VA transportation contracts: how veterans' wheelchair and stretcher rides are bought and paid

Four ways VA gets veterans to appointments

VA moves veterans to care in four ways, and only one of them regularly pays transportation companies by the trip. Knowing which is which saves a lot of wasted calls to a medical center.

Veterans can request both VA-run rides and special mode trips through VetRide, VA’s online ride request system. The volunteer program comes from 38 U.S.C. 111A(b), which has organizations and volunteers carry veterans without reimbursement from VA.

The grants are small and narrow. Under 38 CFR 17.701 to 17.703, only a state veterans service agency or a recognized Veterans Service Organization can apply. A “highly rural area” is a county with fewer than seven people per square mile. VA funds one grantee per area each fiscal year, no grant exceeds $50,000, and rides must be free to veterans. Each round opens with a Notice of Fund Availability in the Federal Register. A grantee can name a subrecipient in its application to do the driving, which is where a local operator can fit.

For most NEMT companies, special mode is the work worth chasing.

What counts as special mode transportation

Special mode is VA’s term for a vehicle built to carry people with disabilities. 38 CFR 70.2 lists “an ambulance, ambulette, air ambulance, wheelchair van, or other mode of transportation specially designed to transport disabled persons.” Buses, taxis, trains, and planes are not special modes. Neither is a privately owned vehicle with adaptive equipment added.

VA pays for a special mode trip when three conditions are met:

1. The travel is medically required. VA.gov describes this as a VA provider deciding the veteran’s condition calls for an ambulance or specially equipped vehicle.
2. The veteran is unable to defray the cost, which the rules define by income or by a service-connected disability.
3. VA approved the trip before it happened, unless it was an emergency.

The veteran also has to qualify for travel pay in the first place. Under 38 CFR 70.10, that includes veterans with a service-connected rating of 30 percent or more, veterans traveling for a service-connected condition, veterans receiving a VA pension or with income under the pension limit, and veterans going to a compensation and pension exam. The per-trip deductible that VA takes from mileage payments does not apply to special mode travel (38 CFR 70.31).

Two practical points follow. First, the approval belongs to VA, not to you. A veteran who calls you directly for a wheelchair ride and plans to “send VA the bill” has no coverage unless the medical center authorized the trip. Second, trips do not only go to the VA medical center. VA pays for travel to VA-authorized community care providers too, and VetRide takes ride requests for appointments at those community offices.

How VA pays vendors today

The regulation says VA pays “the actual cost of a special mode of transportation,” and 38 CFR 70.32 lets VA pay the company that provided the ride instead of the veteran. In practice, medical centers set that cost through contracts with fixed line-item prices, like the ones below.

VA checks every invoice before it pays. VHA Directive 1601B.05 tells each facility’s business office to confirm the veteran attended the appointment before paying a special mode vendor, to review whether the veterans listed on invoices were authorized, and to block the same appointment from also being claimed as mileage.

A rule change is coming, slowly. In February 2023, VA finalized a new method for pricing special mode trips when no contract exists: ambulance trips at the lesser of the actual charge or the Medicare ambulance fee schedule, and other modes based on state posted rates or the actual charge. VA has twice delayed it, and the current effective date is February 16, 2029. Until then, a local contract remains the normal way in.

How VA medical centers buy the service

VA medical centers buy transportation through regional Network Contracting Offices, and the notices appear on SAM.gov. The 2026 notices show the usual patterns:

• Long-term contracts. The Mann-Grandstaff VA Medical Center in Spokane issued a request for quotes in September 2026 for a single-award IDIQ contract: a base year starting October 1, 2026, plus four option years.
• Bridge contracts. When a long-term award is late, centers sign short contracts to avoid a gap. The DC VA Medical Center published a notice for a 3-month wheelchair van contract, and Bay Pines in Florida announced a 6-month bridge for wheelchair and stretcher transport.
• Sources sought notices. Before writing a solicitation, a contracting office asks who is out there. The Wilmington VA Medical Center posted one in July 2026 for ambulance and wheelchair van service in Kent and Sussex Counties, Delaware, to decide whether a planned five-year contract should be set aside.
• Set-asides. The Philadelphia and Baltimore wheelchair van contracts were reserved for service-disabled veteran-owned small businesses. Spokane’s request was not set aside.
• Contract size. SAM.gov lists the Philadelphia award from September 2026 at about $12.9 million and the Baltimore award from June 2026 at about $5.2 million.

