NEMT broker rates: how brokers pay providers and how to judge a rate offer
NEMT broker rates are the per-trip amounts a broker pays a transportation provider, usually a base rate per one-way trip plus a rate per loaded mile, set by level of service. The rates are contract terms. Depending on the state, the broker negotiates them, pays at least the Medicaid fee schedule, or uses one state-approved schedule for every provider.
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How broker rates work
A NEMT broker is paid by the state or a health plan, then pays you for each trip you run. Most broker money comes as a fixed monthly amount per enrolled member. Georgia pays its brokers “a monthly capitated rate based on the number of eligible Medicaid members” in their regions. Modivcare reported that 80.9% of its NEMT revenue in 2024 came from capitated contracts paid per member per month.
The broker keeps the difference between that monthly amount and what it spends on trips and operations. Your rate is one of the broker’s biggest costs. In 2024 Modivcare reported $53.19 of revenue per trip and $46.96 of service expense per trip, and payments to outside transportation providers made up 76.9% of its NEMT revenue.
What you are paid per trip is written into your provider agreement or the rate schedule attached to it. In Virginia, for example, each broker “negotiates contracts and rates” with the providers it enrolls. Those rates are contract terms that differ from one agreement to the next, so the useful skill is testing an offer against your own costs.
Who sets the rate: three state models
States take different approaches, and the approach decides how much room you have to negotiate.
| Model | Example | What it means for you |
|---|---|---|
| Negotiated | Florida: non-ambulance trips are reimbursed “at a mutually agreed upon negotiated rate between the transportation broker contracted with AHCA and the provider” (Rule 59G-4.330) | Everything is on the table. Compare offers across brokers. |
| Fee schedule floor | Louisiana: the rate “shall be no less than the published Medicaid FFS rate” unless the broker and provider agree otherwise in the provider agreement (SPA 24-0017) | The Medicaid schedule is your baseline. Read any clause that sets a lower rate. |
| One standard schedule | Rhode Island: MTM uses a single standardized rate schedule for all providers, approved each year by the state, which the broker may raise but not lower without state approval | Rates are published, and every provider starts from the same schedule. Your main lever is volume, not price. |
Check your state’s rule on its guide. Florida, Texas, and Colorado are good examples of how differently states run it. Our guide to how much Medicaid pays for NEMT covers the state fee schedules themselves.
What a broker rate schedule looks like
Most schedules pay a base rate per one-way trip plus a per-mile rate, with a different pair for each level of service. Two public examples show the structure.
Colorado’s Medicaid fee schedule, effective July 1, 2026:
| Service | Code | Base per one-way trip | Per mile |
|---|---|---|---|
| Wheelchair van | A0130 and S0209 | $34.14 | $2.74 |
| XL wheelchair van (two attendants) | A0130-U9 and S0209 | $63.70 | $2.74 |
| Stretcher van | T2005 and T2049 | $49.42 | $1.86 |
MTM Health’s Rhode Island provider schedule (Schedule A, effective July 1, 2023, and still posted as its current Rhode Island rates) for business-hour, curb-to-curb trips:
| Level of service | Base, first 5 loaded miles | Per mile from 5.01 miles |
|---|---|---|
| Ambulatory | $17.75 | $1.75 |
| Wheelchair | $28.50 | $2.50 |
| Stretcher | $175.00 | $4.50 |
The Rhode Island schedule also shows the add-ons and exceptions that matter in any contract:
- Distance from your garage. A higher Tier 2 rate applies when the pickup is more than 40 miles from where your vehicles are stored.
- After hours. A higher base applies to trips with appointments between 5:00 PM and 4:59 AM.
- Group rides. Lower ambulatory rates apply to riders going to or from the same place at the same time.
- Included services. Door-to-door help, attendants, and additional passengers are listed as “Included,” meaning no extra pay.
What brokers usually do not pay for
The rate covers loaded miles and completed trips. Much of your working day falls outside both.
- Deadhead miles. Colorado’s billing manual excludes “charges incurred while the member is not in the vehicle.” Driving to the first pickup and between trips is on you. See deadhead miles.
- Extra route miles. Colorado pays mileage for “the shortest trip length in miles as determined by an internet-based map, trip planner, or other” GPS. Detours and wrong turns are unpaid.
- Waiting time. Colorado lists waiting time as non-covered. Some contracts pay after a free window. Read yours.
- No-shows and cancellations. Colorado excludes cancellations, Louisiana says scheduled trips with no rider transported are not billable, and MTM Health does not pay for no-shows in Rhode Island or Missouri.
- Off-contract extras. Texas’s inspector general found that SafeRide paid providers “cost override” amounts above contracted rates on 31,149 trips and ruled them unallowable, because Texas brokers may not pay more than contracted rates. Any exception you are promised should be approved in writing before the trip. Oregon’s CareOregon manual says the same: negotiated rates are approved only if the brokerage authorized them before the trip.
How to evaluate a broker rate offer: a worked example
A rate is only good or bad against your costs. Convert every offer into revenue per hour of van time, then compare it to what an hour costs you. The offers below are illustrative, not market rates.
