North Dakota Medicaid NEMT fee schedule: what each vehicle type pays from July 1, 2026

The July 1, 2026 rate table

Traditional North Dakota Medicaid pays NEMT providers directly from a single fee schedule, and each vehicle type has its own base code. ND HHS posts it as a spreadsheet, “data updated as of July 1 2026”. The table compares it with the April 5, 2026 schedule it replaced.

Every code shows “No” in the spreadsheet’s service authorization column. Do not read that as permission to skip approval: the NEMT manual still requires an SFN 1507 before taxi trips and all three van types (minibus, wheelchair, stretcher).

A worked example, labeled as one: a hypothetical 40-mile stretcher van trip pays $97.37 plus 40 miles of T2049 at $2.57, or $200.17. At April rates the same trip paid $196.26.

Why the rates rose in July 2026

The change is a flat inflation adjustment. The 2025 Legislative Assembly funded a 2 percent increase for most Medicaid providers in each year of the 2025 to 2027 biennium, and ND HHS applied the second year to fee schedule codes starting with July 1, 2026 dates of service. The A0130, S0209, T2005, and taxi lines all moved by that 2 percent.

The state’s public notice spells out how it hit transportation:

• NEMT services received the 2 percent increase, except private vehicle mileage and lodging. The state estimated $50,000 a year in added NEMT spending.
• Noncommercial passenger vehicle mileage was adjusted to the limit set by the North Dakota Legislature. A0080 went from $0.70 to $0.72.
• Meals rose to an amount within the Legislature’s limits.
• Lodging did not change: $110 for A0180 and $169 for A0200.

Tribal providers share in it. ND HHS told tribes in June 2026 that services paid outside the Indian Health Service all-inclusive rate, NEMT included, receive the 2 percent increase, while the all-inclusive rate itself does not change.

The April 5 and February 8, 2026 schedules carried the same trip, mileage, and meal rates as the July 1, 2025 schedule. So the April archive is the right baseline for “what changed”: it is the last schedule before the second-year increase.

Notes the new spreadsheets dropped

The July 1, 2025 schedule was a PDF with notes that the 2026 spreadsheets do not repeat. Read the new rates with those notes in mind, and confirm with ND Medical Services (1-800-755-2604) where they matter to your billing.

Two of these need an answer before you bill. The 15-mile note decides whether short wheelchair van trips earn any mileage, and neither the 2026 spreadsheet nor the January 2026 manual repeats it. BCBSND’s Medicaid Expansion code list still ties its mileage lines to trips longer than 15 miles one way. A0170 carries a national description of parking fees and tolls, while the manual’s non-covered list includes parking fees and the 2025 schedule used the code for minibus miles.

How a trip gets approved: zones, tribes, and hospitals

For traditional Medicaid, human services zones and tribal offices decide the mode and approve trips on the Non-Emergency Medical Transportation Authorization, SFN 1507. The zone or tribe gives you a copy of the approved form before the ride, and you keep it on file to support the claim.

Wheelchair and stretcher van trips also require that the member’s mobility impairment make a bus, a taxi, a private automobile, or another common carrier unsafe to use. A retroactive approval for an urgent trip has to note in the destination field whether it was an ER or an after-hours urgent care visit.

Rural distances, volunteers, and overnight trips

Long rural trips are where the North Dakota rules bite hardest. The manual sets these limits:

• Map miles. Mileage is map miles, counted from where the member is picked up (or their residence or community) to the facility.
• One member per trip. On private vehicle trips and on minibus, wheelchair, and stretcher vans, the provider bills one member no matter how many ride.
• Pickup points. Taxi and van trips are covered only from the member’s home, school, or job to the appointment and back. An emergency that starts somewhere else is the exception, and the provider documents it for ND Medicaid review.
• Local care first. If similar services are available in the member’s community and the member chooses to go elsewhere, the trip may not be covered.
• Volunteer mileage. Noncommercial and volunteer drivers bill A0080 for loaded miles only, with an SFN 1507. A zone can ask ND Medicaid for extra mileage when that is what keeps a volunteer driving.
• Overnight stays. Meals and lodging are covered only for approved overnight travel, for example when the member must leave the day before to reach the appointment on time, or returning home that day is not feasible. ND Medicaid pays enrolled providers for them, not the member.

For attendants and parents, meals and lodging may be authorized for a driver, for an attendant the referring provider finds medically necessary, and for one parent of a child under 18. One parent or legal guardian of a child under 18 can also travel without the child to support them at the facility.