Most of these notices use NAICS 485991, Special Needs Transportation, which has a $19 million size standard. Notices that include ambulance work may use 621910 instead, where the limit is $22.5 million.

The set-aside rule comes from 38 U.S.C. 8127. A VA contracting officer must limit a competition to veteran-owned small businesses when two or more are expected to offer a fair and reasonable price. SBA’s VetCert program handles that certification, which moved from VA to SBA on January 1, 2023. If you win a set-aside service contract, 13 CFR 125.6 limits how much you can pass on: no more than 50 percent of what the government pays you can go to firms that are not similarly situated.

What a VA solicitation asks for

A VA solicitation spells out its service terms line by line. The Spokane request for quotes shows what to price and staff for.

Bay Pines added two points worth noting. It asked interested companies to describe their experience with VetRide and how long they would need to get running on it. Its estimated workload was split into line items by vehicle type and distance band, with separate lines for mileage, wait time past 15 minutes, and contractor-furnished attendant hours. Expect to price every one of those lines, not a single trip rate.

Pricing a VA bid: a worked example

VA price schedules reward companies that know their cost per hour, since the unpaid miles get covered by the base rate or not at all. Every figure in this example is made up for illustration.

Suppose you bid on a Spokane-style schedule with these prices:

A 38-mile trip with a 60-minute approved wait pays $85 + (13 × $3) + (2 × $12) = $148.

Now the cost side. The same trip keeps your van and driver busy for about 2.5 hours once you count the 12 unpaid miles to the pickup. At a fully loaded cost of $45 per van hour, that is $112.50, for a margin of $35.50. A short 6-mile trip pays only the $85 base but may tie up the van for an hour, so it earns more per hour. Your mix of long and short trips decides whether the schedule works. Build the Service Contract wage floor into your hourly cost before you price. Plug your own costs into the trip price calculator to test a schedule before you bid.

Steps to win VA transportation work

1. Register in SAM.gov with NAICS 485991 (and 621910 if you run ambulances). Our government contracts guide walks through registration and capability statements.
2. Get VetCert if you qualify. A veteran-owned or service-disabled veteran-owned certification opens set-asides that other companies cannot bid on.
3. Watch the right channels. Save a SAM.gov search for special needs transportation near your area, and check VA’s procurement forecast for requirements that are coming up.
4. Answer sources sought notices. A strong answer can influence whether the work is set aside and how it is written.
5. Have the file ready. Driver licenses, first aid cards, background check records, insurance certificates, and a vehicle maintenance file for each van. Our driver file checklist covers most of it.
6. Plan for VetRide. Solicitations expect trips and invoices to run through it. Spokane also wants a written contingency plan for outages: a log of each request’s date and time, actual versus scheduled pickup, pickup and delivery points, mileage, and any waiting, sent to the contracting officer’s representative every month.

VA work also changes your payer mix. It pays the line-item prices from your own bid rather than a broker’s rate sheet, and invoicing runs on VA’s schedule. See NEMT payer mix for weighing it against Medicaid and private pay.

Running VA trips in HealthRide

VA reconciles every invoice against the trip, so the record matters. HealthRide stores GPS-recorded miles with every ride, plus the moment of each pickup and drop-off, any signatures, and recorded no-show waits. When the travel office questions a line item, the trip log in reports exports to CSV or PDF.