NEMT vs NMT: How Medical and Non-Medical Transportation Differ

What NEMT and NMT each mean

The two terms overlap, and each one means something different depending on who is paying. Federal Medicaid rules require every state to ensure necessary transportation to and from providers (42 CFR 431.53). They define that transportation broadly: the cost of travel by ambulance, taxicab, common carrier, or other appropriate means, plus meals, lodging, and an attendant when needed (42 CFR 440.170(a)). The same rule lists wheelchair vans, taxis, stretcher cars, and bus passes and tickets among the rides a state broker may arrange. So NEMT in the federal sense covers every Medicaid ride to medical care, from a taxi to a stretcher car. See what NEMT is for the basics.

“NMT” is where the meanings split.

Term	Where you see it	Where the ride goes	Who qualifies	The rule behind it
NEMT	Every state’s Medicaid program	Covered medical care	Medicaid members who need a ride, at the level of service they need	42 CFR 431.53 and 440.170(a)
NEMT in Medi-Cal	California	Covered medical care	Members whose condition rules out an ordinary car, taxi, or bus	22 CCR 51323
NMT in Medi-Cal	California	Covered Medi-Cal services, plus prescription and medical supply pickups	Members who attest they have no other reasonable way to get there	Welfare and Institutions Code 14132(ad)
Waiver NMT	States with home and community-based services waivers	Jobs, day programs, and community activities in the service plan	People enrolled in the waiver	Each waiver’s service definition
Transportation for non-medical needs	Medicare Advantage plans that choose to offer it	Grocery stores, banks, and similar errands	Chronically ill members who qualify	CMS guidance of April 24, 2019

How Medi-Cal splits NEMT and NMT

California uses NEMT for the rides that need special vehicles. Medi-Cal covers ambulance, litter van, and wheelchair van rides only when an ordinary car, taxi, or public transportation is medically ruled out (22 CCR 51323). A wheelchair van fits a rider who cannot sit in a private car or taxi and needs a wheelchair or help between home, vehicle, and the place of treatment. Nonemergency rides need a prescription from a physician, dentist, or podiatrist and prior authorization, except a move from an acute hospital stay straight to a nursing facility, and approval goes only to the lowest cost type of ride that meets the rider’s needs. Medi-Cal health plans arrange NEMT from a Physician Certification Statement that the rider’s provider fills out, good for up to 12 months, and neither the plan nor its broker may change the mode it names (All Plan Letter 22-008, May 18, 2022).

NMT covers the rest. State law defines it as round-trip transportation to covered Medi-Cal services by passenger car, taxicab, or any other public or private conveyance. It also covers mileage when the member arranges a private car, and bus passes, taxi vouchers, and train tickets (Welfare and Institutions Code 14132(ad)). NMT never includes a rider who needs an ambulance, litter van, or wheelchair van. The plan letter adds that NMT also covers trips to pick up prescriptions that cannot be mailed and medical supplies or equipment, but never trips to non-medical places.

Who books each ride

For a member of a Medi-Cal health plan, the plan provides NMT. For a fee-for-service member, the state provides it. Plans can split the two between vendors:

• Inland Empire Health Plan began managing all NEMT trips itself on May 12, 2026, while Call the Car keeps coordinating NMT (IEHP provider notice, May 11, 2026). See IEHP and Call the Car.
• Partnership HealthPlan of California runs its own Transportation Services Department for NEMT, NMT, and gas mileage reimbursement, and asks members to call at least 5 days ahead (member transportation page, September 2026). See Partnership HealthPlan.

A billing example: one 10-mile trip, two ways

Here is one 10-mile one-way trip under Medi-Cal fee-for-service maximum allowances. Medi-Cal pays your usual charge to the public, up to these amounts (rate pages updated August 2020 and September 2023).

	NMT in a sedan	NEMT in a wheelchair van
Base code and maximum	A0120, $17.65	A0130, $20.30
Mileage code and maximum	A0390, $1.30 a mile, so $13.00	A0380, $1.50 a mile, so $15.00
Most the trip can pay	$30.65	$35.30
Paperwork before the ride	The rider’s written or verbal attestation, kept in the rider’s file	A prescription and an approved Treatment Authorization Request
Limit	Eight A0120 units a month, unless the claim shows the rides were needed for Medi-Cal care	The authorization

An NMT attestation can cover one trip or up to one month of regular rides. After each month, the rider completes a new one. Medi-Cal health plans set their own rates, so treat these numbers as a reference point, not a plan’s rate.

Waiver NMT: rides to the rest of life

In a Medicaid home and community-based services waiver, non-medical transportation takes a participant to waiver services and to community services, activities, and resources in the service plan. CMS’s core definition says it comes on top of the state’s medical transportation and never replaces it. Free help from family, neighbors, friends, or community agencies is used whenever possible (1915(c) technical guide, version 3.6, January 2019).

Three rules shape the work:

1. No medical trips. A waiver member’s ride to state plan medical care is billed as state plan transportation or an administrative cost, never as waiver NMT.
2. No double billing. When another service’s rate already includes transportation, such as adult day health, the state must stop the same ride from also being billed as NMT.
3. The service plan rules. Only rides the plan authorizes are paid.

Ohio is one example. Its developmental disabilities waiver rule, effective January 2, 2025, defines NMT as rides to a job, an adult day or employment support site, a volunteer activity, a post-secondary education program, or an internship (Ohio Administrative Code 5123-9-18). Providers are paid per trip or per mile in modified or regular vehicles. A modified wheelchair vehicle must be checked by its first driver each day it is used, and the check is written down. For how to enroll in a waiver and what it pays, see how to become a waiver transportation provider and 1915(c) waiver.

Medicare Advantage rides for non-medical needs

Medicare Advantage plans may offer extra benefits to chronically ill members, and one of them is transportation for non-medical needs. CMS describes it as rides to get non-medical items and services, such as grocery shopping and banking, and rides tied to other extra benefits. A plan may reimburse it, arrange it, or provide it directly (HPMS memo, April 24, 2019). Each plan decides whether to offer it and who qualifies, so ask the plan. See Medicare Advantage transportation.

What changes for your company

	Medi-Cal NEMT	Medi-Cal NMT	Waiver NMT
Vehicle	Wheelchair van, litter van, or ambulance equipped under state rules	Passenger car with DMV registration and insurance	Set by the waiver rule. Ohio allows regular or modified vehicles.
Help from the driver	Help between home, vehicle, and treatment when the rider needs it	A rider who uses a wheelchair must be able to walk without the driver’s help	Set by the waiver
Before the ride	Prescription or Physician Certification Statement, plus approval	Rider’s attestation	Authorization in the service plan
How you enroll	The Medi-Cal transportation application package	Add NMT with form DHCS 6209, or apply new with DHCS 6206, 6207, and 6208 and the fee	The agency that runs the waiver
Who sends trips	The health plan or its broker for plan members, the state for fee-for-service members	The health plan or its broker for plan members, the state for fee-for-service members	Only rides in the participant’s service plan are paid

A company new to Medi-Cal that wants only NMT files the full transportation package: the Medical Transportation Provider Application (DHCS 6206), the Disclosure Statement (DHCS 6207), the Provider Agreement (DHCS 6208), and the application fee. The Medi-Cal manual lists what to attach for each car and driver: registration, proof of insurance, each driver’s license and DMV record, and the MCSA-5875 and MCSA-5876 medical examination forms. For the rest of the state’s rules, see the California guide.