NEMT KPIs: The Metrics to Track, With Formulas and Real Contract Targets
The NEMT KPIs that matter most are on-time pickup and arrival rates, will-call response time, trip acceptance, missed trips, no-shows, complaints, deadhead share, trips per vehicle hour, revenue and cost per trip, and days to payment. Brokers score the service measures, with published targets such as 95% on time and complaints under 1%. The money measures tell you whether a route pays.
On this page
Two kinds of KPI
NEMT KPIs split into two groups, and they answer different questions.
- Service KPIs answer whether riders get where they need to be, on time, safely. Brokers and plans score these, because federal rules require a state’s NEMT broker to monitor complaints and ensure transportation is timely (42 CFR 440.170(a)(4)). Your trip volume rides on them.
- Business KPIs answer whether the work pays. Nobody scores these for you, and they decide whether you can keep doing the work.
The targets below come from current broker requirements and state contract criteria. Where no published target exists, the section shows how to calculate the measure so you can set your own.
Service KPIs brokers score
| KPI | Formula | Published target |
|---|---|---|
| On-time pickup rate | Pickups inside the window ÷ eligible scheduled pickups × 100 | 95% (SafeRide). At least 90% (Medi Trans, Louisiana) |
| On-time arrival rate | Legs delivered on time for the appointment ÷ legs with an appointment time × 100 | At least 90% on-time drop-offs (Medi Trans). 90% of riders on time for appointments (Indiana broker criteria) |
| Will-call response rate | Returns picked up within the limit ÷ all will-call returns × 100 | 95% within one hour of notification (Indiana broker criteria) |
| Ride acceptance rate | Trips accepted ÷ trips offered × 100 | 95% (SafeRide) |
| Ride response rate | Offers answered ÷ offers received × 100 | 100% (SafeRide) |
| Turnback rate | Accepted trips handed back ÷ trips accepted × 100 | Set by each contract. A pattern of last-minute returns can bring a corrective action plan (CareOregon) |
| Missed trips | Accepted trips you did not complete | Zero per month (Medi Trans) |
| Complaint rate | Valid complaints ÷ completed trips × 100 | Under 1% (SafeRide and Medi Trans) |
| Rider no-show rate | Legs where the rider was not there ÷ legs still scheduled on the day × 100 | No provider target. Indiana holds its broker to 1.5% of scheduled pickups |
SafeRide’s list of provider standards also includes a kickback rate under 5%.
For context on what good looks like at scale, Indiana’s broker reported valid complaints on 0.04% to 0.05% of completed one-way trips each quarter against a 1% cap, and rider no-shows of 1.19% to 1.68% against its 1.5% cap, in its first contract year (FSSA NEMT Commission, August 2025). In its second contract year, reported in August 2026, its quarterly trip completion rate ran between 98.5% and 99.2%. Mississippi’s 2024 broker contract allows a fine when combined complaints from members, facilities, and providers, excluding rider no-shows and lateness, exceed 0.17% of total trips in a month (PEER Report #705, October 2024). Those are broker-wide numbers, not provider targets, but they show how closely states watch complaints.
The on-time performance guide covers how to count pickups and arrivals, and the no-show guide covers what to exclude and how to document it.
Productivity KPIs
These measure how much work each vehicle and driver does. No broker publishes a target for them, and your service area changes what is realistic, so compare against your own history.
| KPI | Formula |
|---|---|
| Trips per vehicle hour | Completed legs ÷ vehicle service hours |
| Vehicle utilization | Hours with a rider aboard or driving to a pickup ÷ hours on shift × 100 |
| Deadhead share | (Total miles minus loaded miles) ÷ total miles × 100 |
| Legs per vehicle per day | Completed legs ÷ vehicles in service ÷ operating days |
Here is a worked example for a hypothetical 8-van week:
| Measure | Value |
|---|---|
| Completed legs | 412 |
| Vehicle service hours | 352 (8 vans, 5 days, 8.8 hours) |
| Trips per vehicle hour | 1.17 |
| Hours with a rider aboard or driving to a pickup | 261 |
| Vehicle utilization | 74.1% |
| Total miles | 6,840 |
| Loaded miles | 4,120 |
| Deadhead share | 39.8% |
| Legs per vehicle per day | 10.3 |
A falling trips-per-hour number with a rising deadhead share usually means routes are spreading out. The deadhead guide covers how to pull them back in.
Financial KPIs
| KPI | Formula |
|---|---|
| Revenue per leg | Revenue billed ÷ completed legs |
| Revenue per vehicle hour | Revenue billed ÷ vehicle service hours |
| Cost per leg | Total operating cost ÷ completed legs |
| Margin | (Revenue minus operating cost) ÷ revenue × 100 |
| Days sales outstanding | Accounts receivable ÷ average daily revenue |
| Days to bill | Average days from the trip date to the claim or invoice going out |
| Claim or invoice rejection rate | Rejected or denied claims ÷ claims submitted × 100 |
Days to bill is the part of your cash cycle you control. Federal rules require state Medicaid agencies to have providers submit fee-for-service claims within 12 months of the date of service (42 CFR 447.45(d)). A broker contract can set a shorter deadline, so check yours. The payer’s side has limits too. Indiana’s pay-for-outcomes criteria require its broker to pay or deny 98% of clean electronic claims within 21 days of receipt and paper claims within 30 days.
