MassHealth wheelchair van rates: the 101 CMR 327 fees and the enhanced broker trip rate

Two state rates for one wheelchair van trip

Massachusetts publishes two prices for a wheelchair van ride, and both come out of the same regulation. 101 CMR 327.00 is the state’s rate rule for ambulance and wheelchair van services, issued by EOHHS (the Executive Office of Health and Human Services), and section 327.03 holds its fee schedule. Section 327.04(2) then allows EOHHS to pay a transportation broker other rates under a selective contract.

MassHealth wheelchair van rides now run only through that broker arrangement, the Human Service Transportation (HST) brokerage. For MassHealth members, the selective-contract rate is the one EOHHS pays. The 327.03 fees remain the rates the regulation sets for other government buyers of wheelchair van rides for publicly aided people.

A company that subcontracts with a broker is paid a third amount: the rate in its own contract with MART or GATRA. Those terms are covered in the MART and GATRA guides. Licensing, insurance, and joining the brokerage are in the Massachusetts NEMT guide.

The 101 CMR 327.03 wheelchair van fees

The current text of 101 CMR 327.00 covers services delivered on or after September 26, 2025. Its wheelchair van section has three lines, and none of them moved from the April 2025 text:

Three definitions in section 327.02 decide how those lines apply:

• Trip. Picking up a person, carrying them, and delivering them to or from a hospital or other health care facility.
• Loaded mileage. The distance actually traveled with the person aboard. Miles driven empty to reach a pickup are not loaded miles (see loaded miles).
• Wheelchair van. A motor vehicle specifically equipped to carry people who have a mobility disability or who use a wheelchair.

The lowest of three amounts

Section 327.03(1) pays the lowest of three figures: your usual fee to patients who are not publicly aided, the charge you actually submitted, or the fee on the schedule. It is the regulation’s version of the usual and customary charge rule. For example, a company that charges private riders $35 for a wheelchair van base is paid $35 by a state buyer, not $40.55. The rates are also payment in full, administration and supervision included.

An example: one-way, 12 loaded miles, with an attendant on board, priced on the schedule:

1. Base (A0130): $40.55
2. Mileage (S0215): 12 loaded miles at $1.46, or $17.52
3. Attendant (T2001): $8.00

That totals $66.07, unless your usual private fee or your billed charge is lower.

When the fees do not apply

Section 327.01(5) says the fees do not apply under any conditions when the buying agency decides that no medical need existed, that some other kind of transportation could be used without endangering the patient, or that the van was used for an unauthorized purpose. Services that are authorized but not listed are paid by individual consideration: the agency prices the bill it receives, and the provider keeps records that support the claim. The regulation also says it authorizes nothing. Each agency that buys rides defines, authorizes, and approves the service itself.

Why MassHealth stopped paying these fees directly

MassHealth moved its fee-for-service wheelchair van rides into the HST brokerage in 2022. Transportation Bulletin 19, issued in November 2021, gave providers notice: starting April 1, 2022, MassHealth would no longer directly enroll or pay anyone for nonemergency wheelchair van transportation. A company that wanted to keep doing the work had to sign with one broker or both. All Provider Bulletin 339, in February 2022, told hospitals, skilled nursing facilities, and other medical providers that every wheelchair van ride would need a PT-1 request from April 1.

Transmittal letter TRN-40, dated October 2022, explains that providers were allowed to bill MassHealth for two more months after April 1. From June 1, 2022, providers could no longer bill MassHealth directly for wheelchair van transportation. TRN-40 removed these codes from the Transportation Manual’s list of service codes:

• A0130, plus A0130-TS, used when a member had more than two one-way trips in one day
• A0130-TK and A0130-TK-TS, the extra patient lines, which allowed no mileage fee
• S0215 and S0215-TS, the mileage lines
• T2001 and T2001-TS, used for a second attendant
• A0120, used only for wheelchair van transport of a person under investigation for, or known to have, COVID-19
• A0170, used only for ferry charges

Ambulance was left out of the change. Emergency and nonemergency ambulance trips stay fee-for-service with MassHealth, and ambulance providers keep the Medical Necessity Form on file.

