NEMT cost per mile calculator: fuel, upkeep, and fixed costs per mile

How to use the cost per mile calculator

Work with one vehicle and one ordinary month. The fields open with sample figures, not averages. Replace them with your own, and the answer updates as you type.

1. Enter the miles driven per month and the share of those miles driven empty.
2. Enter the fuel price per gallon and the miles per gallon this vehicle actually gets.
3. Enter maintenance and repairs and tires, both as a cost per mile.
4. Enter the monthly insurance, vehicle payment, and other fixed costs for that vehicle.
5. The total cost per mile leads the results. The cost of each loaded mile sits in the last section.

If your fleet mixes minivans, full-size wheelchair vans, and stretcher vans, run the calculator once per type. Fuel use, insurance, and repair bills differ enough between them to change the answer. Our guide to running a mixed NEMT fleet covers the other differences.

Where each number comes from

Fuel prices can swing quickly. Regular gasoline cost $4.478 a gallon on average nationwide in the EIA’s September 21, 2026 survey, $1.305 above the same week a year before. Regions differ widely: the West Coast stood at $5.600 that week and the Gulf Coast at $3.972. Fuel is also why the IRS business rate jumped midyear, from 72.5 cents in the first six months of 2026 to 76 cents from July 1.

Work out fuel economy from your own receipts, not a brochure. EPA fuel economy testing exempts cargo vans over 8,500 pounds gross vehicle weight rating and passenger vans with a rating of 10,000 pounds and up. A heavy conversion may have no official figure. Your receipts also capture the time spent idling outside clinics. The Department of Energy puts idling at 0.25 to 0.5 gallons for every hour, with bigger engines and heavy air conditioning at the high end.

How to read the result

The big figure at the top is the total cost per mile: every vehicle cost you entered, divided by every mile driven. The two figures under it split that total in two.

• Variable cost per mile is fuel, maintenance, and tires. It stays the same per mile whether the van drives 1,000 miles or 5,000.
• Fixed cost per mile is insurance, the vehicle payment, and other monthly costs, spread over the month’s miles. It shrinks as the miles grow.

The breakdown shows what each line adds to a single mile. The last section turns the total into a cost per loaded mile by dividing it by the share of miles with a rider aboard. That is the figure to hold against a payer’s rates, because many Medicaid programs pay mileage only for loaded miles. Arizona’s Medicaid agency, AHCCCS, defines loaded mileage as distance traveled with the member on board and bars claims for unloaded mileage. Illinois lists mileage other than loaded miles among the charges it will not pay.

Worked example

These inputs come preloaded as an example, not a benchmark. One wheelchair van covers 3,000 miles in a month, and 30% of those miles are empty. Fuel costs $4.00 a gallon at 16 miles per gallon. Maintenance runs $0.10 a mile and tires $0.02. Insurance is $650 a month, the van payment $750, and other fixed costs $100.

• Fuel: $4.00 divided by 16 is $0.25 a mile.
• Variable cost: $0.25 plus $0.10 plus $0.02 is $0.37 a mile, or $1,110 for the month.
• Fixed cost: $650 plus $750 plus $100 is $1,500 a month. Over 3,000 miles, that is $0.50 a mile.
• Total: $0.87 a mile, or $2,610 for the month.
• Loaded miles: 2,100. Cost per loaded mile: $0.87 divided by 0.70, about $1.24.

Now change one number. At 3,600 miles a month with the same costs, the fixed share drops to about $0.42 a mile and the total to about $0.79. Each loaded mile then costs about $1.12.

Checking the number against what a trip pays

Compare your cost per loaded mile with the whole payment for a trip, not only the mileage rate. Many fee schedules, Arizona’s among them, combine a fixed amount for each trip with a payment for every loaded mile, so a short trip earns more per mile than a long one.

Take the AHCCCS fee-for-service schedule that starts October 1, 2026. Urban wheelchair van trips, those beginning in the Phoenix or Tucson metropolitan areas, earn $11.15 under A0130, and S0209 adds $1.54 for every loaded mile. Trips from anywhere else in the state count as rural, carry the TN modifier, and pay $12.21 and $1.66.

In the 10-mile example, about $14 is left after the van for the driver, the office, and profit. The 30-mile example leaves about $20, spread over a trip three times as long. Broker rates come from your own provider agreement, so run the same check with those numbers. The guides on Medicaid NEMT rates and mileage billing explain how programs pay for miles.

Ways to bring the number down

• Cut empty miles first. They add cost without adding a single paid mile, so they push up cost per loaded mile faster than anything else. The deadhead cost calculator shows what they cost you each month.
• Turn the engine off while waiting outside a clinic when weather and the rider’s comfort allow. Idle time burns fuel and adds no miles.
• Check tire pressure weekly. The Department of Energy estimates mileage falls about 0.2% for every pound per square inch the tires average below the correct pressure.
• Coach smooth driving. By the same agency’s estimate, speeding and hard starts and stops can lower mileage anywhere from 10% to 40% in stop-and-go driving.
• Keep vehicles busy. A van parked most of the week still carries its full insurance and payment. The fleet size calculator checks whether your trips justify every van you insure.
• Watch repairs per mile each year. When the figure keeps climbing, compare it with a newer vehicle’s payment. Our guide on when to replace a NEMT vehicle walks through that decision.

For more on fuel and upkeep, see the guides to reducing NEMT fuel costs and NEMT vehicle maintenance.

Real miles instead of estimates

The answer depends on accurate miles. HealthRide’s driver app saves the GPS miles and the route driven on every trip, and the trip log lists those miles by leg, vehicle, and driver. Odometer readings at checkout and check-in sit alongside the GPS miles in fleet management, so both the monthly miles and the loaded miles come from records.