What is a dry run in NEMT?
A dry run is a NEMT trip where the vehicle drives to the pickup and leaves without a rider, because the rider is not there, cancels at the door, or the address is wrong. Medicaid generally does not pay for it, since nobody was transported. The miles and driver time are a loss unless a private-pay agreement includes a dry-run fee.
On this page
What counts as a dry run
A dry run is any dispatched trip where the vehicle gets to the pickup and no one is transported. The drive happened, the driver’s time is spent, and there is nothing to bill. Common causes:
- The rider is a no-show.
- The rider cancels at the door or refuses the ride.
- The rider is too sick to travel when the driver arrives.
- The address is wrong or the driver cannot get into the building.
- The appointment was cancelled and nobody told dispatch.
Brokers record these under narrower status codes. Indiana’s monthly NEMT report, for example, splits trips not provided into categories that include member no-show, member cancelled, member too sick, member hospitalized, and provider no-show, all counted by leg. “Dry run” is the operator’s word for what all of them cost: a trip’s worth of driving with no revenue.
Dry run vs related terms
| Term | Vehicle drove to pickup | Rider transported | Billable to Medicaid |
|---|---|---|---|
| Completed trip | Yes | Yes | Yes |
| Dry run | Yes | No | Generally no |
| No-show | Yes | No | Generally no |
| Late cancellation | Sometimes | No | Generally no |
| Deadhead mile | Yes, empty | No | No |
Who pays for a dry run
In Medicaid work, usually nobody does. The rules line up across federal guidance, brokers, and states:
- CMS. If a beneficiary fails to show for a transportation appointment, the provider cannot bill Medicaid for the no-show.
- MTM. Its Missouri provider page states that MTM does not reimburse transportation providers for no-shows.
- Colorado. The NEMT billing manual lists cancellations, and response calls where no transportation is needed or provided, among services it does not cover.
- Virginia. The June 2026 member handbook tells riders that if they do not cancel early enough, the provider will not be paid for the trip.
Private-pay and facility work is where a dry-run fee can live, because you set those terms. Put it in writing before the first ride. Start from our no-show policy template, and see the private-pay guide for pricing.
Keeping a dry run from costing twice
The first cost is the wasted drive. The second is a complaint or a penalty if the broker thinks the dry run was your fault. Protect yourself on every one:
- Arrive inside the pickup window.
- Wait the full time your broker requires. MTM’s general handbook (August 2022) sets 10 minutes after the scheduled pickup, and CareOregon’s manual sets at least 15.
- Call the rider, then call dispatch, before you leave.
- Record the arrival time, the wait, and the reason.
- Report it the way the contract says. MTM wants no-shows reported in real time, before the driver leaves.
Confirming every ride the day before gives riders a chance to cancel before the van rolls. MTM’s handbook makes that confirmation call, 24 hours ahead, the provider’s job. Our guide on reducing NEMT no-shows has more ways to prevent them.
Proof on the record
HealthRide keeps recorded wait times on no-shows, so the time your driver spent at the door stays on the trip if a broker asks.
Frequently asked questions
- Is a dry run the same as a no-show?
- Not exactly. A no-show is one cause of a dry run, where the rider is not at the pickup. A dry run is the wider result, the wasted drive, whatever the reason. A rider who cancels at the door, a wrong address, or a clinic that closed without telling anyone all produce a dry run without being a no-show.
- Can I bill Medicaid for a dry run?
- Generally no. CMS says a provider cannot bill Medicaid when a beneficiary fails to show, and that claiming loaded mileage for a no-show is billing for services not rendered. MTM's Missouri provider page answers the no-show and cancel-at-the-door question the same way, saying MTM does not reimburse providers for no-shows. Colorado lists cancellations among services it does not cover.
- How do I charge private-pay riders for dry runs?
- Write the fee into your service agreement or no-show policy and have the rider or facility accept it before the first ride. State the amount, what counts as a dry run, and how much notice avoids the fee. A fee nobody agreed to in advance is hard to collect.
