Special Mobility Services Medicaid Transportation: Eastern Washington Provider Guide for 2027

Special Mobility Services (SMS) is a nonprofit in Spokane Valley that has carried passengers in Washington since 1981 and has arranged Medicaid rides since 1989. It is one of six regional brokers the Washington State Health Care Authority (HCA) pays to run nonemergency medical transportation (NEMT) for Apple Health members. SMS takes each ride request, confirms the rider qualifies, picks the least costly ride that fits, and gives the vehicle trips to companies and agencies under subcontract.

SMS runs public services too. Under Washington State Department of Transportation (WSDOT) grants, its Community Shuttles link Davenport, Deer Park, Newport, Reardan, Ritzville, and Sprague with Spokane on weekdays, and it runs a dial-a-ride service in Deer Park. Those are separate from the Medicaid brokerage. SMS says its shuttle phone lines and dispatch email do not take Medicaid requests.

Which counties Special Mobility Services covers

HCA divides the state into 13 NEMT regions. SMS holds four of them on HCA’s regional broker map. HCA’s May 2025 broker list and its county directory, still current in September 2026, name SMS for all ten counties.

HCA region	Counties	Public transit SMS lists there
1B	Ferry, Stevens, Pend Oreille	Gold Line intercity bus between Kettle Falls and Spokane; Community Shuttle from Newport
1C	Lincoln, Grant, Adams	Grant Transit Authority in Moses Lake and Grant County; Community Shuttles from Davenport, Reardan, Ritzville, and Sprague
1D	Spokane	Spokane Transit buses and Spokane Paratransit; Deer Park Dial-A-Ride
1E	Whitman, Garfield, Asotin	Pullman Transit; Asotin County Public Transportation Benefit Area in Clarkston and Lewiston; Garfield County Transportation

The transit column matters because Washington pays for a bus first. When a fixed route runs within three-quarters of a mile of the rider, the broker does not pay for a car or van unless it documents a need for something more, such as a portable ventilator, a walker, or a quad cane (WAC 182-546-6200). Vehicle trips are the ones transit cannot handle: riders who use wheelchairs or need a stretcher, riders who cannot walk to a stop, and places no bus reaches.

Riders book with the broker for the county they live in. The nine counties to the west and south, from Okanogan and Chelan to Walla Walla and Columbia, belong to People for People. If your vans cover both areas, you need a subcontract with each broker.

Rides across the Idaho line

Washington recognizes five Idaho cities as bordering cities: Coeur d’Alene, Moscow, Sandpoint, Priest River, and Lewiston (WAC 182-501-0175). Apple Health covers care there on the same basis as care in Washington, and the NEMT rules treat those cities as in-state (WAC 182-546-5700 and 5900). A ride from Clarkston to a Lewiston clinic, or from Pullman to Moscow, is a normal SMS trip.

Care anywhere else outside Washington needs HCA’s approval, and the request must reach HCA at least seven business days before the rider travels (WAC 182-546-5800). Idaho’s own Medicaid riders go through a different broker. Idaho’s Medicaid provider handbook (version 16.0, March 30, 2026) names MTM as the transportation provider for all of Idaho’s non-emergency, non-ambulance medical transportation. A company based near the state line that wants both states’ trips needs an SMS subcontract and a separate MTM Health agreement. The Idaho state guide covers that side.

How SMS decides which ride to book

State rules make the broker choose two things for every trip: the level of help the rider needs (curb to curb, door to door, door through door, or hand to hand) and the lowest cost mode that is accessible and fits the rider’s condition (WAC 182-546-5200). SMS’s FAQ says it uses local transit whenever it can, because transit usually costs least. A rider who says they cannot ride the bus may be asked for a letter from their primary care provider. See least costly mode.

HCA posts a sample of its broker contract on its provider page. The sample is the contract that began July 1, 2021, extended to June 30, 2025 by an amendment effective July 1, 2023, and HCA still links it as its sample in September 2026. The terms below come from it, so confirm each one against the subcontract SMS gives you.

The sample adds a money reason to book cheap rides. Exhibit B pays a broker a quarterly bonus, capped at 5 percent of its monthly administrative payment, when its share of trips on low-cost modes rises over the same quarter a year earlier, with up to 1 percent more for a rise in shared rides. A separate bonus of up to 5 percent rewards a lower service cost per trip. The low-cost modes are public bus, ADA bus service, gas vouchers and gas cards, mileage, agency and broker volunteers, commercial bus, and train. Taxi, wheelchair van, and stretcher trips are not on that list, so a company’s trips are the ones those options cannot cover.

