Stretcher van transport cost: crews, equipment, and what programs pay

What drives the higher price

Compared with a wheelchair trip of the same length, a stretcher trip ties up an extra crew member, costlier gear, and more minutes at each end. Payers and private customers pay for all three.

Two people on every trip. New York’s Medicaid policy manual puts at least two employees on every stretcher trip. Besides the driver, an assistant rides in the back with the patient and alerts the driver to any sudden change. Illinois goes further: under 77 Ill. Adm. Code 515.845, a stretcher van cannot operate with fewer than two trained attendants, one of whom stays with the passenger, and both must hold CPR certification and stretcher training. Wheelchair programs often pay a second person as an extra, as Ohio ($15.00) and Illinois ($20.00) do under the attendant code T2001, while stretcher service builds two people into every trip. That second wage is a large part of the gap.

Equipment built for the job. New York requires a wheeled cot, patient straps supplied by the cot’s manufacturer, and a mount for the cot built by that manufacturer and fixed to the vehicle. Illinois sets a minimum cot size (75 by 22 inches), requires a three-point quick-release fastener rated to stay put in a crash, a mounting bracket for each oxygen cylinder, room for two attendants, and pillows, sheets, and blankets on board. That is more money tied up in each van. The stretcher van equipment guide covers the gear in detail.

One bed, several names. Rules and plans name the same wheeled bed in several ways. New York writes stretcher (cot), Illinois writes wheeled litter, Medi-Cal calls the vehicles litter vans, and Kaiser Permanente’s Georgia plan covers stretcher or gurney vans. A quote for any of them should describe the same service.

Fewer riders per van. Illinois allows only one stretcher passenger in a van at a time. Where a wheelchair van can group riders and share its cost among them, a van limited to one stretcher patient cannot.

More time at each end. The crew moves the patient from a bed or chair to the cot, secures them, and reverses it at the destination. In New York, the crew is expected to handle curbs, doorways, and stairs with the cot whenever a building lacks an elevator or ramp. Each of those minutes is two people’s time.

Stretcher van rates in published Medicaid schedules

Programs that cover stretcher vans usually pay a flat amount for each one-way trip under T2005 and a per-mile rate under T2049 for miles with the patient aboard. The table shows published rates. The 15-mile column counts every loaded mile as billable unless the base already covers some miles.

A few notes on reading the table:

• Staffing is often built in. New York treats the second crew member as part of a stretcher trip. MTM’s Rhode Island schedule lists the attendant fee as included. Minnesota is the exception here, adding $9 when a second attendant is medically necessary.
• After-hours and larger patients cost more. MTM’s Rhode Island schedule pays $190.00 for an after-hours stretcher base and $300.00 for a bariatric stretcher trip in business hours.
• Minnesota’s rates stay put for now. They were due to lapse for fee-for-service trips when July 2026 began, under a 2025 law. The legislature changed that in May 2026: the statutory rates now last until a new transportation administrator takes over.
• Some programs send stretcher riders by ambulance. Ohio’s fee-for-service schedule, enacted July 10, 2026, has no stretcher van code. Indiana has booked fee-for-service stretcher trips straight with enrolled ambulance companies, rather than through its broker, starting with July 1, 2023 dates of service.

Broker and managed care rates are contract terms and can differ from the state schedule. The New York and Arizona rate guides go county by county and code by code.

The price gap between a stretcher van and an ambulance

For the same trip, a payer usually spends far more on a BLS (basic life support) ambulance run than on a stretcher van. The ambulance carries an EMS crew and medical equipment and can treat the patient in transit. The stretcher van crew only transports.

Here is the same hypothetical 15-mile trip under each program’s published rates, with every mile billable:

The Medicare row uses the 2026 ambulance fee schedule: an urban non-emergency BLS base of $261.60 to $380.05 depending on the locality, plus $9.33 per urban mile. New York City is the outlier, because its $230.00 stretcher base sits above its $192.99 BLS ambulance base.

