New Jersey Medicaid MAV rates: the fee schedule, the statewide broker, and partial care trips

The broker contract sets what a MAV trip pays

A mobility assistance vehicle (MAV) company in New Jersey is paid by the state’s broker, not by Medicaid directly. N.J.A.C. 10:50-1.4(a) requires every non-emergency medical transportation service to be provided by an independent broker that holds a contract with the state’s Department of Human Services, and it lists the services that covers: non-emergency ground ambulance, MAV, livery and modified livery, lower-mode trips such as taxi, train, and bus, and fixed-wing air. New Jersey’s Medicaid agency, DMAHS, names Modivcare as the medical transportation broker serving NJ FamilyCare members statewide.

Payment runs through two contracts:

1. Between the state and the broker. The solicitation for the next broker contract asks bidders for one all-inclusive monthly capitation rate per beneficiary, covering MAV, livery, specialty care, urgent, basic life support, ground ambulance, and ambulatory MAV trips. A 2023 fiscal note on a broker bill from New Jersey’s Office of Legislative Services put the capitation at $9.42 a month for each member, covering September 2022 through August 2023.
2. Between the broker and its network. The same solicitation has the broker negotiate rates with participating providers for the levels it uses, choosing at a minimum among wheelchair, specialty care transport, bariatric stretcher, and two-person special-rated wheelchair trips. It may use competitive bidding to set them.

One state rule still reaches every MAV company. Under N.J.A.C. 10:50-1.3(a)1.i, the broker must require that every transportation company in its network be approved by DMAHS. MAV licensing under N.J.A.C. 8:40 is in the New Jersey state guide, and joining the network is in the Modivcare guide.

What N.J.A.C. 10:50 still prices

The Transportation Services Manual no longer carries MAV fees. The 2022 amendment (R.2022 d.045, effective April 4, 2022) rewrote the ambulance part of the fee table in N.J.A.C. 10:50-2.2 and deleted parts (b) and (c), and part (b) was where the MAV codes had been listed. What remains is a short list of ambulance fees, for the trips that independent providers still bill to Medicaid fee-for-service: emergency ground ambulance and rotary-wing air ambulance under 10:50-1.4(b).

The chapter’s definitions still describe the work a MAV company does under broker contracts:

• Mobility assistance vehicle service. Broker-provided non-emergency transportation in a vehicle licensed and run under N.J.A.C. 8:40, staffed by certified personnel, for people under a doctor’s care whose condition falls short of needing an ambulance but would put their life or health at serious risk in a cab, bus, or private car.
• Modified livery. Livery or MAV service for beneficiaries under 21 who need supervision from a qualified attendant the broker supplies.
• Waiting time. Actual time in 15-minute increments, starting 30 minutes after the rider is delivered, for ground ambulance and MAV service.
• Multiple loading. More than one beneficiary in the same vehicle at the same time.

The chapter switched from “invalid coach” to “mobility assistance vehicle” in a 1999 amendment (R.1999 d.5). The mobility assistance vehicle entry covers the vehicle and crew rules.

The transportation lines on the 2026 fee listing

New Jersey’s state plan points to the Procedure Master Listing on NJMMIS as its Medicaid fee-for-service schedule. SPA 26-0002, approved July 24, 2026 with an April 1, 2026 effective date, names the CY 2026 listing as the main file of billable codes. The posted copy is marked as updated September 1, 2026, with rates effective July 1, 2026 and labeled proposed until CMS approves them. Its MAV and related lines:

Treat these amounts as reference points. Because every MAV and non-emergency ambulance trip for a NJ FamilyCare member goes through the broker, your Modivcare agreement sets the actual price. The listing marks codes that start with W, X, Y, or Z, such as Y0010, as paper-claim only.

The rule text and the listing do not always agree. For emergency basic life support (A0429), N.J.A.C. 10:50-2.2 shows $326.02 while the CY 2026 listing shows $200.00, and the BLS mileage line shows $6.04 in the rule against $1.50 on the listing. Ambulance companies billing Medicaid directly should confirm the amount in effect with DMAHS before relying on either.

