Non-ambulatory transportation: what it means and which ride level a rider needs

What non-ambulatory means in NEMT

A non-ambulatory rider cannot walk between the door and the vehicle on their own, so the ride needs a wheelchair van with a lift or ramp, or a stretcher van. It is the opposite of ambulatory transportation, and it is a word from statutes and manuals, not a billing code. Claims still go out under each mode’s base code: A0130 when the rider rides seated in a wheelchair van, T2005 when they lie on a stretcher.

Georgia’s NEMT manual (version October 1, 2026) gives a clean test. If a member cannot get from their door to the vehicle on foot, even with someone helping, the broker sends a wheelchair or stretcher ride. A member who lives in a wheelchair or a bed day to day gets a vehicle that fits that confinement.

Federal guidance points the same way. CMS’s Medicaid transportation guide (SMD 23-006, September 28, 2023) tells states to pick the cheapest mode that still fits the beneficiary’s physical and emotional condition. In the same guide, CMS says a beneficiary who uses a wheelchair gets a wheelchair-accessible vehicle. The least costly mode entry covers that rule. Where the term sits among the other levels is on the level of service page.

How state rules use the word

The same word points to different vehicles depending on who wrote the rule. Four dated examples:

• Connecticut. Section 19a-175 of the state’s EMS statute (revised to January 1, 2026) defines an invalid coach as a vehicle used only for nonambulatory patients who do not need a stretcher, on nonemergency trips between home and a medical facility. Here the word means the wheelchair rider.
• Kentucky. KRS 281.873 (effective June 24, 2015) creates Certificate Type 08, a specialty carrier using ADA ramp or lift vehicles to carry nonemergency, nonambulatory persons. The rider’s level comes from a written recommendation by a physician, physician assistant, advanced practice registered nurse, or qualified mental health professional. On request, the broker must provide specialty transport for up to 30 days without that recommendation, and it may not change the level.
• Georgia. Section 709.3 of the manual reserves stretcher service for non-ambulatory members who take two people to move, lying back, between the vehicle and the provider. Before the third scheduled stretcher ride, the broker has to hold a medical necessity certification or a letter of medical necessity.
• Indiana. The state’s Transportation Services module (version 6.1, August 19, 2025) calls the wheelchair van level nonambulatory service and pays it when a member must travel in a wheelchair. Companies enroll for it as specialty 265, common carrier (nonambulatory).

New York’s Medicaid transportation policy manual, in force since August 25, 2023, and Virginia’s fee-for-service vehicle rules (updated May 26, 2026) take the term one step further. Their stretcher rider is non-ambulatory, cannot use a wheelchair either, and needs no medical monitoring during the ride.

Wheelchair or stretcher: the question that splits it

Once a rider cannot walk to the vehicle, the next question is whether they can sit up in a wheelchair for the whole trip. If they can, the trip is a wheelchair van ride. If they must travel lying down but are stable, it is a stretcher ride. Minnesota’s statute defines its stretcher mode as transport in a prone or supine position, for example. If the rider needs care or monitoring on the way, the trip belongs to an ambulance.

Medi-Cal adds a second reason for the wheelchair van: a rider who cannot transfer unassisted from home into a car or other ordinary transportation because of a physical or mental limitation. The wheelchair transportation entry lists the rest of California’s test, and sitting tolerance explains how long a rider must be able to sit.

Questions that set the level at booking

Minnesota pays by the rider’s assessed mode and Indiana by the level of service delivered, not by the vehicle sent, so settle the level before a van is assigned:

1. Can the rider walk from the door to the vehicle, with or without help? If not, the trip is non-ambulatory.
2. Do they ride in their own wheelchair, and can they stay upright in it for the ride and any wait? If not, ask about a stretcher.
3. Are there steps at either end with no ramp or elevator? Stairs can call for a second crew member, covered under two-person assist.
4. Do they need anyone to watch or treat them on the way? New York and Virginia keep riders who need monitoring off stretcher vans, so that ride goes by ambulance.
5. Does the paperwork match? A trip authorized at one level and run at another can be paid at the lower rate, as level of service downgrades explains.

HealthRide keeps the wheelchair or stretcher need on each trip so it is matched to a van equipped for it, and the dispatch board warns you if a wheelchair rider is about to land on a van that has no lift.