Bed-to-bed transport: the stretcher service that starts and ends at the patient's bed
Overview
Bed-to-bed transport is stretcher service that collects the patient from a bed or treatment chair at the pickup and delivers them to a bed or treatment chair at the destination, instead of meeting them at a door. A crew of at least two moves the patient. Georgia, for example, books stretcher dialysis trips bed to bed or treatment chair, and the clinic must have its chair ready on arrival.
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What bed-to-bed means
Bed-to-bed is the stretcher version of full assistance. The crew goes to the patient’s bed or treatment chair, moves the patient onto its stretcher, and delivers them to a bed or chair at the other end. It goes further than door-through-door service, which brings a rider inside a building, and it differs from hand-to-hand service, which is about who receives the rider.
The riders who need it are the ones who travel lying down. Medi-Cal’s ground transportation manual lists bed-bound recipients among its examples of riders who qualify for a litter van. Hospital discharges home, moves between facilities, and stretcher dialysis runs are typical examples. The term also turns up outside Medicaid: One Call, which arranges rides for injured workers, lists bed-to-bed service with its fixed-wing air ambulance option.
Georgia writes the term into its rules. Its NEMT manual (version October 1, 2026) sets the service for each mobility level on dialysis trips:
| Mobility level | What the NEMT crew provides at the dialysis center |
|---|---|
| Ambulatory | Curb to curb; extra help comes from an escort or the facility’s staff |
| Wheelchair | Door to door, with no lift assistance into the dialysis chair |
| Stretcher | Bed to bed or treatment chair; the facility must have the bed or chair ready for immediate offload |
Every request for a standing stretcher order has to come with a letter of medical necessity, the same section says. Once the member arrives, the dialysis team takes over, including weighing the member and moving them into the dialysis chair.
Who moves the patient off the bed
A stretcher crew of at least two does the moving. Georgia builds that into its definition of a stretcher rider: a member who needs two people to move them, reclined, between the vehicle and the provider. State crew rules are on the stretcher transportation page, and the other reasons a ride needs a second person are under two-person assist.
Moving a patient from a bed to a cot is what safe patient handling guidance calls a lateral transfer: a slide from one surface to the next. The Veterans Health Administration’s algorithm for that move, reprinted in NIOSH’s 2009 safe patient handling curriculum, calls for a friction-reducing device or lateral transfer board for a patient under 200 pounds who can help only partly or not at all. Over 200 pounds, it calls for a mechanical or air-assisted device, or a ceiling lift, and three caregivers. It also says the surface the patient moves onto should sit half an inch lower. Other transfer methods a crew may need are in safe passenger transfers.
Going into the room can need permission of its own. CareOregon’s manual (version 1.3, February 2024) keeps drivers out of a private home or a member’s room in a care facility, and away from moving a member out of bed, unless the brokerage has authorized it after licensing and training.
Getting the cot to the bedside is part of the job too. New York expects stretcher crews to get it past curbs, doorways, and steps where a building has no elevator or ramp. The stair chair entry and when the stretcher will not fit in the elevator cover the equipment and the tight spots.
Where the crew’s job ends
The crew’s job ends when the patient is on the receiving bed or chair and someone there has taken over. It does not stretch into the visit:
- No exam table moves in New York. Vendors are not obliged to go into an exam room to move an enrollee on or off the table.
- No staying through the visit. New York also spares vendors from sitting in on the appointment to carry treatment details back to a nursing home or caregiver, and from leaving their stretcher behind for the practitioner to use.
- No treatment on the company stretcher. Georgia bars stretcher providers from letting a facility treat members on their stretchers.
- Never alone in the van. Virginia does not allow a stretcher passenger to be left unattended at any time.
Bedside details to get before dispatch
- Which room and bed is the patient in at each end, and which floor?
- Is there an elevator big enough for the cot, or stairs that call for a stair chair?
- What does the patient weigh, so you know how many crew members and what slide aid to bring?
- Who will receive the patient at the destination, and will the bed or chair be ready?
- Is the stretcher level authorized, with the medical necessity letter the payer wants?
In HealthRide, stretcher needs are matched to vehicles that can carry a stretcher, and the driver app captures a signature on screen at drop-off and saves it to the trip.
Frequently asked questions
- Is bed-to-bed the same as hand-to-hand service?
- No. Hand-to-hand is about who receives the rider: the driver passes the rider to a caregiver at each end. Bed-to-bed is about where the trip starts and stops for a patient who travels lying down: at a bed or treatment chair, not at the door or curb. A bed-to-bed trip still needs a named person to take over at the destination.
- Does the stretcher crew put the patient on the exam table?
- Not in New York, where the state's Medicaid transportation manual excuses vendors from going into an exam room to move an enrollee on or off the table, and from leaving their stretcher behind for the practitioner to treat the patient on. Ask the clinic before the trip who will make that move.
- Can the patient stay on the stretcher during treatment?
- Georgia says no. Its NEMT manual bars stretcher providers from letting the treating provider or facility treat members on the company's stretcher. Plan for the receiving bed, chair, or table to be ready when the crew arrives, so the transfer happens at once.
