Nebraska Medicaid NET rates in 2026: the 471-000-503 schedule and where PSC rates fit

The July 1, 2026 schedule

Nebraska’s Medicaid transportation rates sit in one short document, 471-000-503, the fee schedule for non-emergency medical transportation (NET) services. DHHS publishes it as a PDF with the definitions and a spreadsheet with the codes. These are the rates for trips billed to Nebraska Medicaid fee-for-service, effective July 1, 2026.

“By report” means DHHS pays the public published rate, with an administrative fee, based on the service and circumstances. The schedule also notes that an actual payment may be a cent or so off the printed figure, because the payment system carries seven decimal places and the schedule prints two.

Under the state plan’s transportation payment page (Attachment 4.19-B), Nebraska Medicaid pays whichever is less: your submitted charge or the schedule amount. Bill your normal charge and let the system cap it.

What the base rate already covers

A Nebraska base rate is meant to be the whole trip, not just the pickup. The schedule and 471 NAC 27 define it the same way: base rates include vehicle operating expenses, personnel, all unloaded mileage, the first five loaded miles, and usual waiting or standby time.

That has two practical effects:

1. Mileage starts at mile six. Pay for loaded miles one through five sits inside the base, so S0209 or S0215 covers only the loaded miles after that.
2. Deadhead and routine waits earn nothing extra. Driving to the pickup, driving home, and a normal wait at the clinic are already in the base. There is no waiting time code on the schedule.

Two examples, using July 2026 rates. A hypothetical 18-mile wheelchair van trip pays A0130 plus 13 miles of S0209: $46.12 + $24.05 = $70.17. A hypothetical 30-mile trip from outside Lincoln or Omaha in a sedan pays T2003-52 plus 25 miles of S0215: $9.41 + $46.25 = $55.66.

Loaded miles are only miles with the client aboard. The loaded miles entry and the mileage billing guide cover how to measure and document them.

Modifier 52 and the Lincoln and Omaha line

Modifier 52 on T2003 is Nebraska’s split between city trips and everything else. The DHHS fee-for-service claim instructions say the modifier is used for trips not wholly within the corporate city limits of Lincoln or Omaha.

The 52 line pays less than half the city base, so on those trips most of the money comes from the per-mile code. A city trip of five loaded miles or less earns the base and nothing more.

T2001, the attendant or escort code, also carries a 52 rate ($6.05 against $2.87). The claim instructions describe modifier 52 only for T2003, so confirm with Medicaid Claims Customer Service (877-255-3092, option 1) before you bill T2001-52.

Three state fiscal years without a raise

The July 2026 schedule carries a printed note: rates do not reflect an increase because there were no rate increase appropriations for this state fiscal year. Trip and mileage codes last changed on July 1, 2023.

Two lines did change. A0090, the individual provider mileage rate, went from $0.67 a mile in 2024 to $0.70 in January 2025, $0.72 in January 2026, and $0.76 in July 2026. State law caps it at the mileage rate Nebraska pays its own employees (Neb. Rev. Stat. 75-303.03(4) and 81-1176). A0110, bus service, moved from a flat $6,154.87 through January 2026 to “by report” in July 2026.

For a fleet, three flat years mean fuel, insurance, and wages all rose against a fixed rate. Price private-pay and facility work to carry that difference.

Codes and modes the schedule leaves out

Nebraska’s NET schedule lists 13 codes. It has no line for:

• Stretcher vans. No T2005 or T2049. 471 NAC 27 names personal vehicles, fixed route transit, ambulatory sedans, vans and handi-buses, wheelchair-accessible vans, and commercial airlines as the modes.
• Taxi and volunteer codes. No A0100 or A0080. The only individual-vehicle line is A0090, per-mile pay for an enrolled individual provider the client chooses. The state plan defines those providers as a friend, a family member who is not legally responsible for the client, or a volunteer. Clients driving their own vehicles are excluded under 471 NAC 27.
• Waiting time. No T2007. Usual waiting is in the base rate, and 471 NAC 27 lists wait times as non-covered.

Meals and lodging (A0180 to A0210) pay by report. The state plan limits them to the lower of the submitted charge or the average cost of mid-priced hotels and restaurants within ten miles of where the expense happens, using at least five of each where the area has that many. Escorts must be enrolled as providers to be reimbursed for their meals and lodging.

