Stretcher vs gurney in NEMT: the terms, the equipment, and the rules for stretcher vans
In NEMT, stretcher and gurney describe the same service. A gurney is a wheeled cot or stretcher, and a stretcher is any device for carrying a sick or injured person. What matters is the service level: a stretcher van carries a medically stable rider who cannot sit in a wheelchair and needs no medical monitoring. HCPCS code T2005 describes a stretcher van trip.
On this page
The words: stretcher, gurney, and cot
A gurney and a stretcher are the same thing in everyday NEMT talk. Merriam-Webster defines a gurney as “a wheeled cot or stretcher” and a stretcher as “a device for carrying a sick, injured, or dead person”. Strictly, every gurney is a stretcher, but not every stretcher has wheels.
Regulators and payers use their own words:
| Where you see it | Term used |
|---|---|
| Federal Medicaid brokerage rule, 42 CFR 440.170 | “Stretcher cars” |
| HCPCS code T2005 | “Stretcher van” |
| Federal ambulance equipment specification cited by Virginia | “Elevating wheeled cot” |
| Everyday operator speech | Stretcher, gurney, or cot |
When a broker sends a stretcher trip, it means a service level, not a piece of equipment. The rider travels lying down or reclined in a vehicle built to carry a stretcher, with a trained crew. Our stretcher transportation glossary entry covers the service level in short form.
Stretcher van vs ambulance
The line between the two is medical need during the ride, not the vehicle. A stretcher van is transportation. An ambulance is medical care that moves.
| Stretcher van | Non-emergency ambulance | |
|---|---|---|
| Rider’s condition | Medically stable, cannot sit in a wheelchair | Needs monitoring or treatment in transit |
| Care during the trip | None beyond first aid | Provided by licensed EMS crew |
| Typical HCPCS code | T2005, stretcher van | A0428, basic life support non-emergency transport |
| Markings | No ambulance markings, lights, or sirens in Virginia | Licensed ambulance markings |
| Regulated by | Medicaid program and broker, plus state vehicle rules | State EMS office |
Virginia requires ambulances converted into stretcher vans to remove all ambulance markings, red or amber lights, and flashing lights. In Virginia, only providers licensed by the state EMS office may show the Star of Life emblem.
Who qualifies for stretcher transport
Virginia’s DMAS standards give the clearest public definition. A stretcher van is for a medically stable person who needs a routine trip to a non-emergency appointment, who is convalescent or otherwise non-ambulatory and cannot use a wheelchair, and who does not need emergency transport, monitoring, aid, care, or treatment on the way.
Virginia lists riders who are not eligible for a stretcher van:
- Riders who need invasive procedures, such as IV therapy, drug administration, or IV pumps
- Riders who need mechanical monitoring
- Riders who need mechanical respiratory procedures or suctioning
- Riders who need oxygen therapy, other than self-administered oxygen
- Riders with an injury that a physician has not yet evaluated
- Riders known to have an acute infectious process
A stretcher van also may not carry anyone with a temporary invasive device in place, including a saline lock, or more than one stretcher passenger at a time. If a rider’s condition changes during the trip, the driver calls 911 first, then dispatch.
Stretcher equipment standards
Virginia’s inspection list is detailed because it borrows from the federal ambulance specification, GSA KKK-A-1822E. It is a useful baseline even outside Virginia.
| Equipment | Virginia requirement |
|---|---|
| Stretcher, Style 1 | Elevating wheeled cot, at least 75 inches long and 22 inches wide, no more than 15 inches high when collapsed |
| Stretcher, Style 2 | Elevating wheeled cot with front roll-in wheels, at least 79 inches long and 22 inches wide |
| Mattress | At least 3 inches thick, with a non-porous cover that meets FMVSS 302 |
| Patient straps | At least three, at chest, hip, and knee, plus over-the-shoulder torso restraints |
| Strap build | At least 2 inches wide, metal-to-metal quick-release buckles, easy to disinfect |
| Stretcher mount | Crash-stable side or center mount with a quick-release latch, tested to a 2,200 pound pull under AMD Standard 004 |
| Oxygen | Self-administered tanks secured to AMD Standard 003 |
| Position | Rider carried supine or in Fowler’s position, loaded headfirst |
| Sanitation | Hand sanitizer, cleaning supplies, clean linens changed after each use, red or orange bags for regulated waste |
The van must also meet every general vehicle rule: current state safety inspection, seat belts for all passengers, climate control, and ADA compliance. Our NEMT vehicle requirements guide covers those.