A broker offers two wheelchair rate options:
- Offer A: $32 base plus $2.00 per loaded mile.
- Offer B: $24 base plus $2.90 per loaded mile.
Your costs: $46 per van hour for driver, fuel, insurance, maintenance, and overhead.
Now apply both offers to two typical days for one van:
| City day | Rural day | |
|---|---|---|
| One-way trips | 12 | 7 |
| Average loaded miles per trip | 5 | 18 |
| Loaded miles | 60 | 126 |
| Van hours, including deadhead and unpaid waits | 9 | 9 |
| Cost at $46 per hour | $414 | $414 |
| Offer A revenue | 12 × $32 + 60 × $2.00 = $504 | 7 × $32 + 126 × $2.00 = $476 |
| Offer B revenue | 12 × $24 + 60 × $2.90 = $462 | 7 × $24 + 126 × $2.90 = $533.40 |
| Offer A margin | $90 | $62 |
| Offer B margin | $48 | $119.40 |
Offer A wins on short city trips because the base rate carries the day. Offer B wins on long rural trips because the mileage rate carries it. The better offer depends on your trip mix, not on the headline number.
Then stress-test the winner:
- Add two no-shows a day. On the city day with Offer A, you lose two trips’ revenue, $84 at the average trip, and keep all the cost. Margin falls to $6.
- Add an hour of unpaid waiting. Cost rises to $460. Offer A’s city margin falls to $44.
- Move your garage. If most pickups are 40 miles out, check whether a distance tier like Rhode Island’s applies before you assume it does.
Run your own numbers in the trip price calculator and the deadhead cost calculator.
Negotiating rates and other terms
Where rates are negotiable, bring evidence and ask for specific terms. Where they are fixed, negotiate the terms around the rate.
- Know your floor. Know your cost per van hour and per loaded mile before the call.
- Show performance. On-time rate, acceptance rate, and complaint rate are what brokers track. Our guide on getting more trips from brokers lists the metrics.
- Price the hard trips. Long rural trips, stretcher trips, and after-hours trips are where brokers struggle to find providers. Ask for distance tiers or after-hours rates if the schedule has none.
- Ask about wait and no-show pay. A modest no-show fee changes the math more than a small base increase.
- Get exceptions in writing, in advance. A promised bonus that is not in the contract can be clawed back.
- Check payment terms. Claim deadlines, appeal windows, and payment timing affect cash flow. Rhode Island’s broker contract requires clean claims to be paid within 30 days. MTM Health’s Rhode Island handbook gives providers 90 days from the date of service to submit a claim and sets a deadline for appealing each denial.
Keep a written rate sheet for every broker and payer so dispatch and billing work from the same numbers.
Tracking what each broker is really worth in HealthRide
HealthRide prices every completed trip from that payer’s rate schedule. The payer summary report shows completed trips, cancellations, revenue billed, and what is still owed for each payer over any period. When a broker contract comes up for renewal, you can see exactly what it earned you in reports.
Frequently asked questions
- What is a typical NEMT broker rate?
- There is no national rate. Each broker agreement sets its own, and the rules behind it differ by state. Public schedules show the structure: Colorado's Medicaid fee schedule pays a wheelchair van $34.14 per trip plus $2.74 per mile from July 1, 2026. Your offer can be higher or lower than any published number, so evaluate it against your own cost per hour.
- Are NEMT broker rates negotiable?
- Sometimes. Florida leaves non-ambulance rates to negotiation between the broker and the provider, and MTM Health says it sets rates with each provider individually in Missouri and Minnesota. Louisiana sets the Medicaid fee schedule as the floor unless both sides agree otherwise. Rhode Island's broker uses one standard schedule for every provider and can adjust it upward but not downward without state approval. Read your state's rule before you ask.
- Do brokers pay for deadhead miles?
- Usually not. Broker and state schedules pay loaded miles, the miles with the rider on board. Colorado's billing manual excludes charges incurred while the member is not in the vehicle, and it pays mileage on the shortest route found by a mapping tool or GPS. Your deadhead miles are a cost you recover inside the base rate.
- Do brokers pay for waiting time or no-shows?
- Often not. Colorado's Medicaid billing manual lists waiting time and cancellations as non-covered, and Louisiana says scheduled trips where no one is transported are not billable, and MTM Health does not pay for no-shows in Rhode Island or Missouri. Some broker contracts pay a no-show or wait fee, so check yours. Treat unpaid waits and dry runs as a cost in your rate math.
- How fast do brokers pay NEMT providers?
- It depends on the contract. Rhode Island's broker contract requires clean claims to be paid within 30 days, with interest on late payments. Colorado's statewide broker pays completed and verified trips every two weeks. MTM Health's Rhode Island handbook gives providers 90 days from the date of service to submit a claim.
- Why do broker rates look lower than private pay rates?
- A broker trip comes with the marketing, intake, scheduling, and payment already done, and the broker is paid a fixed monthly amount per member by the state or plan. Its margin is the gap between that amount and what it pays providers. Private pay rates have to cover the work of finding and serving each customer yourself.
