Master services agreement (MSA): the umbrella contract a health system signs with a ride company

What a master services agreement is

A master services agreement is one contract that sets the terms for every service a buyer orders from you, so a new service line needs a schedule and not a new negotiation. Ride contracts already work this way, as a facility transportation agreement does with its rate schedule. Four public examples:

• MTM, Pennsylvania HealthChoices (January 1, 2023). The agreement carries the standing terms. Appendix A is the business associate agreement, Appendix B the credentials, and Appendix C a program requirements addendum. Schedule A is the rate sheet and Schedule B the performance standards.
• WellTrans, Indiana (revised October 16, 2025). Four exhibits follow the agreement: liquidated damages, rates with invoicing and payment terms, a subcontractor business associate agreement, and a fraud, waste, and abuse policy.
• Hamilton County Job and Family Services, Ohio (contract sample for June 1, 2026 to May 31, 2028). A purchase contract plus six exhibits: the request for proposals, the provider’s proposal, the budget, a procedure memo, invoice file requirements, and unallowable costs.
• MART, Massachusetts (template effective July 1, 2024). The agreement lists attachments A through R. Performance standards are Attachment G, and rates and routes are Attachment R. MART revised Attachment G on July 1, 2025 and sent it as an amendment package, with a reminder to contact MART about any concern before returning it signed.

A health system’s paperwork points the same way. Mass General Brigham writes its 2026 insurance obligations as a section of its supplier agreement, with some coverages applying only if the supplier provides a given service.

The closest federal tool is the basic ordering agreement in FAR 16.703: terms and clauses for future orders, a description of the services, and methods for pricing, issuing, and delivering orders. The FAR notes that it is not itself a contract, which an MSA is.

Which terms go in the agreement and which in a schedule?

Terms that apply to every service tend to sit in the body, and terms that change with the service sit in a schedule, but the line moves from one agreement to the next. MTM’s compensation clause says it pays at the rates in Schedule A, while the body fixes the rest: uncontested invoices are paid within 30 days after online submission, and a claim filed more than 90 days after service, or after whatever other period MTM’s client sets, is not eligible. WellTrans puts rates, invoicing, and payment terms together in Exhibit B. Hamilton County keeps its budget in Exhibit III, while the body sets the term and a maximum contract amount.

Before you sign, list each term and write down where it lives. A rate change should be a schedule change, and a change to indemnity or insurance should need a signed amendment.

How an MSA differs from a rate sheet, a purchase order, and a BAA

Each of the four documents does a different job:

• Rate sheet. Prices only. It is a schedule under the MSA, as Schedule A is in MTM’s agreement.
• Statement of work. The description of one service line under the MSA, usually what you will do, where, when, and to what standard. Some buyers put the price in it and others in a rate schedule.
• Purchase order. A numbered order for specific rides or a period of rides, placed under the agreement. The purchase order entry covers why some buyers will not pay without one.
• Business associate agreement. A separate contract that HIPAA requires when you create, receive, keep, or send patient information for a covered entity, usually attached as an exhibit. The rule in 45 CFR 164.504(e) and a fill-in form are in the BAA template.

Clauses to read twice before you sign

Five clauses decide how much risk and money an MSA holds:

1. Amendment. MTM’s agreement lets MTM amend it without your consent to keep up with a law or program requirement, and otherwise on written notice, compensation rates included. The amendment is deemed accepted unless you reject it in writing within 30 days.
2. Order of precedence. Hamilton County’s contract says the contract controls over its exhibits, then ranks the exhibits: the request for proposals first, the provider’s proposal and budget below it. A promise in your proposal can lose to the county’s own request.
3. Volume. MTM’s agreement promises no minimum number of trips, and WellTrans’s commits it to no set number of requests. An MSA gives you the terms for work, not the work.
4. Term and exit. MTM’s runs three years and renews only by mutual written agreement, and either party may end it on 30 days’ written notice. Hamilton County’s runs two years with two two-year renewals at the county’s option, and the county can decline to renew by giving 120 days’ notice before the first term ends. The termination for convenience entry explains the 30-day exit.
5. Insurance and indemnity. Mass General Brigham sets limits by service: $1 million per accident for a supplier that operates vehicles, and $20 million per accident for one that transports people. It also says the insurance obligations do not reduce the supplier’s indemnity obligations, and that coverage stays in force until the statute of limitations or repose expires. Compare each limit with your policy, and read hold harmless clauses and becoming a hospital vendor for the rest.

Facility rates in HealthRide

HealthRide prices each facility’s completed trips from that facility’s rates and sets invoice due dates from its payment terms, so the rates and terms in a facility agreement are entered once and applied to every invoice. See invoicing.