Do Medicaid programs and brokers pay providers for no-shows?

Generally not. Illinois lists no-show trips, where the patient was not transported, among the services it will not pay for. New York's Medicaid transportation policy denies payment when the transportation was not actually provided. MTM tells its Missouri providers that it pays nothing for no-shows. Your own private-pay and facility contracts can say otherwise.

What is the required wait at a no-show pickup?

The payer sets it, and it differs by program and by pickup type. New York's Medicaid transportation rules set a 15-minute minimum wait after the scheduled pickup time and require every no-show to be documented. Some brokers wait longer at facilities than at homes. Your broker's manual has the exact rule, and the driver should not leave before it is met.

What no-show rate should a NEMT provider expect?

There is no national figure, and rates depend on the riders, the program, and how you count. One public reference: Wisconsin's statewide NEMT manager counted 406,006 scheduled trip legs in May 2026, and riders failed to show for 8,566 of them, about 2.1%. Track your own rate every month, since the trend matters more than any outside number.

How is a late cancellation different from a no-show?

A no-show is a rider who cannot be found at pickup once the required wait has passed. A late cancellation is a ride called off after your notice cutoff, often before the driver gets there. Both usually cost the trip revenue. A no-show also costs the trip out and the wait.

Can I charge riders a no-show fee?

Yes, for rides you sell directly to private-pay riders or facilities, as long as the fee is in your written policy and in the signed agreement before service starts. For Medicaid riders, your state rules and broker contract decide what happens after a no-show. If a payer does pay you something for one, enter it in the calculator's fee field.

NEMT no-show cost calculator: the revenue and driver time lost to no-shows

Updated September 29, 20265 min read

A NEMT no-show costs the trip revenue you never collect, since Medicaid programs and brokers generally pay nothing when no ride takes place, plus the paid driver time spent reaching the pickup and waiting. A late cancellation costs the revenue of a slot you cannot refill. Enter your trips, rates, revenue per trip, and driver time to see the monthly cost and what a reduction saves.

On this page

The numbers filled in are examples, not averages. Replace each one with your own quotes, rates, and costs.

Your scheduleFor a typical month, counting each one-way leg as a trip.

Trips scheduled per month

Before cancellations and no-shows.

No-show rate

The rider is not there when the driver arrives.

Late cancellation rate

Canceled too late to give the time to another rider.

What a missed trip costs

Average revenue per trip

What you are paid per leg, across all your payers.

No-show fee received

What the payer pays when the rider is not there. Often $0 on Medicaid trips.

Driver minutes per no-show

The drive to the pickup plus the wait before the driver can leave.

Driver cost per hour

Hourly pay plus payroll taxes and any benefits.

Your goal

Cut missed trips by

The share of no-shows and late cancellations you want to prevent.

Cost of missed trips

Example numbers

Monthly cost of no-shows and late cancellations

$3,100

60 missed trips, 6% of the schedule.

Yearly cost: $37,200
Yearly savings with a 25% cut: $9,300

Each month

Revenue lost60 trips at $45.00: $2,700
No-show fees received: $0
Driver time on no-shows20 hours at $20.00: $400
Monthly cost: $3,100

Missed trips each month

No-shows: 40
Late cancellations: 20
Monthly savings with a 25% cut: $775

How to use the no-show cost calculator

Use last month’s numbers, or an average of the last three months if your volume swings. The sample figures in each field only show how the math works, so overwrite every one before you trust the answer.

Enter the trips scheduled per month, before anything is canceled.
Enter your no-show rate and late cancellation rate as percentages of scheduled trips.
Enter the average revenue per trip, plus the no-show fee you collect, if any.
Add the driver minutes per no-show, then the driver cost per hour.
Set the share of missed trips you want to prevent, then read the monthly and yearly cost.

Every field counts one-way legs, not round trips. When the rider is not home for the outbound leg and you call off the ride back in time, record one no-show and one timely cancellation, not two no-shows.

What each field asks for

Input	What it means	Where to find it
Trips scheduled per month	Every one-way trip booked, before cancellations and no-shows	Last month’s schedule or trip log
No-show rate	Trips where the rider could not be found once the required wait ran out	No-shows divided by scheduled trips
Late cancellation rate	Trips canceled after your notice deadline, too late to rebook the time	Late cancellations divided by scheduled trips
Average revenue per trip	What a completed one-way trip pays, across payers	Last month’s trip revenue divided by completed trips
No-show fee received	What a payer pays you when the rider is not there	Rate sheets and contracts. Usually $0 on Medicaid trips
Driver minutes per no-show	Travel out to the pickup, plus the wait the payer requires before the driver can go	Trip records, plus the wait rule in your broker manual
Driver cost per hour	The hourly wage with payroll taxes and benefits added	Payroll, or the driver cost calculator
Cut missed trips by	The share of no-shows and late cancellations you aim to prevent	Your goal

Payers set the wait. New York’s Medicaid manual says providers “shall wait at least fifteen (15) minutes after the scheduled pick-up time” before recording a no-show. MediTrans, the Louisiana broker, sets two waits: 15 minutes at a residence and 20 at a facility. Before leaving, its drivers try the member’s phone number on file and then call dispatch.

