# Medicaid Mileage Reimbursement: How Gas Money for Riders and Family Drivers Works

Canonical URL: https://nemtguide.com/glossary/mileage-reimbursement/ · Updated 2026-09-29

Medicaid mileage reimbursement pays a member, relative, or friend a set amount per mile for driving the member to a covered appointment in a private car. It is billed with codes such as A0090. As of September 2026, rates include 18 cents a mile in Utah, 36 cents in Louisiana, and 53 cents in Indiana, and a broker may offer it before sending a trip to a transportation company.

- Mileage reimbursement pays the person who drives, not a transportation company, and programs such as Vermont's pay only the shortest direct route.
- Federal guidance tells states to use free rides first and the least costly mode that fits, so a rider with a car or a willing driver may be offered mileage instead of a van.
- Louisiana tells its broker to consider public transit first, then gas reimbursement, and only then nonprofit and for-profit providers.
- In May 2026, about 29 percent of completed Medicaid trip legs in Wisconsin were members who found their own ride and were paid mileage.
- The rates are far below yours: Louisiana pays 36 cents a mile for gas reimbursement, against $13.50 plus $1.10 a mile for an ambulatory trip.

## What Medicaid mileage reimbursement is

Medicaid mileage reimbursement, often called gas reimbursement, pays for the miles a private car drives to get a Medicaid member to a covered service. The money goes to whoever drives: the member, a relative, a friend, or a neighbor. It does not pay a transportation company for its trips.

Federal rules allow it. Under [42 CFR 440.170(a)](https://www.ecfr.gov/current/title-42/section-440.170), Medicaid travel expenses include the cost of transporting the member "by ambulance, taxicab, common carrier, or other appropriate means." The CMS Medicaid Transportation Coverage Guide (SMD 23-006, September 28, 2023) adds three rules that make mileage reimbursement common:

- **Free rides first.** States must first try any free ride available, such as a ride from family or friends.
- **Least costly mode.** When several modes are available, states must use the least costly one suited to the member's physical and emotional condition. See least costly mode.
- **Own car where possible.** A state may expect a member to use their own car, unless their circumstances prevent it. CMS names maintenance and fuel costs as examples.

Mileage reimbursement fills the gap between those rules: the member has a car or a willing driver, but not the gas money. Pennsylvania's Medical Assistance Transportation Program (MATP) puts it that way. It offers mileage reimbursement when the rider has a private vehicle but lacks the funds for fuel, parking, or tolls (DHS study, June 25, 2026).

Programs call it different things. Louisiana and MTM Health in Virginia say gas reimbursement. MTM Health in Rhode Island says gas mileage reimbursement. Vermont runs a Hardship Mileage Reimbursement Program, Texas pays individual transportation participants, Utah pays personal mileage, and New York's manual (effective August 25, 2023) lists self-drive mileage reimbursement as a transportation service.

## The billing codes behind it

These are the national HCPCS codes, as worded in the October 2026 CMS file. Each state decides which ones it pays.

| Code | Description | How programs use it |
|---|---|---|
| [A0090](https://nemtguide.com/glossary/a0090/) | Non-emergency transportation, per mile, vehicle provided by individual (family member, self, neighbor) with vested interest | Louisiana labels it "Gas Reimbursement." Indiana, Arizona, and Illinois pay it per mile. |
| [A0080](https://nemtguide.com/glossary/a0080/) | Non-emergency transportation, per mile, vehicle provided by volunteer (individual or organization), with no vested interest | Volunteer drivers. Arizona pays it at the same rate as A0090. |
| [S0215](https://nemtguide.com/glossary/s0215/) | Non-emergency transportation; mileage, per mile | Texas's fee-for-service Medical Transportation Program lists it for individual transportation participants, with taxonomy code 347C00000X (September 2026 handbook). |
| A0170 | Transportation ancillary: parking fees, tolls, other | Vermont's manual lists it, and pays in-state parking and tolls under its hardship rules. |
| A0180 to A0210 | Lodging and meals for the member and an escort | Overnight trips. Louisiana caps them at U.S. General Services Administration per diem rates. |

The unit is one mile. There is no base charge for the trip, which is the main difference from what a transportation company bills. See [NEMT mileage billing](https://nemtguide.com/guides/nemt-mileage-billing/) for how provider mileage works.