A worked example for a hypothetical month:
| Measure | Value |
|---|---|
| Revenue billed | $64,000 |
| Completed legs | 1,760 |
| Vehicle service hours | 1,540 |
| Total operating cost | $51,500 |
| Revenue per leg | $36.36 |
| Revenue per vehicle hour | $41.56 |
| Cost per leg | $29.26 |
| Margin | 19.5% |
| Accounts receivable at month end | $58,000 |
| Days sales outstanding | 27 days (58,000 ÷ 2,133 a day) |
Split revenue and cost by payer, and the numbers can tell a different story than the total. A broker contract with a low per-mile rate can look fine in aggregate while losing money on long rural runs. Revenue per vehicle hour is the fairest way to compare payers, because it counts the time a trip takes, not just its price.
A weekly scorecard
Keep one page with the eight or nine numbers you act on, this week against last week and the target:
| Measure | Last week | This week | Target |
|---|---|---|---|
| On-time pickups | 92.4% | 93.8% | 95% |
| On-time arrivals | 91.0% | 93.0% | 90% |
| Will-call response within 60 minutes | 88.1% | 90.6% | 95% |
| Missed trips | 2 | 0 | 0 |
| Rider no-shows | 4.6% | 4.0% | Falling |
| Complaints per completed trips | 0.4% | 0.2% | Under 1% |
| Deadhead share | 41.2% | 39.8% | Falling |
| Trips per vehicle hour | 1.12 | 1.17 | Rising |
The example values are hypothetical. The layout is the point: every row has a formula, a target or a direction, and an owner who acts on it.
How to set your targets
- Start with the contract. Copy every number your brokers and facility contracts hold you to.
- Measure a baseline. Run eight weeks with fixed definitions before you set internal targets for the rest.
- Go one level down. Break each KPI out by driver, route, time of day, and facility. The fleet average hides where the problem is.
- Write down the exclusions. Which delays are excused, which cancellations are removed, and what counts as a service hour. Change them and your trend breaks.
- Keep the list short. Nine numbers reviewed every week beat 30 numbers nobody reads.
The data behind the numbers
Every KPI above comes from a few fields captured on every leg: scheduled and actual pickup times, actual drop-off time, appointment time, the time a will-call came in, the reason for any delay, cancellation time and reason, loaded miles, and the driver and vehicle. CareOregon’s transportation provider manual (February 2024) already requires many of these as minimum trip documentation. If you capture them for the broker, you have what you need for your own scorecard.
Where software helps
HealthRide’s reports cover a performance overview, trip log, on-time performance, payer summary, and driver activity, with CSV and PDF exports. On-time performance is tracked automatically on every leg, overall and per driver, and mileage comes from recorded GPS routes rather than estimates.
Frequently asked questions
- What is the most important NEMT KPI?
- On-time performance, because it is the number brokers and plans score first and the one riders feel. SafeRide requires 95% from its network providers, and the Medi Trans manual in Louisiana requires at least 90% on-time pickups and drop-offs. Track pickups and appointment arrivals separately, since a trip can pass one and fail the other.
- How often should I review NEMT KPIs?
- Review the service measures every week, because late trips and missed trips need fixing while the pattern is fresh. Review the money measures every month, once invoices and payments for the period are in. Keep the definitions fixed so this month compares cleanly with last month.
- What is a good complaint rate for a NEMT provider?
- Under 1% of completed trips is the published bar. SafeRide requires a complaint rate under 1% from its providers, and the Medi Trans manual sets an overall complaint rate of less than 1%. At the broker level, Indiana's criteria cap valid complaints at 1% of completed one-way trips, and its broker reported 0.04% to 0.05% by quarter in its first contract year.
- How do I calculate trips per vehicle hour?
- Divide completed legs by the hours your vehicles were in service. A van that completes 9 legs in an 8-hour shift runs 1.1 trips per vehicle hour. Use the same definition of service hours every week, such as first pickup to last drop-off or clock-in to clock-out, or the trend will mislead you.
- What is a turnback rate and what limit do brokers set?
- A turnback rate is the share of accepted trips you hand back to the broker. Limits are set contract by contract, so read yours. CareOregon's manual treats a pattern of returning many trips, or many trips at the last minute, as grounds for a corrective action plan. Turn back early and for reasons your broker accepts, such as a trip outside your service area or hours.
- What is days sales outstanding for a NEMT company?
- Days sales outstanding is the average number of days between providing a trip and getting paid for it. Calculate it as accounts receivable divided by average daily revenue. It shows whether billing delays, claim rejections, or slow-paying facilities are tying up your cash.