Other rules shape which rides reach a vehicle:

• Distance. Trips shorter than three-quarters of a mile are not covered unless the rider cannot walk that far or the route is unsafe or not accessible (WAC 182-546-5500 and 6200).
• One round trip a day. Coverage stops at one round trip per day unless several appointments cannot be reached in one (WAC 182-546-5500, amended effective April 11, 2026).
• Local care first. Riders go to a local provider. To go farther, the rider’s provider fills out SMS’s referral form, which must reach the call center at least two full business days before the visit. WAC 182-546-5700 lists continuity of care exceptions such as active cancer treatment, a transplant in the last 12 months, surgery in the next 60 days or the past 90, and the third trimester of pregnancy.
• Stops. A trip may stop only for the next medical appointment or a pharmacy within reasonable distance of the route (WAC 182-546-5600).
• Overnight trips. SMS may approve meals and lodging for up to one calendar month at a time, measured against the state per diem (WAC 182-546-5900).

The local care rule and its exceptions decide which long trips to specialists are covered. Rural NEMT and long-distance medical transport show how to price long runs before you accept them.

What riders are told about booking

SMS lets riders book up to a month ahead and recommends 7 to 14 days. A rider who calls with less than two business days’ notice for a trip that is not urgent may be asked to move the appointment if no ride is found. Riders with dialysis, chemotherapy, or other recurring care can book a month of appointments in one call or on a ride request form. That steady work is where standing orders come from.

Who SMS contracts with

SMS’s FAQ names the providers it uses for Medicaid trips: public transit systems, fuel voucher vendors, commercial providers such as taxi and cabulance companies, nonprofit organizations, and intercity bus and train. It also works with organizations that supply volunteer drivers and vehicles, and it manages a small group of its own volunteers who are reimbursed by the mile. SMS says it is always looking for organizations with experience running community transportation with volunteers.

HCA’s sample contract sets the ground rules for that network:

• An open marketplace. The broker must build its network through a fair and clear contracting process that creates a competitive marketplace with a variety of providers for each mode (Schedule A, section 5).
• No self-dealing. The broker may not provide transportation directly, though the contract lets it run a pool of volunteer drivers. It may not subcontract with a company it, or an immediate family member, has a financial relationship with (Schedule A, section 6).
• Ownership disclosure. The broker collects disclosure information on each subcontractor’s owners of 5 percent or more and its managing employees, and searches the federal exclusion lists at least monthly (Schedule A, section 4).

Stretcher, tribal, and facility work

HCA wants more stretcher capacity. Since May 2021, HCA’s brokers have run a stretcher pilot with private transportation companies, and HCA’s December 2024 report to the Legislature names the cost of insurance and low or inconsistent trip volume as the biggest barriers to growing it. HCA’s sample contract defines a stretcher car or van as a vehicle that can legally carry a rider lying down who needs no medical attention on the way. See stretcher van requirements.

Two other groups can carry riders and bill through a broker. When a federally recognized tribe whose contract health service area falls in the region asks, the broker must negotiate a contract with it in good faith (WAC 182-546-5200). HCA’s December 2024 report says billing agreements draw on the transportation systems of 22 federally recognized tribes, which were paid more than $2.5 million for trips in 2023. The same report counts five behavioral health facilities with billing agreements for trips in their own vehicles, one of them in eastern Washington.

What you need before you call SMS

Licenses

If you are	You need (September 2026)
A for-hire company, such as a taxi or cabulance	A Department of Licensing (DOL) for-hire license, applied for through the Department of Revenue’s Business Licensing Service and printed on your business license
In a city or county that does not license for-hire businesses	DOL’s for-hire permit, $110
Running for-hire vehicles	A for-hire vehicle certificate for each one, $55, with registration use class F/H or CAB
Applying to DOL	A For Hire Addendum signed by your local jurisdiction, and an insurance certificate showing at least $325,000 combined single limit or $300,000/$100,000/$25,000 split limits
A private nonprofit carrying riders with special needs	A Utilities and Transportation Commission (UTC) permit under RCW 81.66 instead, which usually takes about eight days when the application is complete

DOL sends the license and vehicle certificates within 14 business days of getting every correct document. Your business name and trade name must match on the application, the registrations, and the insurance certificate. The Washington state guide covers forming the company.

Insurance

HCA’s sample contract (Exhibit I) sets a floor by the kind of provider you are. A company licensed by DOL or the UTC carries at least the minimum the law sets for it. A provider that no agency regulates carries the same types and limits as the broker (section 3.7): $1 million auto liability per occurrence, general liability of $1 million per occurrence and $2 million aggregate, and errors and omissions coverage of $1 million per claim and $2 million aggregate, plus privacy breach response coverage. SMS’s subcontract sets the limits it wants, so ask for them before you buy a policy. See NEMT insurance requirements.

