Flat rate or per mile NEMT pricing: zones, mileage bands, and minimum fares for private pay and facilities

Three ways to structure a private ride price

Every private rate sheet uses one of three structures, or a mix of them. The choice decides who carries the risk of a long trip: you or the customer.

• Base plus mileage. A fixed fare per one-way trip, then a charge for every loaded mile. The price follows the trip, so long trips pay for themselves. Riders and facilities cannot know the exact price until both addresses are set.
• Flat zone. One price for any trip that starts and ends inside a defined area, such as a city or a radius around your base. It is the easiest price to quote and budget. You absorb the cost of the longest trips inside the zone.
• Mileage bands. A flat price per band of trip length, such as 0 to 10 miles, 11 to 20, and over 20. It sits between the other two. The open-ended top band is where it leaks money.

Whichever you pick, give each service level its own prices. Nebraska and Colorado both pay a wheelchair van more than an ambulatory trip in the same structure. Medicaid programs use all three structures, and their published schedules show how each one behaves. The pricing guide covers building the underlying rates from your cost per trip. This page is about the shape of the price.

Nebraska: a flat city rate beside base plus mileage

Nebraska’s waiver schedule for aged, disabled, and brain injury waiver transportation uses a flat zone and a base-plus-mileage rate side by side. For commercial carriers, the CY2026 schedule pays:

• $19.69 flat per one-way trip wholly within the corporate city limits of Omaha or Lincoln.
• $9.41 base per one-way trip not wholly within those city limits, plus $1.85 per additional mile.
• $46.12 base for a commercial wheelchair accessible van, plus $1.85 per additional mile.

Its definitions explain what the base buys. The base rate includes vehicle costs, staff, the first 5 loaded miles, unloaded mileage, and usual waiting time. Loaded mileage is paid only once a trip passes that included distance. So a 4-mile commercial trip in a small town pays $9.41, the same trip inside Omaha pays $19.69, and a 20-mile trip from outside the city pays $9.41 plus 15 additional miles, or $37.16.

Nebraska Medicaid’s regular non-emergency transportation schedule splits T2003 trips at the same city limits, as the Nebraska rate reference shows. The waiver schedule also tracks the IRS. Its rate for individual providers was 72.5 cents a mile from January 1, 2026 and 76 cents from July 1, 2026, matching the IRS business rate for those two periods.

Colorado: three mileage bands

Colorado’s Elderly, Blind, and Disabled waiver pays non-medical transportation by band, with no separate mileage charge. The July 1, 2026 rates for providers outside Denver County, per one-way trip:

Denver County trips pay a little more in each band, $13.70 to $34.53 for a wheelchair van. Rates can also move down: each July 2026 band is about 2 percent below the April 2026 rate in the same schedule, such as $13.34 to $13.07 for a short wheelchair van trip outside Denver. Each band rate covers the whole trip, so a 21-mile trip and a 45-mile trip pay the same. Colorado limits these rides to 208 one-way trips, or 104 round trips, per service plan year, except adult day transportation. Its state plan NEMT schedule is a different structure, base plus mileage, covered in the Colorado rate reference.

Indiana: flat bands for taxis, mileage past 10 for vans

Indiana Medicaid uses both structures in one fee schedule. Taxis whose rates are not set by a local ordinance are paid a flat amount by trip length, with no mileage. For 2026, the 0 to 5 mile band pays $7.63, the 6 to 10 mile band pays $12.71, and any trip of 11 miles or more pays $19.08.

Wheelchair vans, which Indiana bills as nonambulatory service, get a base rate plus mileage, but only past 10 miles. The 2026 base for A0130 is $31.79, and mileage under A0425 with the U5 modifier is $1.67 a mile. Indiana pays loaded mileage only when the rider is carried more than 10 miles one way, and it automatically deducts the first 10 miles from each trip. A 30-mile van trip therefore pays $31.79 plus 20 miles at $1.67, or $65.19. A taxi carrying a rider the same 30 miles gets $19.08.

The Indiana rate reference lists the other codes. That gap is the flat-band problem in one example. The top band has no ceiling, so its price must cover the longest trips you will accept in it.

