What is stretcher transportation in NEMT?
Overview
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.
On this page
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. A gurney and a stretcher are the same thing in everyday NEMT talk, and every gurney is a stretcher even though not every stretcher has wheels. Regulators and payers use their own words:
| Where you see it | Term used |
|---|---|
| Federal Medicaid brokerage rule, 42 CFR 440.170 | “Stretcher cars” |
| HCPCS code T2005 | “Stretcher van” |
| Federal ambulance equipment specification cited by Virginia | “Elevating wheeled cot” |
| Everyday operator speech | Stretcher, gurney, or cot |
When a broker sends a stretcher trip, it means a service level, not a piece of equipment: the rider travels lying down or reclined in a vehicle built to carry a stretcher, with a trained crew. The stretcher van equipment guide covers 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. The diagnosis codes that go with these riders are in ICD-10 codes for wheelchair-bound and bed-bound riders.
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, both trained in first aid, bloodborne pathogens and stretcher loading, with the second seated in the patient compartment and watching for changes in the rider’s condition, and it allows one stretcher passenger at a time, never left unattended. 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. The stretcher van equipment guide lists the cot, mattress, strap and mount standards, and stretcher training for NEMT crews covers the training.
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.
A stretcher van carries a stable rider who needs no care on the way, and an ambulance carries one who needs care or monitoring en route, which is why the base codes differ. NEMT vs ambulance draws the line.
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.
- 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.