Drivers

Exhibit F of the sample contract requires a valid license, an abstract of driving record, and insurance before a driver’s first ride. Every new driver and volunteer needs a fingerprint-based Washington State Patrol background check that qualifies them for unsupervised access to children and vulnerable adults, repeated every three years, with a Washington Access to Criminal History (WATCH) report in the years between. While a new driver’s fingerprint check is pending, the broker may let the driver start on a WATCH report, and because SMS’s regions border Idaho, it may use a similar report from an appropriate government agency instead.

Before a driver serves an Apple Health rider, the broker also reviews the Department of Social and Health Services (DSHS) Secretary’s List of Crimes and Negative Actions. The list, in WAC 388-113-0020, names the crimes that keep a person out of DSHS work with unsupervised access to minors or vulnerable adults, whether the person was convicted or only has a pending charge. Some bar a person automatically only for a set number of years, such as second degree assault within five years, after which DSHS requires a character, competence, and suitability review. Screen applicants against it before you train them. See NEMT driver background checks.

The same exhibit lists what drivers may not do on an SMS trip:

• Accept money, gifts, or anything of value from riders.
• Smoke in the vehicle with riders aboard, and where possible for 15 minutes before a pickup.
• Eat, or drink anything but water in a closed container, while driving or helping a rider.
• Wear headphones on duty, or hold a phone while the vehicle moves.
• Discourage a complaint, refuse to give contact information, or ask riders or clinics for more business.

Drivers are verified after they start. The broker checks 10 percent of each provider’s drivers face to face in odd years, half planned and half unannounced, and reviews 10 percent of driver files by desk audit in even years. If more than 5 percent fail, it checks every driver, and several complaints about a driver within 60 days trigger a desk audit.

The contract recommends CPR and first aid, a passenger assistance course, fire suppression, and defensive driving training, and requires commercial drivers to be trained in installing and using child safety seats. Federal law adds a floor under section 1902(a)(87) of the Social Security Act, as CMS explained on September 28, 2023: no provider or driver may be excluded from federal health programs, each driver needs a valid license, and your company needs a process for state drug law violations and for disclosing each driver’s driving history.

Vehicles

Exhibit E requires the broker to inspect every vehicle before its first trip. After that, it inspects 10 percent of each provider’s fleet on site in odd years, half planned and half unannounced, and 10 percent by desk audit in even years. A vehicle that fails comes out of service until it passes again. Each vehicle needs:

• A two-way radio or cell phone linking it to your dispatcher. A vehicle whose link is down stays out of service until it is repaired.
• Working heat and ventilation, seat belts for every seat, interior lights, an accurate speedometer and odometer, and two outside mirrors plus one inside.
• Your company name and vehicle number displayed.
• Devices to secure wheelchairs and the ability to secure child safety seats.

The broker also keeps track of which providers carry seat belt extenders, so it can send one of them when a rider asks. The vehicle inspection checklist helps each vehicle pass the first inspection and the checks after it.

How to become a Special Mobility Services provider

1. Choose your counties and ride types. Decide which of the ten counties you will serve, and whether you run ambulatory cars, wheelchair vans, stretcher cars, or several.
2. Get licensed and insured. Line up your business license, DOL for-hire license and vehicle certificates or UTC permit, and a policy that meets the limits above.
3. Call the Regional Manager. SMS asks providers and volunteer organizations to call its Regional Manager at 509-534-9760 or 800-892-4817, weekdays from 8 a.m. to 4 p.m. Ask for the subcontract, the insurance limits, and the driver and vehicle checklist.
4. Offer your rates. HCA’s December 2024 report says HCA sets no NEMT rates, because geography drives what a trip costs, so each broker negotiates with its providers. Price wheelchair, stretcher, long-distance, and after-hours work separately. Negotiating broker rates walks through it.
5. Read the subcontract. Check it against the terms in the next section before you sign.
6. Pass the first checks. The broker verifies every driver and inspects every vehicle before their first trip.

Keep your documents together with the NEMT credentialing checklist. How to get NEMT broker contracts covers what to check before you sign.

What your SMS subcontract must include

Exhibit I of HCA’s sample contract lists the terms every written subcontract with a transportation provider must carry. Use it as a checklist when SMS sends you one.

