Kentucky Medicaid transportation fee schedule: stretcher rates, regional payments, and subcontractor pay

What the 2026 schedule pays for a stretcher trip

The Department for Medicaid Services (DMS) posts one Transportation Fee Schedule, effective January 1, 2026 and revised January 9, 2026, and its non-emergency stretcher lines pay a $55.00 base plus $2.00 a mile. They sit under Provider Type 56, Specialty 16 only. The Kentucky NEMT guide covers enrollment, brokers and operating authority.

Here is a trip at the limit, as a hypothetical example. A stretcher run of 18 miles with oxygen for one patient is $55.00 plus 18 miles at $2.00 plus $10.00, which is $101.00. A second patient on the same run adds $10.00, for $111.00. The state plan counts mileage “from mile one,” so there is no free stretch at the start. Oxygen is paid as a flat $10.00 for each one-way trip when it is medically necessary, according to 907 KAR 1:061.

These are ceilings. Section 2 of 907 KAR 1:061 has Medicaid pay the lesser of your usual and customary charge or the upper limit, so a company whose usual private-pay charge for the base is $48.00, for example, is paid $48.00. Payment also depends on a statement of medical necessity kept in the file, and a provider that charges a rider a membership or subscription fee cannot bill Medicaid for that rider’s trips.

Stretcher rates are unchanged from 2022 through 2026

Every Kentucky transportation schedule from 2022 through 2026 carries the same stretcher amounts, $55.00, $10.00, $2.00 and $10.00. The changes were to codes, not dollars:

• January 1, 2024. DMS added A0998, ambulance response and treatment with no transport, at $82.50.
• January 1, 2025. The stretcher codes T2005 and T2005 GM became A0428 and A0428 GM. The schedule was updated June 1, 2025 to show it.
• January 1, 2026. The revision table says there are no changes or updates.

A rate that stays flat across five annual schedules costs you more every year to run. Add your own cost per mile to the schedule before you accept a trip at the limit, and see how NEMT rates change for what it takes to get one moved. DMS’s fee schedule page tells providers to file an open records request for copies of older schedules.

Who pays: DMS or the member’s health plan

The fee schedule is the price list for fee-for-service claims, which Gainwell Technologies processes. Kentucky’s 2025 waiver renewal says non-emergency ambulance service for people who need a stretcher is not part of the broker program: members in managed care get it through their health plan, and members not in a plan get it through fee for service. House Bill 2 of 2026 (Acts chapter 179, section 14) sets the regional broker rules for the state’s NEMT program and exempts NEMT that a managed care organization covers, stretcher included.

Each managed care plan processes its own claims, so ask each plan for its stretcher rate before you accept its members’ trips. See contracting with Medicaid health plans.

Claims for both go on the CMS-1500, using the codes above. DMS’s Provider Type 56 page sets the filing limit at twelve months from the date of service. An entity enrolls as Provider Type 56 with a Transportation Cabinet taxi or Disabled Persons Vehicle certificate or with an ambulance license from the Kentucky Board of Emergency Medical Services.

The rest of the schedule: ambulance codes

The top of the schedule lists Provider Type 55, licensed ambulance services, and its emergency rates depend on whether the destination is a hospital.

The same pages list a $110.00 medical first response code (A0429 UC), return trip mileage at $2.00, and disposable supply maximums of $200.00 or $150.00 for advanced life support and $150.00 for basic.

Starting January 1, 2026, the state plan also adds a supplemental payment for licensed ground ambulance providers in Classes I through III, which includes the Class II agencies that run basic life support nonemergency transport only. DMS figures it from a fixed $170.00 per non-emergent transport and $470.00 per emergent transport, pays it monthly, and reconciles it each year against the provider’s average commercial rate. Ask DMS provider relations whether your license class qualifies before you count on it. Adding a licensed ambulance to a ride business is covered in adding an ambulance service to NEMT.

Wheelchair and ambulatory rides are not on the schedule

Taxi, wheelchair and ambulatory rides are paid through Human Service Transportation Delivery (HSTD), the regional broker program, so no fee schedule has a line for them. Three payments sit in a row:

1. DMS pays the Transportation Cabinet. A “capitated rate” in 907 KAR 3:066 is one amount a month for each covered Medicaid recipient, not a statewide rate, set individually for each HSTD region. The capitated rate cannot exceed Medicaid’s usual aggregate cost of providing the service on a projected statewide basis.
2. The Cabinet passes it to the regional broker, based on assigned enrollment.
3. The broker pays you for completed trips, at a rate the Cabinet sets.

The certificate type decides which rate a trip earns. KRS 281.873 defines the four a carrier can hold. Each has its own Medicaid provider specialty, and the Cabinet’s fiscal 2023 report shows how trips split among them.