Where a flat price loses money

Run your own numbers against a flat structure before you publish it. The table below compares a base-plus-mileage price with a banded price across four trip lengths. The rates are made up for illustration: $40 plus $3.00 per loaded mile against $60 up to 10 miles, $85 for 11 to 20, and $110 over 20.

The bands overcharge the shortest trips and undercharge the longest. That trade is fine when most trips sit in the middle of each band. It is a problem when a facility sends you a steady stream of 30-mile trips at the over-20 price. Fix it in one of two ways: add mileage above a ceiling (over 20 miles, $110 plus $3.00 a mile past 25), or quote trips over a set distance separately, as the long-distance pricing guide describes.

Drawing zones from your own trip history

Zones and bands work best when they match where your riders actually go. Build them from data, not from a map.

1. Pull three to six months of private trips. Export each trip’s pickup, drop-off, and loaded miles. Leave out Medicaid and broker trips, which follow the payer’s rates.
2. Sort by loaded miles and find the clusters. Most fleets see a heavy group of short trips to nearby clinics and a thinner tail of long ones. The breaks between clusters are your band edges.
3. Check where the trips start and end. If most short trips stay inside one city or a few ZIP codes, a named zone is easier to explain than a mileage band.
4. Price each band from its own trips. Take the average loaded miles and minutes of the trips in the band, cost them with your hourly and per-mile numbers, and add your margin. Then check the longest trip in the band to see what it costs you.
5. Replay last quarter. Re-price every trip from the sample under the new structure and compare the total to what you billed. If revenue drops, move a band edge or raise a band price before customers see it.

Repeat the check once a year, or whenever a large facility customer joins or leaves. The zone dispatching guide covers using the same areas to plan the board.

Minimum fares for short trips

Every trip has a fixed cost no matter how short it is: the drive to the pickup, loading and securing the rider, unloading, and the gap before the next trip. A minimum fare covers that cost on a 1-mile ride.

Published schedules build minimums in different ways. Nebraska puts the first 5 loaded miles inside the base. Indiana pays wheelchair vans no mileage on trips of 10 miles or less, so the $31.79 base is the whole payment. A private minimum can work either way: a base that includes a set number of miles, or a stated minimum such as “$45 or the mileage price, whichever is higher.”

To size it, time the fixed part of a typical trip and multiply by your hourly cost. An example: if the fixed part takes 35 minutes and a van with a driver costs $60 an hour to run, the minimum needs to be about $35 before profit. The cost per mile calculator helps find the hourly and per-mile inputs.

Loaded miles or garage-to-garage

Medicaid schedules pay for loaded miles, meaning distance driven with the rider aboard, and fold the empty miles into the base. Nebraska’s definition says so outright: its base rate includes unloaded mileage. Private quotes usually follow the same convention because riders understand it and it matches what payers do.

Garage-to-garage pricing counts every mile from your lot and back. It belongs on long out-of-area trips, where the deadhead miles home can equal the trip itself, and on charters for facilities. Whichever basis you use, write it on the rate sheet. A quote that says “$3.00 per mile” without saying which miles invites a dispute.

Putting the structure in writing

A pricing structure only works if the customer can check it. For private riders, publish the zone names or the band table, the included miles, the rate beyond them, and any minimum, with every mandatory fee inside each price. California, Minnesota, Colorado, and Massachusetts require advertised prices to include mandatory fees, and zone and band prices make that easy, as the all-in pricing guide explains.

For facilities, put the structure in the signed agreement: the zone boundaries or bands, how trips that cross a boundary are priced, and how miles are measured. The rate sheet template gives a layout for both.

Remember the link to Medicaid. If you also bill a program that pays the lower of its fee or your charge, your private price is your charge to the public. Nebraska’s waiver schedule states it plainly: payment is the lower of the allowable or the submitted charge, and the submitted charge must not exceed the provider’s charge to the public.

Using your own trip data in HealthRide

Every HealthRide trip keeps its GPS-recorded miles, and the trip log exports as a spreadsheet or PDF, so you can pull a quarter of private trips before you draw zones or bands. Prices come from your rate schedules, set per payer, so the prices you agree with one facility apply only to that facility’s trips. See reports.