Kansas Medicaid NEMT rates: the KMAP fee schedule, level 1 and level 2 trips, and KanCare plan rides

KMAP’s fee-for-service amounts by code

Kansas Medicaid pays commercial NEMT providers a flat base per one-way trip, and adds mileage once a trip runs longer than 10 miles. These are the amounts on KMAP’s Title XIX Medicaid fee schedule dated October 1, 2026. The NEMT manual requires prior authorization for every one of these services.

The base amounts have not moved in a long time. The schedule’s effective dates put T2003 and T2002 at these rates since January 15, 2008, A0130 since March 1, 2008, and T2005, A0100, and A0110 since November 1, 2009. Mileage is the line that has moved more recently: A0425 has paid $3.00 a mile since July 1, 2018.

The same A0425 code pays $13.20 a mile when an ambulance provider bills it, under KMAP’s separate ambulance rate type. Provider type and specialty decide which price a claim gets, so the enrollment you hold matters as much as the code you type.

Level I and Level II decide the base

Most KMAP members qualify for Level I, which bills T2003. That covers anyone who can walk on their own or with help and who does not need a wheelchair or equipment that stays attached during the ride. A walker or cane alone does not move a member to Level II.

Level II covers three groups:

• Non-ambulatory members. Riders who travel in a wheelchair or on a stretcher, and riders who can walk but cannot complete the trip without a wheelchair.
• Members with equipment that cannot come off during transit. The manual names a ventilator, IV fluids, and peritoneal dialysis fluids.
• Members weakened by treatment. Outpatient surgery, radiation, chemotherapy, or dialysis can qualify, but receiving one of those treatments does not qualify a member by itself.

The Level II codes (A0130, T2002, and T2005) only pay after the member’s primary care doctor sends the Certification by Medical Provider for Transportation Services form to the NEMT prior authorization team. If the form is not received within 45 days, the claim denies. The certification lasts one year or less, unless the doctor writes that the member is permanently confined to a wheelchair, and it is the transportation provider’s job to get the renewal in before the recertification date.

You can see a member’s current NEMT level, its effective and end dates, and the recertification date at the bottom of the Member Eligibility Verification screen on the KMAP secure site. Only the most current level shows, so check it for the actual date of the trip. For how other payers split riders into service levels, see level of service.

How KMAP counts the miles

On a one-way trip the base code carries the opening 10 miles and bills as one unit. On a round trip it carries 20 miles and bills as two units. Only the miles beyond that go on A0425, one unit per mile, using this formula from the manual:

1. One-way trip. Total miles minus 10 equals billable miles.
2. Round trip. Total miles minus 20 equals billable miles.

Miles must come from mapping software using its shortest-distance option between the pickup and destination addresses. Reporting odometer mileage on the claim or the transportation form is not acceptable, and you cannot bill A0425 without a Level I or Level II base code on the same claim.

Two examples at the current rates, both hypothetical. A Level I one-way trip of 24 shortest-route miles pays T2003 plus 14 miles of A0425: $12.50 + $42.00 = $54.50. A Level II wheelchair van round trip totaling 60 miles pays two units of A0130 plus 40 miles: $60.00 + $120.00 = $180.00. Both units of the same code on the same day go on one detail line, because KMAP denies claims that split repeat trips across lines.

For the general mechanics of mileage units, see NEMT mileage billing.

What the regulation says compared with what KMAP pays

K.A.R. 30-5-107a, the Kansas regulation on NEMT reimbursement, still prints the amounts set when it was last amended on July 1, 2003. The state plan’s payment page for NEMT, approved under KS-21-0020, says motor carrier and subsistence services are paid fee schedule rates, with the schedule published on the KMAP site. Claims price at the schedule.

KS-21-0020 took effect October 1, 2021, and CMS approved it January 27, 2022. It removed the NEMT broker language from the fee-for-service program and states two limits that still shape every claim: waiting time is never paid, and NEMT is covered only when no cheaper way to travel is available.

Extra riders, parents, and attendants

Kansas pays a small add-on, not a second full trip, when more than one person rides.