## Mileage reimbursement rates by state

| Program | Rate | Who it pays | Date |
|---|---|---|---|
| Utah Medicaid | 18 cents a mile, up to $300 a month | The member's personal mileage, when public transit is not available or does not meet the need | Utah DHHS page, September 2026 |
| Illinois | 23 cents a mile (A0090) | Private auto trips, at the same rate in every county | January 1, 2026 |
| MTM Health, Rhode Island | 32 cents a mile driven | A member who can drive, or a friend or family member who drives them | Handbook last updated July 1, 2026 |
| Louisiana | 36 cents a mile (A0090) | Friends or family enrolled as gas reimbursement providers | Fee schedule effective October 1, 2025 |
| Arizona AHCCCS | 44 cents a mile (A0090 and A0080) | Family, self, or neighbor drivers, and volunteers, on the fee-for-service schedule | October 1, 2026 |
| Indiana | 53 cents a mile (A0090) | Family, self, or neighbor drivers, up from 52 cents in 2025 | January 1, 2026 |
| Georgia (Verida) | 54 cents a mile | Only foster parents and approved respite caregivers of Georgia Families 360 members | Manual version July 1, 2026 |

For comparison, the IRS medical mileage rate for 2026 is 20.5 cents a mile from January 1 to June 30 and 23.5 cents from July 1 to December 31. That is a tax deduction rate, not a Medicaid payment. The [IRS mid-year rate change](https://nemtguide.com/news/irs-mid-year-mileage-rate-increase/) covers the business rate your own vans use.

Texas works differently. HHSC's NEMT Services Handbook has health plans pay individual transportation participant mileage "at the rate established by HHSC," and approve advance funds for gas when the driver has none and the member is 20 or younger.

## How riders and family drivers get paid

The forms differ by program, but the steps line up.

1. **Book the trip first.** Modivcare gives a trip number when the ride is scheduled, and a log without it is denied. Its Oklahoma page asks for at least two business days' notice for mileage reimbursement requests. Its Kansas page asks for at least one hour.
2. **Meet the driver rules.** Louisiana's gas reimbursement drivers must be 18 or older, hold a valid Louisiana license, live at a different address than the member, and drive no more than five members across the state's fee-for-service broker and all health plans, unless more than five live in one household. They send a copy of the license, registration, and insurance.
3. **Get the visit signed.** Modivcare's log needs a physician or clinician signature for each date of service. Louisiana's form, required for every claim, carries 17 items, including the facility's signature and stamp.
4. **Send it on time.** Modivcare's standard instructions want the log received within 30 days, with one driver per form. Its KanCare instructions allow 180 days. Vermont wants the monthly trip manifest within 30 days of the last visit that month.
5. **Get paid.** Modivcare mails payment within 30 business days of receiving a complete form. Louisiana's broker issues each gas reimbursement provider an IRS Form 1099.

In Louisiana, payment is per trip, not per person: one gas reimbursement covers everyone in the car, however many members or passengers ride.

Vermont adds a threshold. It pays personal mileage only through its Hardship Mileage Reimbursement Program, for households whose medical travel runs over 215 miles a calendar month or over 50 miles a week, with exceptions for members in its no-show and behavior programs. A signed waiver of liability must be on file first, and the contractor pays by the shortest direct route (manual last updated July 28, 2025).

## How mileage reimbursement affects your trip volume

Every rider paid for mileage is a trip no company runs. Some states put that choice in writing. Louisiana's Medicaid manual (Chapter 10, issued July 14, 2025) tells its broker to consider scheduling providers in this order:

1. Public transit
2. Gas reimbursement
3. Nonprofit providers
4. For-profit providers

Cost explains the order. On Louisiana's fee schedule, a 10-mile leg costs Medicaid this much:

| How the member rides | Rate | Cost of a 10-mile leg |
|---|---|---|
| Gas reimbursement (A0090) | $0.36 a mile | $3.60 |
| Ambulatory trip ([T2003](https://nemtguide.com/glossary/t2003/)) | $13.50 base plus $1.10 a mile | $24.50 |
| Wheelchair van (A0130) | $21.50 base plus $1.30 a mile | $34.50 |

The share can be large. Wisconsin's May 2026 performance report shows 87,582 of 301,246 completed trip legs, about 29 percent, were members who found their own ride and received mileage reimbursement. In Philadelphia, a Pennsylvania DHS study (June 25, 2026) put mileage reimbursement at 1 percent of trips from 2023 to 2025. How much volume it takes depends on your state.

