Texas Medicaid NEMT rates: the demand response fee schedule and what plan vendors pay

A flat rate per leg, not base plus miles

Texas does not pay fee-for-service demand response trips with a base rate plus mileage. The Medical Transportation Program (MTP) pays demand response providers one flat amount for each one-way leg, billed as T2003, with no per-mile line. A modifier tells TMHP which of three county types the trip falls in, and that sets the amount. A 3-mile leg across town and a 25-mile leg in the same county type pay the same.

That changes which trips pay well. Long legs in metro counties earn little per mile, and short legs in rural counties earn a lot, so look at trip length before you accept a standing run.

These rates cover trips MTP arranges for fee-for-service Medicaid clients and two smaller state programs. Health plan members ride through their plan’s vendor at contract rates, covered further down. The Texas state guide explains how the two sides fit together.

The T2003 rates, and how they have moved

TMHP’s demand response fee schedule, printed September 14, 2026, lists three T2003 lines. Each took effect for dates of service on or after September 1, 2026.

Two things stand out:

• Both recent raises were across the board. The November 2024 change lifted all three rates by about 19.6 percent. The September 2026 change added about 4.5 percent to each.
• Rural legs pay more than twice metro legs. At the current rates, a rural leg pays $45.80 more than a metro leg.

The September 2026 rates came out of a calendar fee review of MTP non-emergency transportation, presented at the May 26, 2026 public rate hearing and put in place under TMHP’s August 31, 2026 notice. The fee schedule says Texas Medicaid reviews its rates every two years, or sooner when necessary. The November 2024 rates were a special review presented at a November 12, 2024 hearing.

What one authorization pays

MTP authorizes each one-way leg on its own and gives it a unique authorization number, and you file a claim for each completed leg. TMHP’s T2003 notice adds a detail that changes the math: each leg pays its rate once for every seat HHSC authorized on it.

In a hypothetical, a rural rider travels to a dialysis center and home again with one authorized attendant.

The same round trip for a metro rider traveling alone pays 2 legs x $33.83, or $67.66. Before you accept a run, check how many seats the authorization covers, because an unauthorized companion adds nothing to the payment.

Mileage for people who drive their own car

The one per-mile rate in the program belongs to individual transportation participants (ITPs): a family member, friend, neighbor, or the rider, driving a personal vehicle. They sign up with TMHP as registered participants rather than as enrolled Medicaid providers.

TMHP announced the July rate on September 2, 2026 and said it would reprocess affected claims. To get paid, the ITP fills out the H3017 service record that MTP mails to the rider, has it signed by the doctor, dentist, or pharmacy visited, signs it, and mails it so TMHP has it no later than 95 days after the ride. Filling out the form cannot be charged to the rider or to TMHP.

Who the schedule applies to

According to the MTP handbook, the program handles rides for three groups who lack any other means of transportation: fee-for-service Medicaid clients, CSHCN Services Program clients, and people in the Transportation for Indigent Cancer Patients program. MTP prior authorizes every one of those trips. Managed care organizations authorize their own members’ rides, and the handbook says plainly that it does not cover managed care.

Clients call MTP at 1-877-633-8747 at least two business days ahead of the appointment, or five business days when the trip leaves their home county. A hospital discharge, a pharmacy visit, or urgent care can be set up with less notice.

Getting fee-for-service trips

MTP work runs through HHSC contracts, not open booking. HHSC’s open enrollment HHS0016482 seeks applications from demand response providers to build a statewide network that operates region by region. It was released September 15, 2025, accepts applications until 5 p.m. Central on September 15, 2027, and has been amended eight times, most recently on September 24, 2026.

Two provider types enroll directly with TMHP: demand response transportation service providers and transportation network companies. The handbook recommends these codes for each:

The demand response entry explains the term, and the U modifiers entry shows how other states use the same modifiers for different things.

Billing an MTP trip

Claims go to TMHP electronically through TexMedConnect or vendor software, or on the CMS-1500 paper form. The handbook lists fixed values every MTP claim uses:

• Benefit code: MTP. Provider type: MT.
• Diagnosis: Z753, the recommended code for all MTP claims.
• Place of service: 09 on paper, 99 in TexMedConnect.
• Prior authorization number: the number MTP issued, in block 23.
• Identifier: a demand response provider may use its NPI or its atypical provider identifier (API). Transportation network companies and ITPs use the API.

The filing limit is 95 days from the trip for providers based in Texas and 365 days for those based elsewhere. A new provider gets 95 days from the day its NPI or atypical identifier is issued, but no longer than a year after the trip. TMHP rejects claims until an atypical identifier exists, and the rejection report can serve as proof of timely filing on appeal.

Three more rules matter after the trip. Missed appointments cannot be billed to Medicaid or the client. Payment can be recouped when records do not show that the level of service delivered matches the level billed. And prior authorization records for clients age 20 or under stay on file until HHSC gives notice that they can be destroyed.

Health plan trips pay what the vendor contracts

Every Texas Medicaid health plan contracts with a vendor to arrange its members’ rides. The state’s contact list names these vendors:

The list still pairs Blue Cross and Blue Shield of Texas with Modivcare, but under its August 26, 2026 notice the plan hands its Medicaid rides to MTM Health for trips on or after October 1, 2026. Standing rides and trips already scheduled after that date go to MTM Health without members rebooking.

The MTP schedule does not bind these vendors. MTM Health’s Texas provider page says its rates are worked out with each transportation provider individually, and that it does not reimburse no-shows. Before you accept plan trips, get the rate, the no-show terms, and when you will be paid, all in writing. The MTM Health broker guide and the SafeRide Health guide cover each vendor’s network, and NEMT broker rates explains how those contracts are usually built.

The MTP rates still help in a negotiation. A vendor offer well under $33.83 for a metro leg pays less than MTP pays for a fee-for-service leg in the same kind of county.

Pricing Texas trips in HealthRide

A Texas fleet can run MTP legs, plan vendor trips, and private rides in the same week, each at a different price. HealthRide builds invoices for the facilities and payers you work with from the trips you actually ran. Each invoice is priced from that payer’s own rates, so every customer is billed at the price you set for them.