota approves unloaded miles case by case.
• Distance limits. Minnesota caps trips at 30 miles to a primary care provider and 60 miles to a specialist unless the trip is authorized.
• Mileage edits. Colorado suspends a claim for review when its mileage lines exceed 52 miles, or 125 for members in designated rural counties, and denies it without a supporting attachment. Trips over 25 miles one way also need a verification form signed by the rider’s treating or referring provider.
• Out-of-state care. North Dakota requires a service authorization for travel to a provider more than 50 miles past the state border.

Price long trips with the empty return in mind, since Medicaid generally does not pay for it.

Broker and managed care rates are contract terms

When a broker or managed care plan arranges the trip, the state fee schedule does not set your pay. Your contract does.

• The broker sets the rate in your agreement. In Indiana, Verida bases its rate schedule on the state’s professional fee schedule and can negotiate higher or special rates with each provider. CareOregon’s manual says negotiated rates are approved only if the brokerage authorized the rate before the trip.
• The state still oversees access. CMS says states may direct brokers to use specific provider payment methods and should make sure a broker does not pay so little that local providers refuse to participate.
• Some published schedules reflect negotiation too. The eMedNY schedule notes that its fees apply to the fee-for-service broker program and may reflect specific network negotiations.

Use the state fee schedule as your benchmark when a broker makes an offer. If the offer is well below it, ask what volume, service area, or payment speed makes up the difference. The NEMT broker rates guide covers how those contracts are usually structured, and how to price NEMT trips shows how to check any rate against your real cost per trip.

Keeping rates straight across payers

Most fleets bill several payers at several rates in the same week. In HealthRide, prices come from your rate schedules, set per payer, and each trip is quoted at booking. Invoices for facilities and other payers build from completed trips at those rates, so the amount billed always matches the ride that happened.