Wait-and-return trips: when the driver stays for the appointment
A wait-and-return trip is a round trip where the same driver stays at the medical office through the appointment and then drives the rider home, instead of leaving and coming back. CMS lets states pay for the wait separately only when distance and travel time make staying cheaper than a second trip. Where waiting is billable, it goes on the claim as HCPCS T2007, counted in 30-minute units.
On this page
How a wait-and-return trip runs
The trip is booked as a round trip with waiting written into it. The driver drops the rider at the appointment, parks, and stays until the visit ends. The same vehicle and driver then run the return leg. Nobody has to call for the ride home, and the rider never waits for a van to cross town.
In CareOregon’s network, for example, the provider manual requires drivers to wait on any trip where wait time is marked as needed, and it names pharmacy stops and substance use treatment visits as trips that typically include it. On those, the wait is capped at 15 minutes unless the brokerage approves more.
What CMS allows states to pay
Federal guidance treats paid waiting as the exception. In its September 2023 coverage guide to states (SMD 23-006), CMS explains that a long wait normally cannot be paid as a service of its own. Its reasoning is cost: sending a second driver for the return may be cheaper than paying one driver to sit. It gives dialysis and outpatient surgery as examples of visits that take hours.
States have two ways to cover the cost anyway:
- Build it into the rate. A state can account for waiting in its trip payment method, the same way it can for unloaded miles.
- Pay it separately. A state may cover wait time as a travel expense only when travel distance and time make it more economical for the provider to stay at the medical office. That option needs a state plan amendment with coverage and payment pages.
How programs bill the wait
Where waiting is paid, it bills under T2007, a code the Medi-Cal manual lists for non-emergency vehicle and air ambulance waiting, counted in half-hour units. See the T2007 entry for the code itself.
| Program | When the wait pays | Limits and records |
|---|---|---|
| Medi-Cal (wheelchair and litter vans) | Time spent waiting to load the patient | First 15 minutes unpaid, then up to 90 minutes (three units); wait start and end clock times on the claim (Box 19) or attached |
| Arizona AHCCCS fee-for-service | The driver stayed on site because a run back to base, or to where the trip began, made no practical sense | Not paid under 30 minutes, for trips of 10 miles or less, on one-way trips, when the odometer changes, or when two vehicles or drivers run the round trip; one member’s wait on a shared ride |
| Programs that do not pay waiting separately | Never as its own line; CMS lets states count waiting costs when setting trip rates | Nothing extra to bill |
When it beats a will-call
A will-call sends the driver away after drop-off and brings a van back when the rider is ready. Compare the two before you book:
- Long rural trips. When the drive back to base and out again costs more than the wait, staying wins. That is the test CMS and Arizona both use for paid waiting, and Arizona does not pay waits on appointments 10 miles away or less.
- Short, predictable stops. A pharmacy pickup or a brief clinic visit ends before a returning van could be routed back, so waiting costs little.
- Long visits close to base. A multi-hour dialysis session near your yard is a poor fit. The van can run other trips during the session and come back for the return. The will-call guide covers how to staff them.
Unpaid waiting has the same hidden cost as deadhead miles: a vehicle and a paid driver producing no revenue. Price it before you agree to it, and read the wait time entry for how pickup and return waits work.
Running it in HealthRide
In HealthRide, both legs of a round trip sit on the dispatch board, so you can give the return to the same driver who ran the drop-off. Returns with no set time go on as flexible return trips. They hold their place on the board, then activate the moment the passenger is ready.
Frequently asked questions
- Does a wait-and-return work like a will-call?
- No. On a will-call, the driver leaves after the drop-off and a vehicle comes back when the rider or clinic calls. On a wait-and-return, the driver and van stay on site the whole time. The will-call frees the van for other work. The wait-and-return gets the rider home quickly but takes a vehicle and driver out of service for the length of the visit.
- Will I get paid for the time my driver waits?
- Only where the program pays waiting time and the trip meets its conditions. Medi-Cal pays T2007 for wheelchair and litter vans after the first 15 minutes, up to three units, and wants the clock times the wait began and ended. Arizona's fee-for-service program pays T2007 only for a real wait at the medical office on a trip too far for the driver to head back to base. In programs that do not pay it separately, waiting is not its own line, although CMS lets states account for it when they set trip rates.
- Can my driver run a short errand during the wait?
- Not if you plan to bill the wait in Arizona. Its fee-for-service manual refuses wait time if the odometer shows the van moved while the member was inside, and if the outbound and return legs used a different van or driver. Medi-Cal pays only for time spent waiting to load the patient. Keep the van parked and the odometer unchanged.
- Who decides that a trip is a wait-and-return?
- The broker or payer, when it books the ride. CareOregon's brokerages mark the trips that need wait time, and providers must wait on those. Where waiting is paid, the provider also has to justify it. Medi-Cal wants the reason plus the start and end clock times on the claim or an attachment, and Arizona checks the odometer and the vehicle and driver on both legs. A driver who stays without being asked should not count on pay for the wait.
