# A0130 Billing Code: Wheelchair Van Base Rate, Mileage, Modifiers, and State Rates

Canonical URL: https://nemtguide.com/glossary/a0130/ · Updated 2026-09-28

A0130 is the HCPCS code for a non-emergency wheelchair van trip: the base charge for carrying a rider who travels seated in a wheelchair. Loaded miles go on a second line, usually S0209. Medicare does not pay it, so each state sets the rate: $11.15 in urban Arizona from October 1, 2026, $31.79 in Indiana since January 1, 2026, and $43.39 in South Dakota since July 1, 2026.

- A0130 is the base charge for one wheelchair van trip, and the loaded miles go on their own line.
- The mileage code differs by state: S0209 in Arizona, Ohio, North Dakota, and South Dakota, A0425 in Indiana and Illinois, and A0380 in Medi-Cal.
- The plain base rate ranges from $11.15 in urban Arizona (October 1, 2026) to $64.00 in Nassau and Suffolk counties in New York.
- Modifiers such as TN, TK, TT, UJ, and QM change the amount, and each state defines its own.
- Bill the level of service the rider needed, not the vehicle you sent: a rider who can walk is not an A0130 trip in Indiana.

## What A0130 means

CMS lists A0130 in the national HCPCS code set as "Non-emergency transportation: wheelchair van." The October 2026 quarterly file shows the code has been in the set since January 1, 1982. It carries coverage code I, which means Medicare does not pay it.

A0130 is a base code. It pays for the trip itself, not the distance. The loaded miles go on a second line with a mileage code, most often [S0209](https://nemtguide.com/glossary/s0209/), "Wheelchair van, mileage, per mile." See NEMT base rate and [loaded miles](https://nemtguide.com/glossary/loaded-miles/) for how the two parts fit together.

The code's description names no unit. Each Medicaid program, health plan, and broker decides what one unit is. In most programs it is one one-way trip, so a round trip is 2 units.

States also use different names for the same service. Knowing the local name helps you find the right section of your manual.

| Program | What it calls an A0130 trip |
|---|---|
| Illinois | Medicar |
| New York | Ambulette |
| South Dakota | Secure van, part of secure medical transportation |
| Indiana | Nonambulatory services (NAS) |
| Oregon | Wheelchair car or van |
| Arizona, Ohio, North Dakota, Medi-Cal | Wheelchair van |

Not every program uses A0130 at all. The Texas Medical Transportation Program handbook (September 2026) recommends T2003 for demand response providers, which include wheelchair vans. In Texas fee-for-service, a wheelchair ride bills [T2003](https://nemtguide.com/glossary/t2003/), not A0130.

## Who qualifies for a wheelchair van trip

A0130 pays only when the rider needs a wheelchair van. Each program writes its own test, and the payer can take the money back if your records do not show the rider met it.

| Program | The rule |
|---|---|
| Arizona AHCCCS | The member must require transportation by wheelchair and be physically unable to use other modes of non-emergency transportation (chapter 14, revised July 31, 2026). |
| Medi-Cal | The rider cannot sit in a private car, taxi, or public transit for the time needed, must travel in a wheelchair, or cannot transfer unassisted, and is stable enough not to need an ambulance. Dialysis riders and riders on oxygen who need no monitoring are listed as examples. |
| Illinois | Medicar is for a rider confined to a wheelchair who needs a lift or ramp and a wheelchair lockdown, and needs no medical observation, equipment, medications, or oxygen on the way (handbook, March 11, 2024). |
| South Dakota | The rider must be confined to a wheelchair, meaning unable to walk without the continuous aid of another person. Leaving a hospital in a wheelchair does not by itself qualify (manual, updated August 2026). |
| North Dakota | The rider's mobility impairment must prevent safe use of a bus, taxi, private car, or other common carrier, and the trip must be authorized on form SFN 1507 (manual, updated January 2026). |
| Indiana | Bill the level of service given, not the vehicle type (module version 6.1). A walk-on rider in a wheelchair van bills T2003. |

A rider who needs monitoring or medical care on the way needs an ambulance, not a van. See NEMT level of service and what a WAV is.