What North Dakota Medicaid does not pay

The manual’s non-covered list for NEMT includes:

• Trips to a non-covered service or location, such as a grocery store, health club, or school.
• Court-ordered or law-enforcement-ordered transport to a hospital or other health site.
• Luggage, stair carry, and terminal charges.
• Parking fees.
• Unloaded miles, except with department approval.
• No-shows. The manual calls missed rides “not a distinct, reimbursable service.”

The manual’s no-show section adds a second rule. A company that charges every rider for missed rides may charge its Medicaid riders too, as long as one policy covers everyone, it is posted publicly or handed to riders in writing, and Medicaid members face no extra charge. CMS’s 2023 Medicaid Transportation Coverage Guide bars states and providers from charging a beneficiary for no-shows. Ask ND Medicaid to confirm the rule in writing before you bill a member. The no-show billing guide covers the federal position.

Nursing facilities in North Dakota cannot bill ND Medicaid, or their Medicaid residents, for rides they give themselves, while trips for members in Minnesota nursing facilities are paid separately from the facility’s daily rate.

Billing: charges, forms, and trip tickets

North Dakota pays the calculated Medicaid amount or your usual and customary charge, whichever is lower, and the manual defines usual and customary strictly. Medicaid gets the same price you bill the biggest part of your non-Medicaid business. If you discount multiple-rider trips or give free rides to other riders, Medicaid members get the same. The usual and customary charge entry explains the idea.

The claim itself:

1. Bill on a CMS-1500 or as an 837P. The manual points transportation, meal, and lodging providers to the Travel, Meals, and Lodging claim screen in the North Dakota Web Portal, and providers with an NPI can use the portal’s professional claim.
2. Keep the approved SFN 1507 or SFN 249 on file for every trip.
3. Complete a Non-Emergency Transportation Trip Ticket (SFN 296) for A0100, A0120, A0130, A0170, S0209, S0215, T2005, and T2049.
4. If you are newly enrolled, attach both forms (SFN 1507 and SFN 296) to each claim for the review period ND Medicaid sets.
5. Get the claim to ND Medicaid within 180 days, counted from the date of service (timely filing limits).

Each trip record needs the trip date, your Medicaid provider ID, the rider’s name and member ID, where and when the pickup and drop-off happened, odometer readings, and mileage. Name the facility, not the practitioner the member is seeing. Keep records for seven years, even after you stop providing rides.

Medicaid Expansion members ride through BCBSND

Adults in North Dakota’s Medicaid Expansion are covered by Blue Cross Blue Shield of North Dakota, which has administered the program since January 1, 2022, and their trips follow BCBSND’s rules rather than the fee schedule above.

• Enrollment. Enroll with ND Medicaid first, then contract with BCBSND’s Medicaid Expansion network.
• Trips. Members call BCBSND’s contact center, which sends ride requests to providers to accept or decline. A ride without prior authorization denies as provider liable.
• Pay. Rates and billable codes come from your BCBSND contract. Its code list includes separate loaded and unloaded mileage lines for trips longer than 15 miles one way. Unloaded miles bill only after the first 15, and for one member when several riders share a trip.
• Claims. File within 180 days, put all of a day’s transportation on one claim, and include the BCBSND authorization number. BCBSND’s page suggests Z59.5 for diagnosis and place of service 99.

The June 2026 enrollment freeze and revalidation

New NEMT agencies cannot join right now. Since June 11, 2026, a statewide enrollment moratorium has closed ND Medicaid to new NEMT agencies, using the authority in 42 CFR 455.470. It applies to new enrollments only, lasts six months, and the state can renew it six months at a time.

Providers already enrolled face tighter checks instead. The state’s two-year revalidation strategy names NEMT as a high-risk category and counted 80 NEMT group enrollments and 37 individual ones to revalidate:

• Agencies and every employee driver need an NPI from July 1, 2026. Employee drivers enroll as individual providers and affiliate with their agency.
• New requirements include a needs-based justification, proof of vehicle registration and active insurance, driver requirements, and site visits.
• Every NEMT provider goes through an off-cycle revalidation, and the regular cycle then shortens from five years to three. NEMT revalidation was scheduled first in the 24-month plan: it began July 1, 2026, with all NEMT providers expected to finish by October 1, 2026.

For what a site visit and a revalidation packet involve, see the revalidation guide. Local enrollment steps are in the North Dakota state guide.

Recording North Dakota trip details in HealthRide

North Dakota wants times, addresses, and mileage on every trip ticket, and it can recover payments when the records are missing. HealthRide’s driver app records pickup and drop-off timestamps, GPS miles, and signatures for each trip, and the trip log exports to CSV or PDF for your files. Odometer readings still go on the SFN 296 itself.