Partial care trips

One transportation line sits in New Jersey’s clinic fee rules instead of chapter 10:50. N.J.A.C. 10:66-6.3(e) lists A0425 with modifier UC, a one-way trip to or from a partial care program, at a maximum of $2.50, and a second transportation code, Z0330, at $4.50 one way. The CY 2026 Procedure Master Listing shows A0425 UC, described there as clinic transport mileage, at $2.83, and Z0330 at $12.17.

Two limits apply around those trips. N.J.A.C. 10:50-1.6(f)4 bars payment for transporting a fee-for-service beneficiary from a nursing facility to a clinic for partial care services. And under 10:50-1.6(g)2, an ambulance trip for an ambulatory beneficiary to or from a clinic that runs its own Medicaid-reimbursed van service is not payable.

Payment and insurance terms in the broker solicitation

What the state demands of the broker shapes what the broker can offer its network. The revised solicitation for Bid 24DPP01040 (T2503 Transportation Broker Services), dated February 20, 2026, sets these terms for the next contract:

• Payment time. The broker pays authorized trips in full no later than the 30th calendar day after a clean claim arrives. Claims missing information must be resolved within 60 calendar days, and referrals cannot be left open past 60 days.
• Penalties to the broker. Liquidated damages of $2,500 apply once any provider payment goes beyond 30 calendar days, and $5,000 beyond 60.
• Spending floor. Direct transportation costs must make up 80 percent or more of the capitation the broker receives, tracked through quarterly profit and loss statements the state audits twice a year.
• Provider insurance. Per-occurrence general liability of $1,000,000 with a $2,000,000 aggregate. Business auto at $2,000,000 CSL, including hired and non-owned vehicles. Statutory workers’ compensation, plus $1,000,000 employers liability. The State of New Jersey goes on both liability policies as additional insured.
• Credentialing. The broker checks that providers have completed background checks, drug testing, and driving record reviews for employees who may contact a Medicaid client.

These are the broker’s obligations to the state. Your own network agreement holds the terms that bind your company, so compare the two when you sign.

The 2026 broker award

The broker contract went out to bid on May 7, 2025. The Division of Purchase and Property opened three quotes on March 4, 2026, from Modivcare, MTM, and HBSS Connect Corp, and on August 6, 2026 named MTM as its intended winner. Modivcare filed a protest a week later. In its August 20, 2026 final agency decision, the Acting Director found MTM’s quote non-responsive because of a mandatory form requirement, canceled the notice of intent, and sent the matter back so the contract could go to Modivcare, the only responsive bidder still in the competitive range. Under the court rules, parties have 45 days to appeal that decision to the Appellate Division.

The contract runs four years, and it can be extended by as much as two years, in steps of no more than one year. Two of its scheduling rules matter to a MAV company’s sales plan. Nursing homes and hospitals each choose a preferred transportation company inside the broker’s network, and the broker assigns their reservations to that company. And any trip over 35 miles needs a Closest Provider Certification.

How many trips the broker pays for

The utilization data attached to the solicitation counts verified paid trips statewide: 4,328,583 in 2022, 4,511,512 in 2023, and 4,198,250 in 2024. The same solicitation names two kinds of trips as hard to cover: bariatric wheelchair trips and trips up multiple steps that need a two-person team, and out-of-state trips, which it tracks for New York City, Philadelphia, and Delaware. If your vans and crews can take those trips, put that at the front of your rate talks with the broker.

Getting MAV trips paid with HealthRide

A broker pays a MAV trip only when the trip record matches what it authorized. With HealthRide, the rider signs on the driver’s screen, every pickup and drop-off is time-stamped, and each leg’s miles are recorded by GPS. Invoicing builds your invoices from those trip records, and the exportable trip log in reports is your backup when a payment is disputed.