## A0130 rates by state

These are fee-for-service maximums from each state's own schedule, with the mileage code that pairs with A0130 there. Brokers and health plans pay their own contract rates. See [NEMT reimbursement rates](https://nemtguide.com/guides/nemt-reimbursement-rates/).

| Program | A0130 base | Mileage code and rate | Effective |
|---|---|---|---|
| Arizona AHCCCS | $11.15, or $12.21 with TN outside the Phoenix and Tucson metro areas | S0209: $1.54, or $1.66 with TN | October 1, 2026 |
| North Dakota | $18.05 | S0209: $2.57 | July 1, 2026 |
| Medi-Cal | $20.30, or $26.43 at night with UJ | A0380: $1.50 | Rates page updated September 2023 |
| Illinois (medicar) | $30.00 | A0425: $1.03 in Cook, DuPage, Kane, Lake, McHenry, and Will counties, $1.61 in Madison and St. Clair, $0.80 in other Illinois counties | January 1, 2026 |
| Ohio | $31.00 | S0209: $1.30 | January 1, 2024 amounts, in the appendix in effect since August 1, 2026 |
| Indiana | $31.79 | A0425 with U5: $1.67, paid after the first 10 miles of each one-way trip | January 1, 2026 |
| South Dakota (secure van) | $43.39, or $65.09 with QM for a hospital-arranged discharge | S0209: $2.61, only outside city limits | July 1, 2026 |

North Dakota's July 1, 2025 schedule described its S0209 line as miles greater than 15, so confirm with the state which miles its current rate covers.

### New York ambulette rates

New York sets ambulette fees by county. Its fee schedule, dated April 5, 2026, says the fees apply to the fee-for-service broker and may reflect network negotiations, and that other payers should not read its codes and modifiers as standard definitions. The plain A0130 and S0209 lines for some large counties:

| County | A0130 base | S0209 per mile |
|---|---|---|
| New York City | $52.90 (since May 30, 2024) | $3.60 (since April 1, 2022) |
| Nassau and Suffolk | $64.00 (since May 20, 2024) | $3.00 |
| Westchester | $47.00 (since August 16, 2024) | $3.50 |
| Monroe | $44.00 (since August 1, 2024) | $3.00 |
| Albany | $43.00 (since August 1, 2024) | $3.00 |
| Erie | $41.00 (since August 1, 2024) | $3.00 |

New York's policy manual (effective August 25, 2023) requires ambulette claims to show the driver's license number and the vehicle's plate number. See the [New York state guide](https://nemtguide.com/states/new-york/).

### What one 10-mile trip pays

The same one-way daytime trip of 10 loaded miles, priced at each schedule's plain rates:

| Program | Base | Mileage | Total |
|---|---|---|---|
| Arizona, Phoenix or Tucson area | $11.15 | 10 x $1.54 = $15.40 | $26.55 |
| Indiana | $31.79 | $0, because the first 10 miles are deducted | $31.79 |
| Medi-Cal | $20.30 | 10 x $1.50 = $15.00 | $35.30 |
| Illinois, Cook County | $30.00 | 10 x $1.03 = $10.30 | $40.30 |
| South Dakota, inside city limits | $43.39 | $0 inside city limits | $43.39 |
| Ohio | $31.00 | 10 x $1.30 = $13.00 | $44.00 |

Ohio and South Dakota pay the lower of your usual charge and the schedule amount, so bill your usual and customary charge.

## Modifiers states pair with A0130

A modifier changes what the A0130 line means. The same letters mean different things in different states, so use only the ones your program lists. The official meanings below are from the October 2026 HCPCS file.