The rest were bus service (Type 03, 3%) and a few hundred private auto trips. A Type 08 wheelchair trip and a Type 02 sedan trip in the same county can pay different rates, because the Cabinet sets a rate for each type.

Kentucky’s state plan, Attachment 4.19-B, still has specialty carrier maximums on pages dated 1995 and 1996, such as $25 for the first wheelchair rider plus $1.50 per loaded mile. Wheelchair rides in the broker program are arranged and paid through the regional brokers, at the subcontract rate the Cabinet sets.

What DMS pays each region’s broker per member

DMS’s November 5, 2025 briefing to the legislature lists each region’s capitation rate, and they run from $6.88 to $14.69 per member per month. The broker for each region comes from the Cabinet’s own list.

There is no Region 7, because Kentucky folded the original Regions 6 and 7 into one. The Kentucky state guide lists the counties in each region.

A capitation figure is not a rate for you. A DMS contracted actuary builds each region’s rate from the trips actually provided in an earlier year (calendar 2024 for state fiscal 2026), then adjusts it for enrollment, cost per service and expected use, and adds an allowance for the broker’s administration and a risk margin. CMS approves the rates.

Spread across every trip, the money is thin. Capitated payments came to $174,953,006 in state fiscal 2025, a year with 3,363,272 trips, which works out to about $52 per trip, all in. In fiscal 2023 the Cabinet’s report put it at $53.99 a trip and $4.21 a mile. That has to cover the ride itself, the broker’s staff and the broker’s margin. The regional figures move from year to year too: the Cabinet’s reports list Region 5’s capitation rate at $10.96 for fiscal 2022 and $12.03 for fiscal 2023, against $14.69 for state fiscal 2026.

House Bill 2 now writes how these payments are built into law: a 2 percent performance withhold and a medical loss ratio floor of 85 percent from July 1, 2026. The FTSB guide and the medical loss ratio entry explain both. One more rule touches pay: a hospital or skilled nursing facility that drives its own patients is paid by the regional broker at the same mileage rate a broker-contracted driver would earn for that ride.

The Cabinet sets your rate, and changes it

Section 24 of 603 KAR 7:080 has the Transportation Cabinet set provider rates for each certificate type in each delivery area, uniform for every eligible provider, the broker included. It gives brokers 45 days of notice before a change in subcontractor rates, and a broker may waive that notice in writing. The notice goes to brokers, not to subcontractors, so ask your broker. The six factors the Cabinet weighs are listed in the FTSB guide.

The Cabinet’s yearly reports show how often rates move. Both say subcontractor rates are subject to quarterly review and may be revised during the year.

• Fiscal 2022. Rates were established July 1, 2021, then adjusted August 1, 2021 for every region. After that came September 1, 2021 (Regions 2 and 5), January 1, 2022 (Regions 2, 3, 4, 5, 6, 9, 12 and 16), May 1, 2022 (Regions 3, 6, 8, 13 and 16) and June 1, 2022 (Regions 1, 4, 10, 11, 12, 13, 14 and 15). The report ties the changes to the pandemic and the public health emergency.
• Fiscal 2023. Rates were established July 1, 2022 and adjusted May 1, 2023 for Regions 1, 2, 3, 4, 5 and 14.

Neither report gives a dollar amount, and the Cabinet’s subcontractor page lists none either. The rate lives in the broker subcontract, which must state “the rates for services” under Section 12(6)(c) and cannot take effect until the Cabinet approves the subcontractor.

How to find out what your region pays today

1. Find your broker. The Cabinet’s HSTD page lists each region’s broker and phone number. Rates differ by region, so ask each broker you plan to work for.
2. Ask for the rate for each certificate type you hold. Get it in writing, with the date it took effect. Your subcontract has to list it.
3. Ask when it last changed and whether a change is coming. Brokers get 45 days of notice, so a broker that knows of a change should be able to say so.
4. Compare what you are paid to the sheet. If a payment does not match the rate, start with the broker, then take it to the Cabinet’s Office of Transportation Delivery. 603 KAR 7:080 has the Cabinet investigate complaints about subcontractors and the broker for an area, and the program hotline is 1-888-941-7433.
5. Check your price against your cost. A rate that is the same for every carrier in a region rewards the one with the lowest cost per mile. Use the broker rates guide to work out what a rate has to cover.

Keeping Kentucky trips straight in HealthRide

A stretcher run is paid by the mile, and a company working in two regions may earn a different subcontract rate in each, so each trip needs its own record. In HealthRide the driver app saves GPS-recorded miles, pickup and drop-off times and the rider’s signature when a trip ends, and the trip log in reports exports to CSV or PDF for checking a payment against the miles driven. The dispatch board matches wheelchair, stretcher and oxygen needs to the right vehicle.