What Nebraska Medicaid does not pay for

471 NAC 27 sets the coverage rules behind the rates. A provider may bill only when the transportation comes from an enrolled provider and the client is actually in the vehicle. The chapter’s non-covered list includes:

• Wait times and no-shows. A no-show counts whether the client or the provider fails to arrive for a trip that was not cancelled.
• Trips to a hospital emergency room.
• Trips for services not covered by Nebraska Medicaid, or for services delivered at home.
• Trips for nursing home and ICF/DD residents, except the discharge ride to a private residence inside Nebraska.
• Pharmacy and medical equipment trips where the supplier delivers at no cost. For pharmacies, a new prescription needed right away is the exception.
• Transportation by DHHS staff or by a legally responsible individual (a parent or guardian of a minor, or a spouse).

Coverage runs to the nearest Medicaid-coverable provider within 20 miles of the client’s home, unless DHHS approves otherwise. Routine trips must be authorized three or more business days in advance, with an exception for urgent care, which includes hospital discharges and appointments granted within 48 hours. Children under 13 must travel with a legally responsible individual or an adult that person designates. These rules feed the general claim flow covered in how to bill Medicaid for NEMT.

Heritage Health trips and fee-for-service trips

Members enrolled in Heritage Health, the state’s managed care program, do not ride on the 471-000-503 rates directly. 471 NAC 27 sends authorization for plan members through the NEMT broker contracted by their Heritage Health plan. Fee-for-service trips are authorized through the DHHS Customer Service Center.

One caution: the DHHS member FAQ of May 22, 2026 names Modivcare as the UnitedHealthcare plan’s ride vendor, while the plan’s own provider notice says MTM Health took over on January 1, 2026. Broker trips pay whatever your agreement with the broker sets. The MTM Health broker guide and the Nebraska state guide cover enrollment and credentialing, including the Public Service Commission step that comes before Medicaid enrollment.

Where PSC rates apply, and where they stop

The Nebraska Public Service Commission regulates common and contract carriers of passengers. A regulated carrier must file an Application to Establish/Amend Rates ($100) and have the Commission approve it before it can charge those rates. Those published rates are what you charge riders outside Medicaid.

Medicaid NEMT rates sit outside it. Neb. Rev. Stat. 75-303.03(3), as amended by LB1126 (approved April 14, 2026, effective July 18, 2026), says rates for holders of a PSC designation of authority or a PSC Medicaid NEMT license are not subject to Commission regulation. The PSC’s rate application repeats it: rates for Medicaid NEMT under a contract with DHHS, a Heritage Health plan, or another agent of DHHS are excluded from its review.

Three other pieces of the same statute affect pay:

• Carrier cap. DHHS may reimburse common and contract carriers at no more than three times the state employee mileage rate. The cap does not apply to trips wholly inside the city or village where they start, to a person with a disability carried in an ADA-compliant vehicle, or to Medicaid NEMT under a PSC designation.
• Individual providers. DHHS reimburses an individual chosen by the client at no more than the state employee mileage rate, which is the ceiling on A0090.
• The 2027 license. From January 1, 2027, intrastate Medicaid NEMT done for DHHS, one of its managed care plans, or an agent acting for DHHS requires a PSC license under 75-311(4). It lasts one year, renews annually, and the fee cannot exceed $250.

Filing a fee-for-service claim

Nebraska takes NET claims on the CMS-1500 or as an 837P, and the Medicaid Provider Manual (August 2026) gives you six months from each trip date to file. The DHHS NEMT claim instructions add the fields that trip up new billers:

• Diagnosis R69, with ICD indicator 0.
• Place of service 41.
• One line per procedure code, each with its own charge.
• Units equal to the miles or number of trips for that date of service.
• The 11-digit Medicaid provider number of the billing provider.

Approved claims are typically paid the Tuesday after submission, holidays aside. The instructions also tell providers to keep records of all trips to support billing at audit. For the national code set behind these lines, see the NEMT billing codes guide.

Keeping trip records in HealthRide

Nebraska pays mileage only from the sixth loaded mile and only with the client aboard, so the miles on each trip matter. HealthRide’s driver app records GPS miles, pickup and drop-off timestamps, and signatures on every trip, and the trip log exports to CSV or PDF. Invoicing turns completed trips into invoices, with one ledger tying each payment back to its trip.