Michigan Medicaid NEMT rates: the MDHHS rate schedule and how each program pays

Michigan pays by the mile, not by the code

Michigan’s fee-for-service NEMT program does not publish a HCPCS fee schedule for rides. The Michigan Department of Health and Human Services (MDHHS) keeps a short rate schedule instead: a per-mile maximum, a flat allowance when the trip uses a lift-equipped vehicle or a Medi-Van, and caps on attendants, meals, lodging, tolls, and fees. Transportation providers and riders who drive themselves are reimbursed against it after the trip, on a statement form backed by receipts.

Who authorizes the ride decides whether that schedule applies:

The Medicaid Provider Manual also names three services MDHHS pays transportation providers for directly: long-term lodging near approved transplant hospitals, rides to pregnancy-related care for members in the Maternity Outpatient Medical Services program, and rides to community mental health day treatment for children in the Children’s Waiver Program. The Michigan state guide covers licensing and enrollment.

The July 1, 2026 rate schedule

MDHHS posted this schedule on its NEMT provider page, effective July 1, 2026.

Medicaid reimburses the lower of these maximums or what the provider normally charges the general public. The manual defines that charge as what you bill other payers or the public for the same service, leaving out negotiated contract rates, so a company that gives the public a discount may bill Medicaid only up to that discounted price. The usual and customary charge entry explains why this matters when you set a public price list.

Meals come with time windows. A breakfast counts only if the vehicle leaves before 6:00 a.m. and returns after 8:30 a.m.; lunch needs a departure before 11:30 a.m. and a return after 2:00 p.m.; dinner needs a departure before 5:30 p.m. and a return after 8:00 p.m. Meals bought within the rider’s own city do not qualify.

How the mileage rate has moved

MDHHS keeps its older schedules online. The $35 wheelchair lift amount, the $15 attendant allowance, and the meal and lodging caps appear unchanged in every schedule since 2021. The mileage maximum is what moves.

Each figure MDHHS posted in that period equals the IRS business standard mileage rate for the same dates, including the mid-year IRS increases in July 2022 and July 2026. That pattern gives you a fair guess at the next change, but the schedule on the MDHHS page is the number that pays.

Wheelchair lift, Medi-Van, and attendant allowances

The $35 round-trip amount and the attendant allowance are special allowances. Under the manual, each needs medical documentation on form DHS-5330, Medical Verification for Transportation, kept in the rider’s file and renewed every year.

• Wheelchair lift-equipped vehicle. The rider cannot travel without a wheelchair, or needs life-sustaining equipment that ordinary transportation cannot accommodate. The driver assists and escorts the rider door to door.
• Medi-Van. The rider is able to walk and board on their own but, for medical reasons, needs assistance at the door or the curb. The manual counts demand response paratransit in this group as well.
• Medically necessary attendant. One person beyond the driver who assists because of the rider’s physical, mental, or developmental status. A second attendant needs prior authorization.

The rider’s primary care physician, or a physician assistant or nurse practitioner under that physician’s supervision, signs the first DHS-5330. When the primary care physician cannot complete it in time, another licensed provider who knows the rider’s needs may sign. If the form cannot be secured before the appointment, the authorizing party can still approve and pay the trip as long as the completed form reaches it no more than 10 business days after the appointment. The escort and attendant entry covers how other programs treat the same role.

Getting paid for a fee-for-service trip

Fee-for-service NEMT in Michigan is paid on a statement, not a professional claim. The manual sets the process:

1. Hold active CHAMPS enrollment on the day you drive. Taxicab carriers and public transit are exempt from enrollment, and so are riders who drive themselves and family members driving a relative.
2. Get the trip authorized first. The authorizing party does not pay for rides given before it approves them.
3. Record mileage the way MDHHS checks it. Round the round-trip total up to a whole mile, and make sure an online map or a GPS device can confirm it.
4. Submit form MSA-4674, Medical Transportation Statement, with itemized, unaltered receipts, at most 12 months after the trip. Fee-for-service authorizing parties accept the form and receipts by fax or secure email.
5. Answer questions quickly. The authorizing party may call to fill in missing details or signatures on a submitted form.

Several items never pay, and they belong in your private-pay and facility pricing instead: waiting time, trips where the rider missed the appointment, unloaded miles by commercial and nonprofit providers, several trips for one Medicaid service, and routine care outside the rider’s community when comparable care is local, unless prior authorized. Nursing facility residents’ rides are covered by the facility’s per diem, and trips for managed care members are the plan’s job. The NEMT mileage billing guide covers how to keep miles defensible.

Trips that need prior authorization

MDHHS’s Program Review Division handles prior authorization. The request goes in writing before the trip unless an urgent situation exists and is documented, and a request filed over 30 days after the service cannot be approved for payment. Approval can cover up to six months of repeat trips for treatment lasting more than 12 weeks. Prior authorization is required for:

• Any trip to an out-of-state or beyond-borderland provider.
• Care outside the rider’s community when comparable care is available locally.
• Meals and lodging for an overnight stay within 50 miles of home, or beyond 14 consecutive nights.
• Advance payment of travel costs.
• Travel costs for two or more attendants or people with a vested interest.

Approval does not guarantee eligibility or payment. The authorizing party still has to confirm the rider is eligible on the service date before the ride.

Wayne, Oakland, and Macomb: the broker’s rates

Fee-for-service riders in Wayne, Oakland, and Macomb counties book through ModivCare Solutions, which MDHHS contracts as its transportation broker there. MDHHS pays the broker a fixed monthly sum per eligible member, and the broker contract requires it to negotiate individual service delivery rates with each qualified transportation provider and pay for authorized services. So the MDHHS schedule is not your rate on these trips. Your agreement with ModivCare is. The contract also requires the broker to check that network providers and drivers are enrolled in CHAMPS.

The contract posted on the state’s procurement site runs through change notice 7. Its last option year, exercised in January 2025, set an expiration of July 31, 2026. The Medicaid Provider Manual, in its July 2026 version, still lists ModivCare for these counties, and so does the Office of the Auditor General’s notice for its NEMT audit, which is in progress with release estimated for October 2026. That notice puts NEMT spending at $160.5 million from October 1, 2024 through March 31, 2026, across the broker, the health plans, and local offices. The ModivCare broker guide covers joining its network.

Health plan vendors

Medicaid Health Plans cover NEMT for their members and may set their own prior authorization and documentation rules. MDHHS keeps a list of each plan’s transportation contact, revised May 14, 2026:

Plan vendors pay what your contract says. The MDHHS schedule is still worth keeping next to any vendor rate sheet, because it shows what the state considers a reasonable mileage figure this year.

A worked example

A hypothetical fee-for-service Medi-Van round trip authorized by a local MDHHS office: 11 miles to a clinic and 11 miles back, rounded to 22 miles, with a DHS-5330 on file and a public price at or above the maximums.

The same ride for an ambulatory rider who needs no special allowance pays mileage only: $16.72. Waiting at the clinic between the two legs adds nothing. The NEMT billing codes guide covers how other states split base and mileage.

Keeping Michigan trip details ready in HealthRide

Michigan checks rounded, map-verifiable round-trip miles and wants receipts and signatures behind every statement. HealthRide keeps each leg’s times, signature, and GPS-recorded miles on the trip record, so the details for a statement sit in one place instead of a driver’s notebook. For facility and private-pay work, HealthRide’s invoicing generates invoices from completed trips, priced from each payer’s rates.