Workers' comp transportation: how injured-worker rides are booked and paid

How an injured-worker ride gets paid

A workers’ comp ride is a medical expense on an open claim. The employer’s workers’ compensation insurer, a self-insured employer, or a state fund pays for treatment of a work injury, and travel to that treatment is part of it. The federal rule for longshore and harbor workers spells this out, listing “the reasonable and necessary cost of travel incident thereto” inside its definition of medical care (20 CFR 702.401). Each state law has its own version.

The mechanics differ from Medicaid in three ways:

• The claim number is the key. There is no Medicaid ID. Every trip ties to a claim, and every invoice carries that claim number.
• Someone authorizes each ride. An adjuster or nurse case manager approves the trip, or a network books it on their behalf.
• The injured worker pays nothing. The payer or the network pays you.

Common destinations include physical therapy, doctor visits, diagnostic tests, and independent medical exams.

Who books the ride

Workers’ comp rides reach a NEMT company through a few doors:

Networks do the coordination for the trips they book. One Call lays out its process: after a referral, it sends a confirmation to the adjuster or case manager, reaches out to the worker, and reconfirms the ride a day ahead. On its rideshare sedan service, trips are monitored live and the adjuster hears about any missed ride. Once the provider invoices, One Call pays the provider and bills the payer. Its service levels run from sedan and wheelchair van to stretcher, ambulance, and air ambulance.

State and federal travel rules

Every state writes its own travel rules, and they decide when a ride is covered at all. Four examples show the range:

Washington’s 2026 payment policies go into the most detail of the four. A few rules stand out for NEMT operators:

• Trip tickets. The insurer pays when it has given the provider an insurer-provided trip ticket.
• Separate accounts. An ambulance company that also runs wheelchair vans needs a separate provider account for the van work.
• No-shows. The insurer pays taxi providers a no-show fee only when the worker misses an insurer-arranged exam or consultation.
• Deadlines. Bills are due within a year of the date of service.
• Invoice contents. Providers other than taxis send an itemized statement showing the claim number and worker’s name, the trip date, the pickup address and time, the destination, any wait time, when the worker was dropped off, who drove along with the operator or cab number, and the rates and trip total. L&I pays only to the nearest place that can give proper treatment.

Federal employee claims use a travel authorization form that lists the same HCPCS codes used elsewhere, including A0130 for wheelchair van. Providers submit it through the Department of Labor’s bill processing portal with their OWCP provider ID, and enrollment is online through the OWCP provider portal.

What transportation networks require

Networks credential providers before sending trips, and their paperwork is specific. Two published examples:

MTI America requires a written credentialing application before any service. Its credentialing committee checks items such as work history, current professional liability insurance, and any history of sanctions or disciplinary action, and the process includes an on-site visit. MTI then rates each provider in stars against benchmarks that include injured-worker surveys, pricing, accessibility, reliability, turnaround time, and compliance. A provider under three stars is put on mandatory probation, with outreach and education, until its performance comes back up.

ProCare publishes its full provider packet. A commercial provider sends:

1. The signed transportation application and agreement.
2. A rate sheet.
3. A W-9 and a current business or occupational license.
4. A certificate of auto insurance on the ACORD 25 form, naming ProCare as certificate holder.
5. A list of insured vehicles.
6. A short description of driver hiring criteria, such as background checks and drug testing.

ProCare also accepts independent drivers without commercial auto insurance, who send a driver’s license, personal auto policy, registration, a national criminal background check, and a three-year driving record.

The agreement’s service terms show the kind of rules networks set:

• No-shows. Notify ProCare immediately and wait for its approval to release the driver, or the no-show fee is not guaranteed.
• No payment from the worker. Never ask the claimant, the adjuster, or the case manager for payment.
• No rideshare. Using rideshare apps to carry ProCare claimants is prohibited.
• One rider at a time. Carrying several injured workers in the same vehicle at once is not allowed.
• Wait time. Wait only when authorized, stay visible on site, and report the total within 48 hours of the trip.
• Invoices. Submit within 45 days of the service date. ProCare pays within 30 days of a clean invoice.
• Miles. Only miles with the injured worker in the vehicle are paid. There is no pay for dead miles.
• Term. One year, renewing automatically, with 90 days’ written notice to end it.

Pricing workers’ comp trips

Workers’ comp rates come from your network rate sheet or, in a state like Washington, your usual and customary charges. Either way, the base rate has to absorb the empty miles, because payers generally pay only loaded miles.

Take a hypothetical rate sheet: a $55 wheelchair base, $2.75 per loaded mile, and $30 per authorized hour of waiting. The job is a therapy visit 14 miles from the worker’s home, with a one-hour authorized wait before the ride back.

Say the van also drove 9 miles empty to reach the worker and 9 more to get home afterward. Those 18 miles earn nothing. Your cost per van hour, not only per mile, tells you whether a rate sheet works, and the trip price calculator lets you test it with your own figures.

Getting into workers’ comp networks

1. Apply to the national networks. One Call, MTI America, and ProCare all recruit transportation providers. MTI’s online form asks for your state and service type, with transportation as an option.
2. Meet local adjusters and case managers. They can authorize rides directly, so introduce your company to the claims offices near you.
3. Register with public payers where they exist. In Washington that means an account with L&I. Federal employee claims need OWCP enrollment.
4. Have the credentialing file ready. Insurance certificates, vehicle lists, driver licenses, background checks, and driving records. Our driver file checklist covers the driver side.
5. Protect the worker’s information. ProCare’s agreement requires keeping everything about the claimant confidential, including legal and financial matters. It also bars drivers from discussing those matters or steering the worker to an attorney or doctor.

Workers’ comp trips pay by invoice on the network’s schedule, which changes your cash flow compared with private pay. Weighing these payers against the rest of your work is covered in NEMT payer mix.

Keeping the money straight in HealthRide

Workers’ comp adds another payer to track alongside Medicaid, facilities, and private pay. HealthRide records checks and ACH payments from networks and insurers in one ledger with card payments, matched to trips and invoices, so every dollar is tracked whatever route it took. Invoices are built from completed trips and stay tracked until they are paid.