What is a no-show in NEMT?
A NEMT no-show is a scheduled ride the rider misses without cancelling. It only counts once the driver has reached the pickup on time and sat out the broker's required wait: 10 minutes past the scheduled time in MTM's general handbook, and 15 minutes for CareOregon and SafeRide. The driver reports it before leaving, and Medicaid generally pays nothing for the trip.
On this page
When a trip becomes a no-show
A trip is a no-show only when four things are true. The driver reached the right address inside the pickup window. The driver waited the full time the broker requires. The driver tried to reach the rider. The driver reported it before leaving. Skip any of them and the broker may treat it as your miss instead.
The required wait differs by broker:
| Source | Wait before calling a no-show | Reporting rule |
|---|---|---|
| MTM general Transportation Provider Handbook (August 2022) | 10 minutes after the scheduled pickup time | Report in real time through MTM Link or by phone before leaving |
| MTM Rhode Island handbook (updated July 1, 2026) | 10 minutes after the scheduled pickup time | Tell the member by call or text that you are outside or leaving |
| MTM Virginia fee-for-service handbook (2026) | Until the pickup window closes, 15 minutes after the scheduled time | Follow MTM’s no-show steps and try to reach the member by phone or text first |
| CareOregon provider manual (February 2024) | At least 15 minutes after the scheduled pickup time | Notify dispatch before departing, and notify the brokerage of every no-show |
| SafeRide Health | 15 minutes for most NEMT vehicles, 5 for rideshare | Call SafeRide to report it |
| ADA paratransit, FTA Circular C 4710.1 (2015) | Many agencies use at least 5 minutes, counted from the start of the window | Per agency policy |
The same broker can set different waits in different states, so read the handbook for each contract you hold.
Member no-shows and provider no-shows
Brokers track two kinds. A member no-show is the rider missing the ride. A provider no-show is the vehicle never arriving, and that one counts against you. CareOregon’s manual says providers will not be held accountable for member no-shows, but repeated provider no-shows can lead to corrective action. MTM’s 2026 Virginia handbook sets its standard for vendor no-shows, meaning failure or refusal to complete assigned trips, at under 0.25 percent.
Indiana publishes both. In May 2026, Verida, its fee-for-service broker, reported 234 member no-show legs (0.7 percent of scheduled rides) and 66 provider no-show legs (0.2 percent).
What a no-show costs
Medicaid does not pay for the trip. CMS says a provider cannot bill Medicaid for a no-show, and MTM states it does not reimburse transportation providers for no-shows. The drive to the pickup becomes deadhead, and the wait becomes idle time. That is why operators call it a dry run.
No-shows also matter to the state. Minnesota’s statute requires its NEMT administrative agency to report no-shows and cancelled trips to the commissioner every month.
Cutting no-shows
- Confirm every ride the day before. MTM’s handbook makes that a provider duty, 24 hours ahead.
- Call the rider on arrival, then wait the full time your broker requires.
- Keep member no-shows and late cancellations as separate statuses, each with a reason, so patterns show up by rider and by facility.
- Flag repeat riders to the broker, who can modify their service.
- For private-pay riders, put your no-show terms in a written policy.
Our guide to reducing NEMT no-shows goes further on prevention.
Tracking no-shows in HealthRide
HealthRide can text riders a reminder 24 hours and 15 minutes before pickup. When a rider still does not come out, the leg is marked No show, separate from Cancelled, and HealthRide keeps the recorded wait time on the trip.
Frequently asked questions
- Does the no-show clock start when the driver arrives early?
- No. MTM's handbook says the rider does not have to board before the scheduled pickup time, and CareOregon says the 15-minute wait takes place during the rider's expected pickup window. FTA's ADA paratransit guidance likewise starts its 5-minute wait at the beginning of the window. Arriving early buys you nothing on the no-show clock.
- What happens to the return trip after a no-show?
- Usually the ride home is no longer needed. When a driver marks a participant no-show in MTM's driver app, the trip comes off the driver's assignment and MTM dispatch is notified. Confirm with your broker whether the return leg is cancelled too, and cancel it on your own schedule so no driver goes back for a rider who never left home.
- Can a rider lose NEMT service for repeated no-shows?
- Their service can be changed. CareOregon's manual says brokerages may modify a member's service after recurring no-shows or late cancellations, for example by requiring the rider to confirm on the day of service. In ADA paratransit, the FTA allows suspensions only for a pattern of no-shows within the rider's control.
- How common are member no-shows?
- It varies by program. Indiana publishes monthly figures. In May 2026 its fee-for-service broker reported 234 member no-show legs, 0.7 percent of scheduled rides, compared with 7.6 percent for member cancellations.
