Minnesota NEMT rates: ambulatory, lift-equipped, protected, and stretcher payment rules

Mode, not vehicle, sets the rate

Minnesota pays fee-for-service non-emergency medical transportation by the rider’s assessed mode. Minn. Stat. 256B.0625, subd. 17 says so in plain terms: payment follows the mode the rider was assessed for, not whatever vehicle does the driving. A rider assessed for assisted transport earns the assisted rate even when a lift van does the trip. The Minnesota Department of Human Services (DHS) told a House committee in March 2026 that fee-for-service rates are specified in statute, and that local agencies administer modes 1 to 4 while the state administers modes 5 to 7.

Riders in a managed care plan get their rides through the plan instead. The Minnesota state guide covers special transportation service certification and enrollment, and the level of service entry explains how assessments work in general.

The statutory rates

Subdivision 17, paragraph (r), sets these fee-for-service amounts before any rural add-on or fuel adjustment. The billing codes for modes 1 to 4 come from DHS’s template for county and tribal health care access plans, as filled in for 2026 and 2027.

The unassisted, assisted, and lift amounts reflect a 10 percent increase passed in Laws 2023, chapter 61. The same county plan template shows the old and new figures side by side: bases of $11.00, $13.00, and $18.00 became $12.10, $14.30, and $19.80, and mileage of $1.30, $1.30, and $1.55 became $1.43, $1.43, and $1.70. Protected and stretcher rates did not change in that law. The NEMT billing codes guide explains what each code means nationally.

Rural and super rural add-ons

Minnesota raises rates for riders who live outside its urban areas, using the census-tract rural urban commuting area (RUCA) system. The rider’s residence ZIP code decides which rate applies, not the pickup or the destination.

• Super rural base. The base rate is 111.3 percent of the standard base.
• Rural and super rural mileage, up to 17 miles. 125 percent of the standard mileage rate.
• Rural and super rural mileage, 18 through 50 miles. 112.5 percent of the standard mileage rate.
• Trips over 50 miles. No mileage add-on.

Here is how that plays out on a hypothetical 12-mile assisted trip, before any fuel adjustment:

The rural mileage figure is $1.43 times 125 percent. The super rural base is $14.30 times 111.3 percent, rounded to the cent.

The quarterly fuel adjuster

Paragraph (w) moves the mileage rate with gasoline prices. On the first day of any calendar quarter when the U.S. Energy Information Administration’s posted gasoline price tops $3.00 a gallon, DHS moves the per-mile rate up or down 1 percent per dime of difference from a $3.00 base. The price used is the average of all grades of gasoline for Minnesota. The county plan template dates the current adjuster from January 1, 2024, and states that managed care plans must also give a fuel adjustment when fuel exceeds $3 a gallon.

Take a hypothetical quarter: if the Minnesota average came in at $3.40, the adjustment would be 4 percent, and lift-equipped mileage of $1.70 would become about $1.77 for that quarter. The adjustment applies to the per-mile rate. Because the figure resets every quarter, confirm DHS’s current adjusted mileage before you sign a contract priced off the state rate.

Modes 1 to 4: counties, MTM-MNET, and SmartLink

Local county and tribal agencies administer unassisted and assisted rides for people on fee-for-service Medical Assistance, along with personal and volunteer mileage. Each agency files a two-year health care access plan on a DHS template. Polk County’s plan for 2026 and 2027 shows what providers can expect from a county:

• A bill to the county lists the service date, where the ride began and ended, and direct-route mileage, and the ride has to be for a covered service.
• The county pays bills within 30 business days of receipt.
• Meals are capped at $5.50, $6.50, and $8.00, and lodging at $50 a night unless the agency approves more in advance, which matches subdivision 18a.
• Parking and tolls are paid at actual cost.

In the Twin Cities, MTM Health coordinates fee-for-service Medical Assistance rides through a contract with a metro county consortium, a program DHS calls MTM-MNET. MTM sends trips through its Electronic Trip Download system and sets each provider’s rates in individual talks. It pays nothing for no-shows. Its minimum insurance is $1,000,000 apiece for general liability and auto liability, and both policies must name MTM as certificate holder and additional insured. In Scott and Carver counties, SmartLink Mobility Management provides medical assistance rides and mileage reimbursement. The MTM Health broker guide covers its network.

One claim change took effect August 1, 2026. Claims from a local county, tribal agency, or transportation coordinator that name an individual driver (by UMPI) as rendering provider must now also show the transportation company’s NPI or UMPI in the referring provider field.

Modes 5 to 7: state-administered rides

DHS administers lift-equipped, protected, and stretcher rides for fee-for-service enrollees. DHS’s March 2026 briefing says prior authorization or approval is required for long-distance rides, for modes that need assistance or specialty transport such as wheelchair and stretcher, and for out-of-state trips.