Crew and procedures on a stretcher trip
Stretcher work takes two people. Virginia requires a driver and an assistant on every stretcher trip. Both must complete approved training in first aid, handling bloodborne pathogens, and transferring, loading, and unloading passengers on stretchers.
The procedures are specific:
- Never leave a stretcher passenger unattended.
- Confirm all restraining straps are fastened and the stretcher is locked into its mount before moving.
- Keep the assistant seated in the patient compartment while the van moves, watching the rider.
- Call 911 if the rider’s condition suddenly changes, then notify your base.
- In Virginia, file an exception report with the state EMS office within two business days whenever a stretcher van is diverted to an emergency department or an EMS crew intercepts the trip.
Stair chairs, scoop stretchers, and other transfer devices
Getting a stretcher rider out of a second-floor apartment can be harder than the drive. Virginia requires the NEMT provider to supply a scoop stretcher, a Reeves stretcher, or a stair chair when the rider needs one. Price that equipment and the training into your stretcher rate. The stair chair glossary entry explains when a stair chair is used.
Planning and billing stretcher trips
Stretcher trips change the math of your day. Each one ties up two staff members and a vehicle that can carry one stretcher passenger at a time. Loading, securing, and unloading a stretcher takes more steps than a wheelchair pickup, so time your own stretcher pickups and build that number into the schedule.
For billing, HCPCS T2005 describes a stretcher van trip. Whether you bill T2005, which mileage code pairs with it, and what it pays are set by your state Medicaid program or broker. The NEMT billing codes guide lists the full code set.
Before you add stretcher service
Stretcher work costs more to run than ambulatory or wheelchair trips, because every trip needs two trained people and dedicated equipment. Check these before you accept your first stretcher trip:
- Rules. Read your state Medicaid manual and each broker agreement for stretcher van definitions, eligibility rules, and any separate license or permit.
- Vehicle. Confirm the van has an approved stretcher, a crash-tested mount, restraint straps, oxygen tank retention, and climate control, and that it passes inspection as a stretcher vehicle.
- Crew. Staff two trained people per trip, and schedule the second person as carefully as the driver.
- Training. Document first aid, bloodborne pathogens, and stretcher transfer training for everyone who rides.
- Transfer devices. Buy the stair chair or scoop stretcher your riders will need, and train on it.
- Screening. Ask the broker or facility the eligibility questions above at booking, so a rider who needs an ambulance is not sent a stretcher van.
Dispatching stretcher trips in HealthRide
HealthRide matches wheelchair, stretcher, and oxygen needs to vehicles that can carry them, so stretcher legs are matched to vehicles set up with a stretcher space. See how that works for stretcher fleets on the stretcher transportation software page.
Frequently asked questions
- Is a gurney the same as a stretcher?
- Close to it. Merriam-Webster defines a gurney as a wheeled cot or stretcher, and a stretcher as a device for carrying a sick, injured, or dead person. In NEMT, the equipment in a stretcher van is almost always a wheeled cot, so operators use the two words interchangeably. Broker and billing documents usually say stretcher.
- How is a stretcher van different from an ambulance?
- A stretcher van carries a medically stable person lying down who needs no medical care on the way. An ambulance carries people who need medical monitoring or treatment during transport, with licensed EMS crew. Virginia bars stretcher vans from carrying anyone who needs basic or advanced life support, IV lines, or close observation.
- Can a stretcher van rider use oxygen?
- In Virginia, only self-administered oxygen, and the tank must be secured to the Ambulance Manufacturers Division oxygen tank retention standard. Riders who need oxygen therapy managed by someone else are not eligible for a stretcher van there. Check your own state and broker rules.
- How many staff does a stretcher trip need?
- Plan on two. Virginia requires a driver and an assistant on every stretcher van trip, with the assistant seated in the patient compartment while the vehicle moves. Both must be trained in first aid, bloodborne pathogens, and stretcher transfers.
- What billing code is used for stretcher van trips?
- The HCPCS code T2005 is described as "Non-emergency transportation; stretcher van". Your state or broker decides whether you bill it, which mileage code goes with it, and what it pays. Our NEMT billing codes guide lists the full code set.
