What is stretcher transportation in NEMT?
Stretcher transportation is a NEMT service for riders who must lie flat or reclined but are medically stable and need no monitoring on the way. The rider travels on a wheeled stretcher locked into a stretcher van, usually with a driver and a second crew member. It is billed with HCPCS T2005 for the trip, and some states, such as Colorado, use T2049 for mileage.
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What stretcher transportation means
Stretcher transportation carries a rider lying down, usually on a wheeled cot, on their back or stomach, or reclined with the head raised. Minnesota’s statute defines stretcher transport as transport for a client in a prone or supine position, in a vehicle that can carry them that way. Colorado adds that the rider must not need medical attention en route.
It sits between the wheelchair van and the ambulance on the level of service ladder. The vehicle is a stretcher van, also called a litter van or gurney van. The terms mean the same service. Our stretcher vs gurney guide explains the equipment side.
Who qualifies
California’s 22 CCR 51323 covers litter van service when the rider:
- must lie prone or supine because they cannot sit for the length of the trip,
- needs safety equipment beyond what a car or taxi has, and
- is stable and does not need the staff, equipment, or constant observation of an ambulance.
Medi-Cal’s manual lists examples: riders in a spica cast, bed-bound riders, stable post-operative riders who cannot sit upright for the trip, and chronic oxygen users who need no monitoring. Colorado requires a written statement from the member’s medical professional that the member must lie down and cannot use a less costly mode.
Virginia’s May 2026 rules list who cannot ride a stretcher van. That includes riders with IV therapy or pumps, mechanical monitoring, suctioning, an injury not yet seen by a physician, or a known acute infection.
Staffing and equipment
Stretcher vans usually run with two people. California requires a certified driver and an attendant. Virginia requires at least two crew members, with the second seated in the patient compartment and watching for changes in the rider’s condition.
Virginia publishes a detailed list:
| Rule | Virginia requirement |
|---|---|
| Crew | Driver plus assistant, both trained in first aid, bloodborne pathogens, and stretcher loading |
| Riders per trip | One stretcher passenger at a time, never left unattended |
| Stretcher | Wheeled cot at least 22 inches wide, with a mattress at least 3 inches thick |
| Restraints | Chest, hip, and knee straps, plus over-the-shoulder torso restraints |
| Cot fastener | Crash-stable mount that passes a 2,200-pound pull test under AMD Standard 004 |
| Loading | Rider loaded headfirst |
| Markings | No ambulance markings, emergency lights, or Star of Life unless the provider is a licensed EMS agency |
| Extra equipment | Provider supplies a scoop, Reeves, or stair chair stretcher if the rider needs one |
California’s litter van rule adds a loading door and a second exit that both fit a standard gurney, and fasteners strong enough to hold the gurney if the vehicle overturns.
How stretcher trips are billed
The HCPCS base code is T2005, “Non-emergency transportation; stretcher van.” Colorado pairs it with T2049, the stretcher van mileage code. Medi-Cal’s rate table (page updated September 2023) lists T2005 at a $26.29 maximum, bills litter van mileage under A0380, and requires a treatment authorization request. Its manual counts a crew of two as part of the base rate, not a separate charge. Some fee schedules pay an extra attendant separately under T2001, which that Medi-Cal table lists at $5.52. Check whether your contract counts the second crew member as part of the stretcher rate.
| Stretcher van | BLS ambulance | |
|---|---|---|
| Rider | Stable, lying down, no monitoring | Needs care or monitoring en route |
| Crew | Driver plus trained assistant | Licensed EMS crew |
| Oxygen | Self-administered only, where allowed | Crew administers |
| Base code | T2005 | Ambulance codes |
HealthRide checks stretcher requirements against each vehicle’s saved capabilities on every assignment. See stretcher transportation software for the full workflow.
Frequently asked questions
- How is a stretcher van different from an ambulance?
- A stretcher van carries stable riders who only need to lie down. An ambulance carries riders who need medical care or monitoring on the way. Virginia bars stretcher vans from carrying riders who need life support, close observation, IV lines, or a saline lock. Those trips go by ambulance.
- Are stretcher, gurney, and litter the same thing in NEMT?
- For billing, yes. California's rules call the vehicle a litter van and the equipment a gurney, Colorado's manual allows a stretcher, board, or gurney, and HCPCS code T2005 says stretcher van. All describe a rider transported lying down. Our stretcher vs gurney guide covers the equipment differences.
- Can a stretcher van carry a rider on oxygen?
- Often, if the rider manages it. Virginia allows self-administered oxygen in a stretcher van when the tank is secured to an industry retention standard. Medi-Cal lists chronic oxygen users who need no monitoring among riders who qualify for litter van transport.