Term	What the sample contract requires
Services and pay	The services you will provide and how you are paid, with your rates
Rate reviews	Rates may be adjusted at least every quarter
Care that does not happen	A fair negotiated rate for an authorized trip you gave when the rider’s care is not given through no fault of yours
Appeals	An appeals process for you
When you are paid	No later than 10 calendar days after SMS receives its monthly payment from HCA
No other billing	You may not bill HCA, the rider, or another provider for trips under the subcontract
No kickbacks	No payments, gifts, or services to the broker to win referrals
Unauthorized drivers or vehicles	You return any payment for a trip given by an unauthorized driver or vehicle within 30 days of finding it
Records	The broker can see your trip, billing, and accounting records for six years after the subcontract ends
Your staff	Your drivers are your employees, not the broker’s or the state’s
Your policies	Fraud and abuse procedures, a quality assurance plan, rider confidentiality, and nondiscrimination
Licenses and taxes	Every license and permit the law requires, plus workers’ compensation, unemployment insurance, and the other taxes that apply to you

How SMS trips run and how you get paid

Every trip other than an ambulance trip must be authorized by the broker in advance (WAC 182-546-6000). SMS’s rider FAQ and HCA’s sample contract set the timing you work to:

Situation	Standard
Pickup time	Riders may be asked to be ready up to an hour before a local appointment, and earlier for long-distance trips (SMS)
Wait on the way to an appointment	Average pickup wait of 15 minutes or less and never more than 30. The rider never arrives more than 30 minutes early unless they ask (HCA)
Return booked at a set time	The driver may arrive up to 30 minutes after the set time (SMS); average wait 30 minutes or less (HCA)
Will-call return	The driver has 60 minutes from the call (SMS). A rider who is not ready when the driver arrives must get home on their own
Shared rides	No more than 45 minutes longer than a single-rider trip (HCA)
Rural and out-of-region trips	Exceptions allowed for exceptional rural distances and trips outside the rider’s region, documented in the rider’s file (HCA)
Late arrival	No pay when the rider arrives too late to be seen. The broker may still pay when the delay was not your fault, such as a crash that stopped all traffic, but not for construction zones (HCA)

SMS tells riders to ask the driver for a card with the transportation company’s phone number, and to call that company directly about a late return or a will-call pickup. Put your number on a card in every vehicle and keep the line answered. Managing will-call trips covers staffing for it.

When SMS is closed

The call center is closed on weekends and on New Year’s Day, Martin Luther King Jr. Day, Presidents Day, Memorial Day, Independence Day, Labor Day, Veterans Day, Thanksgiving and the day after, and Christmas. After hours, riders reach an answering service through the call center’s voicemail. If a rider needs an urgent care visit or a ride after a hospital discharge while the broker is closed, you may give the ride under the broker’s after-hours instructions and ask for retroactive authorization within two business days, or you may decline it (WAC 182-546-5200). See after-hours NEMT.

Getting paid

You bill SMS under your subcontract, never HCA or the rider. HCA’s December 2024 report says the broker’s administrative rate is a set amount only the Legislature can change, and the service cost passes 100 percent through to providers. The sample contract sets the chain:

1. You invoice SMS on the terms in your subcontract.
2. SMS invoices HCA by the 20th day of the month after the trips.
3. SMS pays you no later than 10 calendar days after it receives HCA’s monthly payment.

If SMS sends a bill back to you for clarification or backup documents, HCA gives you 60 more calendar days to resubmit it (section 3.3). Expect checks on your trips. Brokers must pre-verify at least 10 percent of trips and confirm at least 10 percent afterward with the medical provider, as HCA explained in May 2025. In each provider’s desk audit every other year, the broker reviews at least 10 random trips for paperwork, timeliness, coding, and medical need, and it visits your office every other year to check that rider files and manifests are secure. Keep a complete trip log for every leg.

Who to call

For	Contact
Provider and volunteer contracts	SMS Regional Manager, 509-534-9760 or 800-892-4817
Medicaid call center	509-534-9760 or 800-892-4817, weekdays 8 a.m. to 4 p.m. TDD 509-534-8566 or 800-821-7167, or 711
Fax	509-534-6980 or 888-829-9915
Office	12615 E Mission Ave, Suite 312, Spokane Valley, WA 99216
Community Shuttles and Deer Park Dial-A-Ride (not Medicaid)	877-264-7433 or 509-534-7171
HCA NEMT program	hcanemttrans@hca.wa.gov
DOL for-hire license, through the Business Licensing Service	360-705-6741, BLS@dor.wa.gov
UTC nonprofit permits	360-664-1222, transportation@utc.wa.gov

Before you call, know which counties, ride types, and hours you will cover and what you need per trip and per mile. SMS matches each ride to the cheapest option that works, so an offer built around the rides buses and volunteers cannot give, such as wheelchair, stretcher, and long rural trips, is the one to lead with.