Illinois Medicaid transportation rates: service car, medicar, and taxi pay by county

How HFS prices a non-ambulance trip

The Illinois Department of Healthcare and Family Services (HFS) builds each medicar or service car payment from three pieces: a base amount per trip, an amount per loaded mile, and a fixed add-on when an approved attendant rides along. The payment is whichever is lower, the HFS maximum or the amount you normally charge the public. Three details decide the number on your remittance:

• Your county group. 89 Ill. Adm. Code 140.492 ties base rate reimbursement to the county where the vehicle is based. The handbook describes it as the county in which you are registered with HFS. The fee schedule sorts counties into three groups, and mileage, taxi, and stretcher amounts differ between them.
• The vehicle category. A medicar (wheelchair van), a service car (an ordinary passenger vehicle, for riders who need neither a lift nor an ambulance), a taxi, and a private auto each have their own codes and rates.
• Prior approval. HFS pays nothing on a non-emergency trip without prior approval or approved post-authorization, and the claim has to match that approval.

The schedule covers fee-for-service riders, meaning people not enrolled in a HealthChoice Illinois plan. Plan members ride through the plan’s vendor, covered later on this page. The Illinois state guide covers licensing and enrollment.

The 2026 HFS rate table

HFS publishes one spreadsheet, the Non-Ambulance Transportation Fee Schedule, effective January 1, 2026. It lists every county. The rates fall into three groups, plus an out-of-state row.

The out-of-state row uses the Chicago-area medicar and service car mileage of $1.03, the $11.64 stretcher amount used outside the Chicago area, and the standard taxi figures. The spreadsheet’s own notes say prior approval is required for all non-emergency transportation, that the rates reflect the SMART Act’s 2.7 percent reduction of July 1, 2012, and that A0120, A0130, T2001, and T2001 TK went up on January 1, 2023.

Two lines need a word of explanation. HFS lists the stretcher code (T2005) under the medicar columns, and the handbook treats a stretcher as a covered extra on a medicar trip, paid at a set amount alongside the base and mileage rather than as a trip of its own. And the taxi figures apply only where no local government sets a taxi rate. In a municipality or township that regulates taxis, HFS pays the community rate plus the attendant amount.

What each vehicle category means

HFS defines each category by the rider’s needs, and the category on the claim has to fit the rider.

Medicar and service car trips are non-emergency only and cannot be billed as emergencies. Billing a stretcher also requires meeting the Illinois Department of Public Health’s licensing rules for stretcher vans (77 Ill. Adm. Code 515.835 and 515.840). Medicar, taxi, and service car companies must certify that each driver and employee attendant completed a safety course approved by HFS before carrying Medicaid riders, and that training must be renewed every three years. A company that cannot show the certificates on request loses every payment for trips an uncertified driver or attendant handled.

Attendants, passengers, and several riders in one van

Illinois separates attendants from passengers, and the difference is money.

• An attendant rides because the rider medically needs one, for example a parent taking a child to the doctor or a helper who assists the rider. Attendants need prior approval case by case. The handbook calls an attendant on your payroll an employee attendant, and a relative or anyone else the rider brings a non-employee attendant.
• Who can bill which attendant. A medicar may bill an employee attendant and a non-employee attendant on the same trip, using the second attendant line with the TK modifier. A service car or taxi may be paid only for a non-employee attendant.
• A passenger simply rides along, Medicaid-eligible or not, if there is room and proper seat belts or car seats. You cannot charge for a passenger.
• Two Medicaid riders together. Each rider gets a separate claim, and each claim can include the base rate and an approved attendant. Mileage goes only on the first rider’s claim, measured along the shortest route from the first rider’s pickup to their destination, however far that rider travels.

Car seats are the parent’s or guardian’s responsibility, so confirm who is bringing one when the trip is booked.

What HFS will not pay

The handbook lists charges the Department refuses outright. Build your prices knowing these never come back:

• Tolls, parking, waiting time, meals, and lodging.
• Miles driven with no rider aboard.
• No-show trips where the rider was not transported.
• Pharmacy runs and trips to collect medical supplies or equipment.
• Trips past the nearest appropriate provider, or a more expensive vehicle than the rider needs, such as a medicar when a service car would do.
• Trips in vehicles the provider does not own or lease and operate.
• Elective moves between long-term care facilities, and hospital inpatients taken elsewhere for outpatient care, which the inpatient hospital pays for.