For hourly employees, those minutes are paid. Federal regulations treat that wait as hours worked, since the driver has been engaged to wait, even when nothing happens. A 15-minute no-show wait is 15 paid minutes, on top of the drive to get there.

For how programs define each one, see the glossary entries for no-show and late cancellation.

How to read the result

The top figure is the monthly cost of no-shows and late cancellations. Under it are the yearly cost and the yearly savings at your target.

The monthly breakdown has three lines:

Revenue lost is every missed trip times your average revenue per trip.
No-show fees received come off that amount, when a payer pays anything.
Driver time on no-shows is the paid time spent driving to each pickup and waiting.

The calculator gives late cancellations no driver time, since the driver has not yet reached the pickup. If yours often happen at the door, count them as no-shows instead. For drivers paid by the hour, the driver line is time you pay for either way. It shows what those hours produced, which was nothing.

Worked example

The calculator starts with the numbers below, which are an example rather than a benchmark. A provider schedules 1,000 trips a month. Four percent end as no-shows and 2% as late cancellations. Each trip averages $45, payers pay no no-show fee, each no-show takes 30 driver minutes, and drivers cost $20 an hour.

No-shows: 40. Late cancellations: 20. Missed trips: 60, or 6% of the schedule.
Revenue lost: 60 trips at $45 is $2,700.
Driver time: 40 no-shows at 30 minutes each is 20 hours, or $400 at $20 an hour.
Monthly cost: $3,100. Yearly cost: $37,200.
Preventing a quarter of the missed trips saves $775 a month, or $9,300 a year.

Now add a fee. If a private-pay contract paid $20 for each of those 40 no-shows, $800 would come back and the monthly cost would drop to $2,300.

One state’s numbers for scale

Wisconsin publishes monthly figures from its statewide NEMT manager, and they show how much of a schedule changes before the ride. For May 2026, the report lists these trip legs:

Measure, May 2026	Trip legs	Share of scheduled
Scheduled	406,006	100%
Canceled	104,602	About 25.8%
Member no-shows	8,566	About 2.1%

The report does not split cancellations by how much notice came with them, so take your late cancellation rate from your own records. The no-show share is a useful reference point. Your rate depends on your riders and payers, so compare with yourself month to month first.

Ways to cut no-shows and late cancellations

Confirm the day before. MTM expects Missouri providers to confirm the trip and pickup time with each rider the day before, and to cancel any ride the rider no longer needs.
Send a reminder close to pickup. A text shortly before the driver arrives catches riders who forgot. The guide to NEMT ride reminder texts covers timing and wording.
Call before the wait runs out. A call from the curb finds riders waiting at the wrong door, and some brokers require that call before a no-show counts.
Keep pickup notes current. Gate codes, the right entrance, and a working phone number save waits.
Put fees in writing for private pay. A clear policy, agreed before the first ride, sets expectations. Adapt the wording in the no-show policy template.
Track by rider and location. Record each no-show against the rider and the pickup address so repeat patterns stand out.

Each step gets more depth in our no-show reduction guide.

Fewer missed trips with reminders

HealthRide sends riders reminder texts before the ride and when the driver is on the way. It also keeps the recorded wait time with each no-show, so you have the record if a payer questions it. Run this calculator for the month before reminders start and again a few months later, and the difference shows what they are worth. Riders and families can also follow their driver live from a text link, while your dispatchers watch every van on the live map.

Frequently asked questions

Do Medicaid programs and brokers pay providers for no-shows?: Generally not. Illinois lists no-show trips, where the patient was not transported, among the services it will not pay for. New York's Medicaid transportation policy denies payment when the transportation was not actually provided. MTM tells its Missouri providers that it pays nothing for no-shows. Your own private-pay and facility contracts can say otherwise.
What is the required wait at a no-show pickup?: The payer sets it, and it differs by program and by pickup type. New York's Medicaid transportation rules set a 15-minute minimum wait after the scheduled pickup time and require every no-show to be documented. Some brokers wait longer at facilities than at homes. Your broker's manual has the exact rule, and the driver should not leave before it is met.
What no-show rate should a NEMT provider expect?: There is no national figure, and rates depend on the riders, the program, and how you count. One public reference: Wisconsin's statewide NEMT manager counted 406,006 scheduled trip legs in May 2026, and riders failed to show for 8,566 of them, about 2.1%. Track your own rate every month, since the trend matters more than any outside number.
How is a late cancellation different from a no-show?: A no-show is a rider who cannot be found at pickup once the required wait has passed. A late cancellation is a ride called off after your notice cutoff, often before the driver gets there. Both usually cost the trip revenue. A no-show also costs the trip out and the wait.
Can I charge riders a no-show fee?: Yes, for rides you sell directly to private-pay riders or facilities, as long as the fee is in your written policy and in the signed agreement before service starts. For Medicaid riders, your state rules and broker contract decide what happens after a no-show. If a payer does pay you something for one, enter it in the calculator's fee field.