What is curb-to-curb service in NEMT?
Curb-to-curb is the most basic NEMT assistance level. The driver meets the rider at the curb or driveway in front of the pickup address and lets them out at the destination curb. The rider gets between the building and the vehicle on their own. Depending on the program, the driver may still open doors, help the rider in and out, and store a wheelchair.
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What curb-to-curb means
Curb-to-curb service starts and ends at the vehicle. The federal United We Ride definition describes it as pickup and drop-off at the curb or driveway in front of the rider’s home or destination. The rider walks, or rolls, between the building and the vehicle without the driver’s help.
Virginia’s Medicaid handbook marks the higher levels, door-to-door and hand-to-hand, as requiring medical necessity. Curb-to-curb carries no such condition.
What the driver does and does not do
The exact duties depend on the payer. NEMTAC’s Levels of Service Standard (October 2024) splits the level in two:
- Curb-to-curb. No assistance at pickup or drop-off. The rider gets in and out without the driver leaving their seat.
- Curb-to-curb with assistance. Minimal help at the curb, such as securing a wheelchair or storing a walker or crutches.
Virginia’s provider manual reads more like the second version. Its curb-to-curb driver opens and closes the vehicle doors, helps the rider in and out, and folds, stores, or secures the wheelchair. The service does not include lifting any member. Drivers stay in or near the vehicle, do not enter buildings, and do not wait with riders at appointments. Virginia’s member handbook adds one more duty: the driver watches the rider enter the facility or home.
CareOregon’s manual tells drivers to park at the curb closest to the pickup location. If the rider is not there, the driver calls the member or the brokerage for instructions.
Curb-to-curb vs other assistance levels
| Level | Driver help starts and ends | Driver goes inside | Handoff to a person |
|---|---|---|---|
| Curb-to-curb | At the vehicle, at the curb | No | No |
| Door-to-door | At the outer door of each building | Usually not | No |
| Door-through-door | Inside the pickup and drop-off buildings | Yes | No |
| Hand-to-hand | With a responsible person at each end | Varies by program | Yes |
Who curb-to-curb fits
It fits riders who can get to the curb safely on their own and who can be left at the destination entrance. That includes many ambulatory riders. It also includes many wheelchair riders who roll to the curb, where the driver runs the lift and secures the chair.
It does not fit riders who get lost, fall easily, or cannot manage steps or doors alone. Those riders need a higher level on the trip record, and the payer has to approve it. Watch return trips too. DOT guidance for ADA paratransit notes that a dialysis patient who waits at the curb on the way in may need help to the door on the way home.
How curb-to-curb is billed
Curb-to-curb has no billing code of its own. The trip bills under its mode, such as A0120 for an ambulatory ride or A0130 for a wheelchair van. Usually the assistance level changes your time at each stop, not the claim line. Minnesota is one exception: it pays assisted transport as a separate mode from unassisted transport.
A curb-to-curb rider has to be outside when the van arrives. HealthRide can send riders a link to track the vehicle live, so they know when to head out. See the live map.
Frequently asked questions
- Does the driver get out of the vehicle on a curb-to-curb trip?
- It depends on the program. NEMTAC's standard describes curb-to-curb as a rider who gets in and out without the driver leaving their seat, and lists a separate curb-to-curb with assistance level. Virginia Medicaid requires the driver to open the vehicle door and help the rider in and out, even at the curb.
- What if the rider is not at the curb?
- Follow the broker's contact steps before you mark a no-show. CareOregon's manual tells drivers to call the member or the brokerage for instructions when the member is not at the curb. Do not go into the building unless the trip allows door-to-door help.
- Is ADA paratransit curb-to-curb?
- Not by default. Under 49 CFR 37.129, ADA complementary paratransit is origin-to-destination service. DOT guidance says a rider's request for a driver to open an exterior building door should generally be granted, unless it poses a direct threat or leaves the vehicle unattended for a long time.