• Lift-equipped/ramp transport is for a rider who depends on a device and needs a vehicle with a lift or ramp.
• Protected transport serves a rider whom a prescreening has ruled out of other modes. The statute bars ambulances and police cars, requires a video recorder, safety locks, and a clear plastic partition separating the rider from the driver, and requires the provider to hold protected transport certification. The protected transport entry explains the service further.
• Stretcher transport carries a rider lying prone or supine, with $9 per trip allowed for an extra attendant when medically necessary.

For every mode run by an NEMT provider, the company must meet the special transportation service operating standards in Minn. Stat. 174.29 to 174.30 and Minnesota Rules chapter 8840. Every driver needs a personal DHS enrollment, and the claim names that driver. The rule does not reach public transit, volunteers, or not-for-hire vehicles.

Rules that reduce or deny payment

Minnesota’s statute and DHS guidance set limits that apply whatever the rate:

• No-load miles. Distance driven without an enrollee aboard is unpaid, the trip out to the first rider included.
• Direct route and distance limits. Drive the most direct route. Without authorization, a primary care trip may not exceed 30 miles and a specialty care trip 60 miles.
• One base per trip. You cannot bill a second base rate for continuing a trip past the original destination.
• Signed trip logs. Each log carries pickup and drop-off times plus a signature from the medical provider or the rider attesting to the mileage.

Subdivision 17b adds a fourteen-part trip record as a condition of payment. The list: rider name and service dates; the driver’s name (printed) or provider number; the driver’s signed, dated statement of services and actual miles; a signature from the medical provider or from the rider (or someone authorized for them), or the driver’s note that signatures were refused; origin and destination addresses with direct-route mileage; the mode; the plate number; the pickup time and drop-off time; odometer readings at both points; an extra attendant’s name if one was used; and how you determined the direct route. Records may be kept electronically or on paper, but DHS can demand them at any time. It can also recover payment for undocumented trips, and DHS uses these record rules when weighing recovery for any audit finding dated January 1, 2020 or later.

Plan-run rides

Most Minnesota NEMT money flows through health plans. DHS told legislators that 80 percent of NEMT spending is overseen by managed care organizations, and its 2024 figures put fee-for-service at 1.4 million trips and $32.2 million paid, against 5.5 million plan trips and $119.2 million.

Paragraph (r) does not set plan rates. Those come from the agreement you sign with the plan or its vendor. Subdivision 18h applies several NEMT provisions to plans, including the RUCA definition, driver-assisted service, the list of modes, and subdivisions 18 and 18a, and it requires plans to provide a fuel adjustment when fuel tops $3 a gallon. Laws 2025, First Special Session, chapter 3, repealed subdivision 18h, with the repeal originally set to reach plans on January 1, 2027. Laws 2026, chapter 121, article 3, section 62, moved that repeal to the day the statewide administrator under subdivision 18i is implemented, so the plan fuel rule stays in force until then. Ask each plan how it applies the adjustment today and what it plans once the administrator starts.

Oversight and what changes next

Minnesota tightened NEMT oversight through 2025 and 2026, and several changes land in the next year:

• Prepayment review. Since the governor’s October 29, 2025 announcement, a third-party vendor, Optum, screens NEMT claims and those of 13 other services that DHS rates as high risk before payment goes out. DHS calls it an ongoing and permanent process and has said some claims may be suspended up to 90 days.
• Post-payment reviews. An August 24, 2026 notice says DHS contracted Myers and Stauffer to review NEMT claims for compliance throughout 2026 and will contact providers selected for review.
• Off-cycle revalidation. NEMT is one of the high-risk provider types DHS called in for revalidation outside the normal cycle, with notices starting January 23, 2026. DHS’s briefing says unannounced site visits at each provider location are part of it.
• Metro enrollment freeze. DHS will not add NEMT companies based in the seven metro counties before the freeze lifts on January 27, 2027. The enrollment moratorium entry explains how these freezes work.
• Electronic visit verification. Laws 2026, chapter 121, brings NEMT under section 256B.073, the state’s electronic visit verification statute, starting January 1, 2027 or with federal approval, whichever comes later. The data has to be captured while the service happens. A visit keyed in by staff later, or changed after the fact, cannot support a claim until it clears DHS’s confirmation process.
• A statewide NEMT administrator. Subdivision 18i directs DHS to hire one administrator for the whole state or one per region, covering plan members too, and to warn counties and plans six months before it begins. The same 2026 law keeps the current rate paragraphs, the rural add-ons, the fuel adjuster, and subdivision 18h alive until that administrator is running. Under the 2025 law they would have ended in July 2026 for fee-for-service trips and in January 2027 for plans.

Keeping Minnesota trip records in HealthRide

Minnesota pays against a detailed trip record, and a missing signature or time can cost the whole trip. HealthRide’s driver app captures the rider’s signature on screen and records the time of each pickup and each drop-off. The trip log in reports exports each leg’s driver, vehicle, and GPS-recorded miles. Those records cover several of the fields subdivision 17b lists, in one place for audits and county bills.