Indiana Medicaid NEMT fee schedule: IHCP codes, rates, and the 2027 changes

One fee schedule, three ways to be paid

Indiana prices Medicaid transportation from a single document, the IHCP Professional Fee Schedule, which the Indiana Health Coverage Programs updates every month. The IHCP fee schedule page says those rates apply to fee-for-service claims and also serve as minimum reimbursement rates for all IHCP managed care programs. Where your claim goes depends on the rider:

Under the transportation module, each provider in Verida’s network signs a rate agreement, and the broker is free to agree higher or special rates with individual providers. WellTrans has arranged rides for all three Healthy Indiana Plan and Hoosier Healthwise plans (Anthem, CareSource, and MHS) since January 1, 2026. In Hoosier Care Connect, Anthem and MHS members ride through WellTrans and UnitedHealthcare members through LCP Transportation. The Indiana state guide covers enrollment, and the Verida broker guide covers joining its network.

2026 rates and the 2027 preview

The table below comes from the Professional Fee Schedule last updated September 8, 2026, which still shows the 2025 lines with their end date, and from the IHCP’s 2027 preview files. CAS means commercial ambulatory service, and NAS means nonambulatory (wheelchair) service.

The 2027 mileage and waiting time lines sit in the EMS preview file, next to the ambulance codes. The rest are in the NEMT preview file. Across these codes the step from 2026 to 2027 is close to 3 percent.

Several codes you might expect are not payable in Indiana. S0209 (wheelchair van mileage) and S0215 (non-emergency mileage) are marked noncovered, and the module tells providers to leave S0215 off claims. The stretcher van base and mileage codes (T2005, T2049) are noncovered too. So are A0170 through A0210, the parking, toll, lodging, and meal codes.

Mileage after the first 10 miles

The transportation module sets these mileage rules for CAS and NAS providers:

• Mileage pays only on a one-way trip longer than 10 miles, and the IHCP removes the first 10 miles of every one-way trip itself.
• You still bill every mile, including the first 10, so the claim prices correctly. When the whole trip is shorter than 10 miles, mileage is optional, and a billed mileage line denies.
• Mileage for a round trip goes on one line with A0425 and the U3 (CAS) or U5 (NAS) modifier. Do not split it across lines.
• Bill whole miles only, so 15.5 miles becomes 16 and 15.4 becomes 15.
• Drive the shortest efficient route, and record the miles on the driver’s ticket, either from odometer readings or from mapping software set to the shortest route.

Taxi providers are not paid mileage. They bill a flat fee set by how long the trip is, or the metered or zoned rate set by local ordinance where one exists, and must still record the miles. The NEMT mileage billing guide compares how other programs count miles.

Waiting time, attendants, and more than one rider

Waiting time. Three conditions apply at once. The trip must be at least 50 miles one way, the vehicle must sit parked outside the medical provider until the rider comes back, and only time after the first half hour is paid. Each 30 minutes of the total wait is one unit. A remainder of 15 minutes or longer rounds up to another unit, and anything shorter rounds down. The driver’s ticket needs the start and stop times.

Accompanying adults and attendants. Riders younger than 16 need an adult, often a parent, with them, and an adult rider may medically require an attendant. Bill the add-on under the member’s IHCP ID: T2001 with T2003, A0130 TK with A0130, or the TK version of the taxi code. The adult or attendant signs the driver’s ticket, which also records their name and relationship.

Extra attendant to load the rider. When the driver cannot load the member alone, for example a wheelchair user who lives upstairs with no ramp, a second employee of the billing provider can help and does not have to stay for the trip. Bill A0130 U6, up to two extra units, and document the need on the ticket. The IHCP pays an extra attendant only on NAS and ambulance trips, and ambulances bill A0424 for it.

Two or more members together. When several members travel together from one county to the same destination area, such as buildings on a single medical campus, only the first member earns the full base, mileage, and waiting time. Everyone after that bills half the base (T2004 for CAS, A0130 TT for NAS), and nothing for mileage or waiting. The IHCP pays no extra for multiple passengers in ambulances or family-member vehicles.

Trips, legs, and the XE modifier

The IHCP counts a trip as everything between the first pickup and the final drop-off. A stop along the way, such as a lab draw while the driver waits, does not make a second trip. A round trip for the same member, date, and base level goes on one line with two units, with all mileage on its mileage line. If the ride out and the ride home were at different levels, the two bases go on two claims, and each carries its own mileage.