Riders can also be moved onto it. Modivcare's Oklahoma page says a member with three no-shows in 90 days risks being placed on mileage reimbursement only. Vermont may shift a member with repeated no-shows to hardship mileage once it confirms they reached their appointments without their rides. CMS guidance lets states offer riders with chronic no-shows the choice to arrange their own ride and be reimbursed, but says states cannot force them to.

What this means for your company:

- **Your trips are the ones mileage reimbursement cannot cover.** Riders who need a wheelchair van or stretcher, need help to the door, or have no car and no driver stay with transportation companies. Build your fleet and your facility work around them.
- **Never bill a trip a family member drove.** The family driver files the mileage claim for that trip, so a claim from you would pay the same ride twice.
- **Do not route your drivers into it.** MTM Health's Virginia handbook says gas reimbursement is not available for contracted transportation providers or drivers.
- **Watch the rate.** A higher mileage rate makes driving, or asking a relative to drive, more attractive to riders who have a car. Check your state's [fee schedule](https://nemtguide.com/glossary/fee-schedule/) each year.

## Frequently asked questions

### How much does Medicaid pay per mile for mileage reimbursement?

Each program sets its own rate. As of September 2026, Utah pays 18 cents a mile up to $300 a month, Illinois 23 cents, MTM Health in Rhode Island 32 cents, Louisiana 36 cents, Arizona 44 cents from October 1, 2026, and Indiana 53 cents. Georgia pays foster parents 54 cents a mile, at a rate set by its broker Verida. Your state Medicaid agency or broker has the current number.

### Can a Medicaid member get mileage reimbursement for driving themselves?

In some programs. MTM Health in Rhode Island pays a member who can drive to the appointment, Utah pays personal mileage, Texas lets a member register as an individual transportation participant, and Vermont's hardship program covers members driving to their own care. Louisiana's fee schedule says Medicaid policy prohibits paying for an enrollee's self-transport, and Georgia's foster parent program excludes people driving themselves.

### How do I submit a Medicaid mileage reimbursement claim?

Book the trip with the broker first and write down the trip number. Take the trip log to the appointment and have the doctor or counselor sign it. Send the completed log by mail, email, or fax. Modivcare's standard instructions want the request made on or before the appointment day, the log received within 30 days, and one driver per form, and it pays within 30 business days.

### Can my NEMT company or my drivers use gas reimbursement?

No. MTM Health's Virginia handbook (approved August 10, 2026) says gas reimbursement is for a family member, friend, parent, or guardian using a personal vehicle, and is not available for contracted transportation providers or drivers. Louisiana treats gas reimbursement providers as individuals, separate from the nonprofit and for-profit providers it credentials. Bill your own trips under your provider codes.

### Is Medicaid mileage reimbursement the same as the IRS medical mileage rate?

Usually not. The IRS medical rate is a tax deduction rate: 20.5 cents a mile from January 1 to June 30, 2026, and 23.5 cents from July 1 to December 31, 2026. Medicaid programs set their own payment rates. CMS names the IRS mileage rate as one existing rate a state may rely on when it sets pay for unloaded miles and wait time.

## Official resources

- [CMS: Medicaid Transportation Coverage Guide (SMD 23-006)](https://www.medicaid.gov/federal-policy-guidance/downloads/smd23006.pdf)
- [Louisiana Medicaid: NEMT fee schedule, including the gas reimbursement rate](https://www.lamedicaid.com/provweb1/fee_schedules/NEMT_Rates.xlsx)
- [Modivcare: Oklahoma mileage reimbursement forms and instructions](https://www.modivcare.com/facilities/ok/)
- [Utah Medicaid: Non-emergency medical transportation and personal mileage](https://medicaid.utah.gov/non-emergency-transportation/)
- [Vermont DVHA: NEMT Program Manual (Hardship Mileage Reimbursement Program)](https://dvha.vermont.gov/sites/dvha/files/documents/Medicaid-NEMT-Program-Manual.pdf)
- [Wisconsin DHS: NEMT monthly performance reports](https://www.dhs.wisconsin.gov/nemt/reports.htm)
- [IRS: Standard mileage rates](https://www.irs.gov/tax-professionals/standard-mileage-rates)