What is a base rate in NEMT pricing?
Base rate is the fixed payment a NEMT provider gets for each one-way trip, separate from mileage. It depends on the service level: a wheelchair van trip bills A0130 and a stretcher van trip bills T2005, each with its own mileage code. For trips on or after October 1, 2026, Arizona's fee-for-service schedule sets the urban wheelchair van base at $11.15, with loaded miles paid at $1.54 each.
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What the base rate pays for
A base rate is the fixed part of a trip’s price. It pays for showing up and carrying the rider, whatever the distance, and mileage is priced on top of it. On a Medicaid claim the two go on separate lines. Arizona’s billing manual, for example, wants the trip count on line one, loaded miles on line two, and billed wait time on line three, all on a single claim. Arizona measures loaded miles in statute miles, counting only distance driven while the member rides.
What the base covers depends on the payer, and Nebraska writes it out plainly. Its base rates include:
- Vehicle operating expenses and the services of personnel.
- The first five loaded miles of the trip.
- All unloaded mileage.
- Usual waiting and standby time.
Unloaded miles are the reason base rates matter so much. In CMS’s 2023 transportation coverage guide, empty miles, including the return after a rider fails to show, are generally not payable on their own as a service or an administrative cost. CMS lets states cover that cost another way: they can fold what empty miles and rider no-shows cost into the rates they pay. In a state that builds them in, the base rate is where your deadhead miles get paid for.
Base rates by service level
Each service level has its own base code and usually its own mileage code. Two published Medicaid fee-for-service schedules show how far the numbers and the structure can differ.
| Code | What it bills | Arizona, trips from Oct. 1, 2026 (urban / rural) | Nebraska, from July 1, 2026 |
|---|---|---|---|
| A0130 | Wheelchair van trip | $11.15 / $12.21 | $46.12 |
| T2005 | Stretcher van trip | $49.09 / $86.70 | Not on the NET schedule |
| T2003 | Non-emergency transportation, per encounter or trip | Not on the NEMT schedule | $19.69 |
| S0209 | Wheelchair van mileage, per mile | $1.54 / $1.66 | $1.85 |
| T2049 | Stretcher van mileage, per mile | $1.54 / $1.66 | Not on the NET schedule |
Arizona’s rural column covers any trip that begins beyond the Phoenix and Tucson metropolitan areas, and those trips carry the TN modifier. Arizona says the rural rate allows for unmaintained or unpaved roads, the long drives needed to reach members, and areas with few providers. The taxi code, A0100, has no unit in its description, so check how your state’s schedule applies it before you bill. Our NEMT billing codes guide lists the rest.
Same trip, two states: a worked example
Take a hypothetical wheelchair van trip with 12 loaded miles, paid at fee-for-service rates.
| Arizona, urban, from Oct. 1, 2026 | Nebraska, from July 1, 2026 | |
|---|---|---|
| Base rate | $11.15 | $46.12 |
| Paid miles | 12 x $1.54 = $18.48 | 7 x $1.85 = $12.95 (first 5 miles are in the base) |
| Total | $29.63 | $59.07 |
The Nebraska base is about four times Arizona’s, but it also buys the first five miles, so the gap between whole trips is smaller than the gap between base rates. Compare total trip pay at your usual distances, not base rates alone. Nebraska also notes that its payment system calculates to seven decimal places while the schedule shows two, so small differences from the printed rate are expected. The rate references for Arizona and Nebraska cover each schedule in full.
Broker and plan trips
For broker and health plan work, the contract sets the pay, not the state schedule. In Virginia, MTM Health prices each trip from its Schedule A rate sheet, which weighs mileage, the transport mode, and chances to carry riders together. WellTrans pays whichever is lower, your billed charge or its contract rate, so billing below the contract rate gives money away on every trip.
Base rates in private-pay pricing
Private-pay price lists tend to copy that structure: a base charge for each one-way trip at each service level, a per-mile rate, and extras for waiting, attendants, or stairs. The difference is that you set the numbers. Build the base from your cost per trip, then write down what it includes, such as how many miles or waiting minutes, on your rate sheet. The pricing guide walks through the math, and the trip price calculator runs a quote.
Pricing trips in HealthRide
Base rates and mileage differ from payer to payer, so HealthRide keeps your fares per payer. Every trip is priced the moment it is booked, and when it is done it turns into an invoice priced from that payer’s rates.
Frequently asked questions
- Does the base rate include any miles?
- Sometimes. Nebraska Medicaid's base rate absorbs five loaded miles, every unloaded mile, and normal waiting time, and mileage pays only past those five. Arizona pays every loaded mile on a separate line. Read the definitions at the top of your state's fee schedule, because the same code can buy different things in different states.
- How many base rates does a round trip earn?
- Usually two, because each one-way leg counts as its own trip. Arizona's billing manual puts the day's trip count in the units of the first claim line and the day's loaded miles on the second, all on one claim. Split billing, with the base on one claim and the mileage on another, is denied there.
- Why is my state's base rate so much lower than my private-pay price?
- Medicaid rates are set by budget and policy, not by your costs. Nebraska kept its July 1, 2026 rates flat, and the schedule explains that no rate increase was appropriated for the state fiscal year. Your private price has to cover your real cost per trip, so build it from your own numbers and use Medicaid rates only as a reference point.