Connecticut regulates ambulance charges too. Its 2026 statewide rate schedule lists $980.00 for a BLS ambulance plus $23.81 a mile, and each company bills under its own approved schedule. Connecticut’s wheelchair vehicle category, the invalid coach, is defined to exclude patients confined to stretchers, so a stretcher patient cannot ride in one.

Who qualifies for which matters for cost and safety. Under 42 CFR 410.40, bed confinement means all three at once: the patient needs help getting out of bed, cannot walk, and cannot sit up in a chair or wheelchair. Medicare treats it as one factor in medical necessity, not the only one. The NEMT vs ambulance guide covers where the line falls and how each ride is coded.

What the patient owes, by payer

The payer shapes what the patient owes:

• Medicaid pays in states that cover stretcher vans, at the rates above. The patient owes nothing beyond any state copay.
• Original Medicare leaves stretcher vans out. Its Part B benefit pays for non-emergency ambulance trips that meet the medical criteria, and the patient owes 20 percent of the approved amount after the $283 Part B deductible. If the ambulance company expects Medicare to turn down a non-emergency trip, the company must first provide an Advance Beneficiary Notice of Noncoverage (ABN).
• Medicare Advantage plans may add stretcher van rides. Kaiser Permanente Senior Advantage in Georgia covers them when a network provider orders the ride and the plan approves it in advance, for a $125 copay per one-way trip.
• Commercial health plans rarely pay for a van of any kind. The private insurance guide explains what they do cover.
• Families and facilities pay the company’s private price. Ask for it in writing before the trip, using the questions below.

What a facility should ask for in a quote

A stretcher quote is only comparable to another when both describe the same trip. Case managers and facility staff get cleaner quotes by asking these questions up front:

1. What the base covers. Whether it includes the second crew member, a set number of miles, and help through the door.
2. How miles are counted. Loaded miles only, or also the drive from the garage.
3. Stairs and access. The number of steps at each end, whether there is an elevator, and any charge per flight.
4. Size and weight. The patient’s approximate weight and height. Cots have weight ratings, and a heavier patient may need a different cot and a larger crew.
5. Oxygen. Whether the patient uses their own oxygen. New York allows a stretcher rider to self-administer oxygen but bars the crew from supplying it and bars oxygen supplies on the van, while Illinois requires every oxygen cylinder on board to sit in its own crash-stable quick-release bracket.
6. Waiting and the return trip. Whether the crew waits, returns at a set time, or comes back when called, and what each costs.
7. Time of day. Evening, overnight, weekend, and holiday rates.
8. Cancellations. The cutoff for a free cancellation and the charge when a crew arrives and the patient cannot go.
9. Whether a van is right at all. A patient who needs monitoring, IV fluids, suctioning, or help with oxygen needs an ambulance, whatever the price.
10. Paperwork. The company’s license where the state requires one, its certificate of insurance, and its invoice terms.

Put the agreed rates in writing. The facility transportation agreement template lists the terms to cover.

For operators: building the price from crew time

Building a stretcher price from crew hours keeps the second wage and the time at each end in view. The numbers below are hypothetical and only show the method.

Example: two crew members paid $20 an hour each, plus 20 percent for payroll taxes and workers’ compensation, cost $48 an hour together. Add $30 an hour for the van, insurance, fuel, and overhead, for $78 an hour. If a local trip ties up the crew for 1.5 hours from the moment they leave the last drop-off to the moment the patient is settled, the trip costs $117 before any profit.

From there, split the cost into a base rate and a per-mile rate, add charges for stairs and waiting, and compare the result with the Medicaid rates in your state. The NEMT pricing guide and the trip price calculator walk through each step. The stretcher business guide covers licensing and crews.

Stretcher trips on the board and on the invoice

In HealthRide, wheelchair, stretcher, and oxygen needs are matched when trips are assigned. You set fares for each payer, so a stretcher trip is priced the moment it is booked and becomes an invoice at that payer’s rates once it is done. See the dispatch board.