| Modifier | Official meaning | How a state uses it with A0130 |
|---|---|---|
| TN | Rural/outside providers' customary service area | Arizona: any trip that starts outside the Phoenix and Tucson metro areas |
| TK | Extra patient or passenger, non-ambulance | Indiana: an accompanying adult or attendant, $15.90. South Dakota: an additional Medicaid rider, $21.70. |
| TT | Individualized service provided to more than one patient in same setting | Indiana: each additional wheelchair rider on the trip, $15.90, with no mileage or wait time |
| U6 | Medicaid level of care 6, as defined by each state | Indiana: an extra attendant to help load the rider, $7.95, up to two units. Ohio: the medical service was not available when the van arrived. |
| U3 | Medicaid level of care 3, as defined by each state | Ohio: a wheelchair van service given in an ambulance vehicle |
| UA and UB | Medicaid level of care 10 and 11, as defined by each state | Ohio: a second and third trip on the same day, in the same kind of vehicle, to or from the same kind of place |
| QM | Ambulance service provided under arrangement by a provider of services | South Dakota: pickup at an inpatient hospital discharge that the hospital arranged |
| UJ | Services provided at night | Medi-Cal: trips between 7 p.m. and 7 a.m. |
| UN to US | Two, three, four, five, or six or more patients served | Medi-Cal: a shared ride from one pickup point to one destination, billed on each rider's claim at $16.22 per patient for two, $12.85 for three, and $11.51 for four or more, with the miles billed only on the first rider's claim |
| HN with QN | HN: Bachelors degree level. QN: Ambulance service furnished directly by a provider of services | Medi-Cal: a transfer from an acute care facility to a level A or B nursing facility, which needs no treatment authorization request |
| Origin and destination pair | Two letters for pickup and drop-off | Indiana: required on the base line and the mileage line. Ohio: lists the pairs it pays without manual review. |

South Dakota also uses the CPT modifier 59 on a second line for extra trips on the same day, and pays up to 4 one-way trips per day. See [origin and destination modifiers](https://nemtguide.com/glossary/origin-destination-modifiers/) and U modifiers.

## How to bill A0130 and its miles

1. **Confirm the level of service.** The rider must meet your program's wheelchair test on the date of the trip. Bill the level you gave, not the vehicle you drove.
2. **Get the authorization or trip number first.** Medi-Cal needs a treatment authorization request. Illinois needs prior approval. The HFS 2270 Physician Certification Statement must be completed for trips from a hospital or long term care facility, and the HFS 2271 Certificate of Transportation Services should be completed for trips from home. North Dakota needs form SFN 1507, and its providers also file the SFN 296 trip ticket. Arizona needs prior authorization only over 100 miles for one member on one day.
3. **Put A0130 on the base line.** Use units for trips, usually 1 for one way and 2 for a round trip. Add the modifiers your program lists, in the order its manual shows.
4. **Put the loaded miles on the next line.** Use your state's mileage code, in whole miles. Indiana rounds 15.5 miles up to 16. Oregon rounds a partial mile up.
5. **Keep base and mileage together.** Arizona denies a base-only claim followed by a mileage-only claim, and wants every trip for one member on one date on one claim.
6. **Attach what your payer requires.** Arizona denies any NEMT claim without the AHCCCS Daily Trip Report, and a paper claim carries the pickup and drop-off addresses in box 19.

See [the CMS-1500 for NEMT](https://nemtguide.com/guides/cms-1500-for-nemt/) for the form itself.

## Worked examples

These use each state's published rates. The trips and distances are example numbers.

### Indiana: home to a dialysis center

A wheelchair rider goes 18 loaded miles from home to a freestanding dialysis center, one way, at January 1, 2026 rates. Indiana deducts the first 10 miles of each one-way trip itself, so you still bill all 18.

| Line | Code and modifiers | Units | Paid |
|---|---|---|---|
| 1 | A0130 RJ | 1 | $31.79 |
| 2 | A0425 U5 RJ | 18 | 8 paid miles x $1.67 = $13.36 |
| Total | | | $45.15 |

Most Indiana fee-for-service rides are brokered by Verida, and those claims go to Verida, whose rates are based on the state schedule. See the [Verida broker guide](https://nemtguide.com/brokers/verida/).

### Arizona: a rural round trip

A wheelchair rider outside the Phoenix and Tucson areas rides 24 loaded miles each way on one date, at October 1, 2026 rates. The day's total is under 100 miles, so no prior authorization is needed.

| Line | Code and modifier | Units | Amount |
|---|---|---|---|
| 1 | A0130 TN | 2 trips | 2 x $12.21 = $24.42 |
| 2 | S0209 TN | 48 miles | 48 x $1.66 = $79.68 |
| Total | | | $104.10 |