Who still pays at the 327.03 rates

The regulation calls its fees the rates “to be used by all governmental units” for ambulance and wheelchair van services to publicly aided individuals. A governmental unit is the Commonwealth or any of its departments, agencies, boards, commissions, or political subdivisions. Section 327.01(1) adds that the ground transport rates also apply to people covered by the Workers’ Compensation Act, M.G.L. c. 152.

Each buyer still decides its own conditions and authorizes each trip, and section 327.04(1) lets a buyer sign a special contract for services not listed or for exceptional circumstances. Before you quote work for a state agency, a city or town, or a workers’ compensation case, ask whether the buyer pays under 101 CMR 327.03 or under a contract of its own.

The enhanced trip rate under the broker contracts

EOHHS pays a separate rate for enhanced wheelchair van trips that the brokers arrange. Administrative Bulletin 23-08, effective April 1, 2022, set $92.88 per trip, and that amount includes the first five miles. Miles past five are paid at the rate set in the broker contract. Bulletin 25-14 defines enhanced trips as wheelchair van trips “that require door-to-door and door-through-door levels of service,” meaning the rider gets help leaving and entering buildings, not just a pickup at the curb (see door-through-door).

Administrative Bulletin 25-14 added a rate for shared enhanced rides on July 1, 2025. When two or more members travel together, the first member is paid $92.88 with the first five miles included, plus mileage past five. Every other member on board earns $46.44 and no mileage, billed as T2002 with modifier TK.

As an example, a 12-mile enhanced trip for one rider is paid $92.88 for the trip and its first five miles, plus seven miles at the broker contract’s mileage rate. Bulletin 25-14 does not print that mileage figure, and the amounts it sets are what EOHHS pays under its broker contracts, announced under section 327.01(7). What a subcontracted company receives for the same trip is set by its own contract with the broker.

PT-1 levels and paperwork

A brokered MassHealth ride starts with a PT-1, the transportation request a medical provider submits online through the MassHealth Customer Web Portal. Any MassHealth provider with an active provider ID can submit one, for members whose coverage is Standard, CommonHealth, or CarePlus. All Provider Bulletin 339 describes three kinds of PT-1:

• Curb-to-curb (traditional). Sedan or wheelchair van, with or without an attendant or escort, who is not supplied by the transportation company.
• Room-to-room (enhanced). The same vehicles, with the help a rider needs to get safely from origin to destination. Enhanced is the same word the rate bulletins use.
• Discharge (14-day authorization). A single-use request to get a member home or to the next setting after an inpatient or outpatient stay, at either level.

GATRA’s member FAQ says MassHealth may take as long as three business days to approve a PT-1. A medical provider whose patient needs a ride before then can phone (800) 841-2900, the MassHealth Customer Service Center, and ask for a verbal approval. On brokered trips, the broker keeps the approved PT-1 as part of the trip’s medical record, so no Medical Necessity Form is needed.

Getting trips and getting paid as a subcontractor

Each broker picks the company for a trip by cost, by the vehicle the rider needs, and by which vehicles are free. Under HST policy, members cannot choose their own company. For room-to-room trips, Bulletin 339 said the broker would try to honor existing relationships between transportation companies and facilities once it learned of them.

Payment then follows your broker contract. MART’s contract, for example, pays authorized trips at each provider’s own rate structure, takes rate changes once a quarter, and pays by EFT no later than 45 days after it receives an approved invoice. Each broker’s current terms are in its guide, and every code on this page has an entry in the billing codes guide.

Keeping miles and times behind the invoice

Both EOHHS rates turn on loaded miles, and a broker or state buyer can ask you to back up the count. HealthRide records each leg’s miles by GPS, along with its pickup and drop-off times and the signatures captured on screen. The trip log report downloads any date range as a spreadsheet or PDF. When you bill a facility or payer yourself, the invoice is built from those same completed trips.