One exception works in the provider’s favor. When the doctor or clinic cancelled without telling the rider, and the rider only finds out at the door, both legs of that trip are billable.

Prior approval through Transdev

HFS contracts with Transdev to approve non-emergency trips under 89 Ill. Adm. Code 140.491. The rider, a representative, the medical provider, or the transportation company can make the request.

1. Request at least seven business days ahead. Single-trip requests can go by phone, fax, or Transdev’s free PassPORT portal.
2. Use a standing approval for repeat care. When a rider goes to the same place for the same care more than three times a month, ask for a standing approval by fax or PassPORT, never by phone, with the medical documentation attached.
3. Wait for the approval before billing. Transdev issues a Request Tracking Number and posts approvals to PassPORT the business morning after its decision. A claim that differs from the approval is rejected.
4. Check eligibility every day. Approval is not an eligibility check. Confirm the rider is eligible in MEDI or through the automated line on the day of each trip.
5. Fix mistakes by phone. Transdev makes changes by phone and issues a new number. Bill remaining trips on the new number and never rebill trips paid on the old one.

When approval could not be obtained in advance, ask Transdev for post-authorization no later than 30 calendar days after the trip. Past that point only HFS can approve, and only in two situations: the rider’s Medicaid application was still undecided on the trip date (send the request within 90 days of the notice approving it), or the rider never told you about their coverage (send it within six months of the trip, attaching the private-pay bills you mailed each month). The Transdev broker guide covers the PassPORT portal.

Medical necessity forms

Illinois uses two standard forms. They apply to fee-for-service riders and to HealthChoice Illinois plan members alike.

A single form can support repeat medicar or service car trips for as long as 180 days. A PCS written for a hospital discharge is good only for that date. If the PCS was not done before the trip, the facility owes it to you free of charge no later than 10 calendar days after you ask, and under 140.491 you have 90 calendar days from the trip to submit the PCS or proof that you tried to get it. A fax receipt, an email receipt, or a signed postal return receipt counts as proof. Private auto trips need neither form.

Filing claims and getting paid

Transportation claims fall under the HFS 180-day limit, counted from the trip date, and resubmissions are held to the same limit. Each claim gets a 12-digit document control number that encodes the year and Julian date HFS received it, which is useful when you need to prove a claim arrived on time. The timely filing limit entry compares Illinois with other programs.

Health plan trips run through vendors

Rides for HealthChoice Illinois plan members do not go to HFS. The handbook says to work with the member’s plan or its administrator, except for ground ambulance and a few Medicare-related cases. The HFS subcontractor list for June 2026 names each plan’s transportation vendor:

In an August 26, 2026 notice, Blue Cross and Blue Shield of Illinois announced the switch. Standing rides and trips already scheduled after October 1 move to MTM Health automatically. Vendor rates are set in your contract, not by the HFS schedule, but the fee schedule still gives you a reference point when a vendor makes an offer. Each vendor’s network is covered in the Modivcare and MTM Health broker guides.

Where the rates came from

The Illinois schedule has changed little over two decades. Under 140.492, since July 1, 2002, transportation has been paid at the lesser of the provider’s usual and customary charge or 94 percent of the fiscal year 2002 rate. Medicar and service car base rates stopped including the first ten miles on July 1, 2006, when mileage became payable from the first loaded mile. The SMART Act cut rates 2.7 percent on July 1, 2012. The fee schedule notes that the medicar and service car base rates and both attendant rates were last raised on January 1, 2023. The HFS taxi rate for areas with no local taxi rate is reviewed each July.

A worked example

Take a hypothetical medicar trip of 8 loaded miles with an approved employee attendant, billed at or above the HFS maximums.

On a trip like this, mileage is a small share of the payment. The base and the approved attendant make up most of it, which is why getting the attendant on the approval matters. For code definitions, see the NEMT billing codes guide, and how much Medicaid pays for NEMT puts Illinois beside other states.

Tracking Illinois trips in HealthRide

Illinois pays by county group, by rider, and by attendant, so the detail of each leg shapes the payment. HealthRide’s reports include a trip log with every leg’s addresses, times, driver, vehicle, and GPS-recorded miles, which you can export as a spreadsheet or a print-ready PDF. A payer summary lists completed trips, revenue billed, and the balance still owed by each payer, so you can see how your fee-for-service work compares with each plan vendor’s.