Bulletin BT2025119 (August 19, 2025) introduced the XE modifier for this: each extra, separate trip a member takes that day carries the XE modifier on its detail line. Modifier 76 is no longer appropriate. XE does not apply when the driver waited between stops, because that counts as one trip. Every base and mileage line also carries a two-letter modifier for origin and destination. The first letter marks the starting point (for example R for residence) and the second marks the destination (for example P for physician’s office). The origin and destination modifiers entry lists the letters.

Who can bill which codes

The IHCP ties billable codes to your provider specialty under provider type 26, and ground trips are billed at the level of service delivered, whatever vehicle carried the rider.

Verida and brokered billing

For fee-for-service members, most NEMT goes through Verida. The IHCP module and NEMT page set out how it works for providers:

1. Enroll with the IHCP, then contract with Verida. Send Verida’s Request for Qualifications and Vehicle List Form, sign its provider agreement, and have credentialing done by day 60 after signing.
2. Take trips Verida schedules. Members schedule nonurgent rides two or more business days in advance, and Verida handles urgent interfacility transports, which it treats as due within three hours of notice.
3. Leave prior authorization to Verida. It obtains any needed authorization from the state’s contractor, so you do not file one for a brokered trip.
4. Bill Verida. Verida pays a clean claim within 14 days if it arrives by Wednesday of that week. You choose a check or electronic funds transfer, and a remittance advice lists what was processed in each payment run.

Some fee-for-service rides are exempt from brokerage and go to Gainwell instead: ALS and BLS ambulance transports, stretcher transports (through enrolled ambulance providers since July 1, 2023), all hospital-to-hospital transports (with the HH modifier), waiver services under 1915(c) waivers, school corporation transport, and Medical Review Team trips. Nursing facilities book and cover their residents’ non-ALS and non-BLS rides, and those costs are folded into the facility’s per diem.

Filing with Gainwell and what the ticket must show

Nonbrokered fee-for-service transportation is billed on a professional claim: the CMS-1500 form, the IHCP Provider Healthcare Portal, or an 837P transaction. Use ICD-10 code R69 as the primary diagnosis when the real diagnosis is unknown, because a claim without a valid diagnosis code denies. Bill all of one member’s same-day services on one claim. Claims must reach the IHCP no more than 180 calendar days after the service date. Since January 29, 2026, Gainwell has deducted a $5 fee from later payments for each fee-for-service paper claim on its first submission. Corrected and adjusted claims are not charged.

The driver’s ticket or run sheet backs every claim. The module lists what it must show:

• Full date of service, the member’s name and pickup address with county and ZIP, and the member’s IHCP ID.
• The member’s signature or, if the member cannot sign, the driver’s note giving the reason.
• The destination provider’s full name and address.
• The driver’s name.
• Odometer readings when each trip begins and ends, or shortest-route mileage from mapping software.
• One-way or round trip, plus the level: CAS or NAS.
• Waiting start and stop times.
• The name, relationship, and signature of an accompanying adult or attendant, if one rode along.

Missing documentation puts the payment at risk of recoupment. The NEMT documentation guide covers building these fields into the driver’s routine.

What changes on January 1, 2027

Bulletin BT2026143, issued August 27, 2026, sets the transportation lines of the Professional Fee Schedule equal to Medicare’s January 1, 2026 rates, for services on January 1, 2027 and later. The same bulletin moves physician, equipment, and supply rates on the same basis. The new figures appear in the 2027 preview files on the IHCP fee schedule page and in the table above.

Managed care entities must update their own fee schedules to mirror the 2027 IHCP schedule by January 1, 2027. If you run plan trips through a broker, ask whether your rate sheet is tied to the IHCP schedule and whether it steps up on that date.

A worked example

A hypothetical NAS round trip, 14 miles each way, priced at the IHCP fee schedule amounts with no waiting time:

Now take a 60-mile one-way dialysis trip where the driver waits 2 hours and 10 minutes. That wait is four full half hours plus 10 minutes, so you bill 4 units of T2007 U5. The first 30 minutes are not covered, so the IHCP pays 3 units, or $22.29 at the 2026 rate. The NEMT billing codes guide explains each code in general terms.

Recording Indiana trip details in HealthRide

Indiana’s claims depend on details from the road: odometer or mapped miles, wait start and stop times, signatures, and who rode along. HealthRide’s driver app captures signatures on screen and records each leg’s times, and the trip log in reports exports every leg with its GPS-recorded miles as a spreadsheet or PDF. That puts the ticket details your biller needs in one file.