• TK, extra members. When two or more Medicaid members share the same pickup or the same destination, claim 1 carries the base code and any mileage. Every other member’s claim carries the base code with TK, which pays $2.50, and no mileage. When pickups differ but the destination is the same, claim 1 goes to the member carried the farthest.
• UK, a parent or guardian. UK pays $2.50 for transportation provided for someone other than the member, such as a parent. It attaches to A0130, T2002, T2003, or T2005, covers up to one round trip (two units) per member per day, and pays for only one parent or guardian even if two come along. It must sit on the same claim as the member being accompanied.
• No mixing. A claim with a TK line and a UK line together denies.
• No paid attendants. Attendants who help the driver with members who have restrictive disabilities are on the never-covered list.

The TK modifier entry covers how other states use the same code.

Lodging, meals, and non-commercial drivers

Subsistence is normally limited to the member, under the state plan. An attendant, parent, or guardian traveling with a child, or with an adult who has restrictive disabilities, also receives subsistence. The October 2026 schedule lists these amounts:

• A0180, member lodging. $54.00.
• A0190, member meals. $10.50.
• A0200, escort lodging. $54.00.
• A0210, escort meals. $10.50.
• A0140, air travel. Manually priced.

A0080 and A0090, the per-mile codes for non-commercial drivers, each pay 30 cents a mile. A commercial NEMT company cannot bill for carrying its own relatives. The manual says a provider transporting a relative must enroll as a non-commercial NEMT provider. The ancillary codes entry lists the full A0170 to A0210 range.

Rules that decide whether a trip pays at all

A rate only matters if the trip qualifies. The KMAP manual sets these conditions for fee-for-service rides:

1. Prior authorization before the ride. Call the automated line (1-800-285-4978) or fax the request (1-800-913-2229), giving the shortest-route miles and whether the trip is one-way or round trip. Requests after the trip are denied, except an emergency ride outside business hours or on a weekend or holiday, which you report within 48 hours. Report changes within 72 hours.
2. More than two round trips in a day. If one member gets more than four units of A0130, T2002, T2003, or T2005 on one date, mail copies of the transportation forms to the NEMT PA team within 45 days.
3. Trips longer than 50 miles each way. Keep a Commercial NEMT Medical Necessity form signed by an MD, DO, APRN, or PA, obtained before the trip or within 72 hours after. It is valid for six months.
4. Kansas or a border city. Travel must be within Kansas or to an approved border city within 50 miles of the state line, to the closest provider for the member’s condition.

The never-covered list includes trips for nursing facility residents, rides to waiver-covered services like respite care, and pickup-only trips for medications or equipment. One pharmacy stop is allowed on the return leg after an appointment.

Filing the claim

KMAP takes NEMT claims on the CMS-1500, or electronically. The NEMT manual sets these field rules:

• Field 21. Diagnosis code R6889, for trips on or after October 1, 2015.
• Field 23. The prior authorization number.
• Field 24A. One line per date of service, never a date range.
• Field 24B. Place of service 99.
• Field 24F. Your usual and customary charge for each line.

Paper claims go to the Office of the Fiscal Agent, PO Box 3571, Topeka, KS 66601-3571. Under the General Billing manual, KMAP must have the claim in hand inside 12 months of the trip. Keep a completed NEMT Transportation form for every trip, signed in the original by the member when the ride happens, for at least five years. Failure to keep complete records results in recoupment after a utilization review. Each national code used above is explained in NEMT billing codes.

KanCare members ride on the plan’s money

When a member is enrolled in a KanCare plan, the KMAP manual says commercial NEMT is the plan’s responsibility. The plan’s transportation vendor schedules the ride and pays you under your agreement with it, not under the KMAP schedule. KMAP’s Bulletin 19019, revised March 2026, lists where each plan’s transportation claims go.

QMB-only and MediKan members have no NEMT benefit at all. Members on a medically needy spenddown are covered only once the spenddown is met. Until then KMAP does not cover the trip and you may charge the member. If the member pays, submit the claim anyway so the amount counts toward the spenddown. For enrollment steps, see the Kansas state guide. Broker credentialing is covered on the SafeRide Health and MTM Health pages.

Keeping Kansas trip records in HealthRide

KMAP can take money back for any trip whose paperwork does not hold up in a utilization review. HealthRide’s driver app stores the miles it tracks by GPS, the time of each pickup and drop-off, and an on-screen signature for every completed trip, and you can pull the full trip log into a CSV or PDF file when KMAP asks for records. When KMAP or a KanCare broker pays, you can record the check or deposit in invoicing, which keeps every payment in one ledger.