## Mistakes that get A0130 claims denied

- **A walk-on rider billed as a wheelchair trip.** Indiana bills by level of service, so that trip is T2003.
- **The wrong mileage code.** S0209 is not the code in Indiana, Illinois, or Medi-Cal.
- **Miles your program does not pay.** South Dakota pays S0209 only outside city limits, counted from the point the trip leaves them.
- **Mileage on every rider of a shared trip.** South Dakota pays one mileage charge per trip, North Dakota lets you bill for only one member, Medi-Cal takes the miles only on the first rider's claim, and Indiana pays no mileage for added riders.
- **Split claims.** Arizona denies base and mileage sent on separate claims.
- **A missing origin and destination pair.** Indiana wants it on the base line and the mileage line.
- **Missing forms.** No PCS or CTS in Illinois, no SFN 1507 in North Dakota, no Daily Trip Report in Arizona, or no license and plate numbers in New York.

For fixes and resubmissions, see [NEMT claim denials](https://nemtguide.com/guides/nemt-claim-denials/) and [NEMT billing codes](https://nemtguide.com/guides/nemt-billing-codes/).

## Frequently asked questions

### What is the mileage code that goes with A0130?

Usually S0209, "Wheelchair van, mileage, per mile." Arizona, Ohio, North Dakota, South Dakota, and New York pay it. Other programs use ambulance mileage codes instead: Indiana bills A0425 with the U5 modifier, Illinois pays A0425 on medicar trips, and Medi-Cal bills A0380 at $1.50 a mile. Use the code on your state fee schedule or broker rate sheet.

### Does Medicare pay the A0130 billing code?

No. The October 2026 CMS HCPCS file gives A0130 coverage code I, which means not payable by Medicare. Wheelchair van trips are paid by state Medicaid programs and the health plans and brokers that work for them. For a rider with both Medicare and Medicaid, bill the van trip to Medicaid, its health plan, or its broker.

### Can I bill A0130 when the rider can walk?

Not in Indiana. Its transportation module says to bill the level of service given, not the vehicle type, so a walk-on rider in a wheelchair van bills T2003, the ambulatory code. Arizona says a wheelchair van rider must need a wheelchair and be unable to use other modes. Check your state rule before you send a van for a rider who walks.

### How do I bill a second wheelchair rider on the same trip?

It depends on the payer. Indiana bills A0130 with TT at $15.90 for each added rider, with no mileage, as of January 1, 2026. South Dakota bills A0130 with TK at $21.70 and pays one mileage charge per trip. Medi-Cal bills A0130 with UN through US on each rider's claim at a lower per-rider rate, and bills the miles only on the first rider's claim. North Dakota lets you bill for only one member per trip.

### Does an A0130 trip need prior authorization?

Often. Medi-Cal requires a treatment authorization request for wheelchair van trips. Illinois requires prior approval for all non-emergency transportation. North Dakota requires the SFN 1507 authorization before the trip. Arizona fee-for-service needs prior authorization only when one member's trips on one day total more than 100 miles. Broker trips need the broker's trip number.

## Official resources

- [CMS: HCPCS quarterly update files](https://www.cms.gov/medicare/coding-billing/healthcare-common-procedure-system/quarterly-update)
- [AHCCCS: Ground NEMT rates, effective October 1, 2026](https://www.azahcccs.gov/PlansProviders/Downloads/FFSrates/Transportation/FY27_FinalWebsiteRates_TransGroundNEMT.xlsx)
- [Indiana Health Coverage Programs: Transportation Services module](https://www.in.gov/medicaid/providers/files/modules/transportation-services.pdf)
- [Ohio: Appendix to rule 5160-15-28, transportation rates and modifiers](https://codes.ohio.gov/assets/laws/administrative-code/pdfs/5160/0/15/5160-15-28_PH_FF_A_APP2_20260710_1407.pdf)
- [South Dakota Medicaid: Transportation Services Fee Schedule](https://dss.sd.gov/docs/medicaid/providers/feeschedules/Other_Services/Transportation_Services_Current.pdf)
- [Medi-Cal: Ground transportation billing codes and rates](https://mcweb.apps.prd.cammis.medi-cal.ca.gov/file/manual?fn=mctrangndcd.pdf)
- [eMedNY: NYS Medicaid Transportation Fee Schedule](https://www.emedny.org/ProviderManuals/Transportation/PDFS/Transportation_Fee_Schedule.xls)