# What Is a No-Show in NEMT? Wait Times, Contact Steps, and Who Is at Fault

Canonical URL: https://nemtguide.com/glossary/no-show/ · Updated 2026-09-28

A no-show in NEMT is a scheduled ride where the rider is not at the pickup, or will not board, within the required wait after the pickup time. The state or broker sets the wait: 10 minutes in Texas and Georgia, 15 minutes in New York. Before leaving, the driver tries to reach the rider and reports the no-show to dispatch.

- A rider no-show means the rider was not there, or would not board, after the driver arrived on time and waited the full time.
- The wait counts from the scheduled pickup time, not from when the driver pulls up early.
- Brokers such as MTM Health and MediTrans ask the driver to call or text the rider before leaving, and MediTrans and CareOregon also want a call to dispatch.
- A provider no-show is the opposite: the vehicle never came, and brokers count it against you.
- Federal Medicaid funds do not pay for a ride that did not happen, and the rider cannot be charged for it.

## What counts as a no-show

A no-show, in NEMT, is a scheduled ride the rider misses. The vehicle arrives on time, the driver waits the required time, and the rider is not there or will not get in. Programs word it a little differently:

- **Texas.** The HHSC NEMT Services Handbook (Uniform Managed Care Manual Chapter 16.4, version 2.0.1) defines a member no-show as "a trip when the provider waits for the Member ten (10) minutes beyond the scheduled pick-up or return time."
- **Oregon.** CareOregon's provider manual (version 1.3, February 2024) calls it "a situation during which a member is not at the pickup location as arranged in the scheduled ride."
- **Louisiana.** The Medicaid manual (Chapter 10, issued July 14, 2025) has each broker set a protocol for no-shows, "when the beneficiary is not present for pick-up at the specified location."
- **Georgia.** The NEMT manual (July 1, 2026) describes a member who "fails to board the vehicle" within the time the pickup standards allow.

In practice, three things must all be true before a trip is a rider no-show:

1. **You arrived on time.** Georgia's broker pays for the "A" leg, the first leg of a no-show trip, only if the provider arrived on time.
2. **You waited the full required time.** The clock starts at the scheduled pickup time.
3. **The rider was not there, was not ready, or would not board.**

Some other cases count too. MTM Health's Missouri and Wisconsin provider pages put a no-show and a rider who "cancels at the door during pick-up" in one question, under the same rule: no pay for no-shows. In Texas, if a child needs a car seat and the parent has none or cannot install it, the trip is canceled and recorded as a member no-show.

A no-show is not the same as a late cancellation, which comes before the driver arrives. It is also not a missed trip, where your vehicle never came.

## How long the driver must wait

Each state or broker sets the wait. Your broker agreement is the rule you follow, and it can be stricter than the state's.

| Program | Required wait | What the driver does before leaving |
|---|---|---|
| Texas Medicaid health plans (HHSC Chapter 16.4, as of September 2026) | At least 10 minutes after the scheduled pickup or return time | Tells the member the ride has arrived. Every no-show is documented. |
| Georgia Medicaid (DCH manual, July 1, 2026) | Not required to wait more than 10 minutes after the scheduled pickup time | If early, the 10 minutes start at the scheduled time. |
| New York Medicaid (manual effective August 25, 2023) | At least 15 minutes after the scheduled pickup time | Documents every no-show. The driver's trip record notes the no-show. |
| CareOregon, Oregon (manual version 1.3, February 2024) | At least 15 minutes after the scheduled pickup time | Makes their presence known, tries to reach the member, and tells dispatch before leaving. |
| MediTrans, Louisiana (September 2026) | 15 minutes at a home, 20 minutes at a facility | Calls the member at the number on file, calls dispatch, and marks the no-show in the portal with the time. |
| MTM Health, Virginia (handbook approved August 10, 2026) | The pickup window runs from 15 minutes before to 15 minutes after the scheduled time | Follows MTM's no-show steps and tries the member by phone or text before leaving. |
| Modivcare SoonerRide, Oklahoma (September 2026) | Up to 15 minutes from the pickup time | Members are told to be ready 15 minutes before the pickup time. |

Arriving early never shortens the wait. Georgia's manual says so directly. MTM Health's Virginia handbook says a member may not be required to board before the scheduled pickup time, and CareOregon says drivers cannot make a member leave earlier than scheduled. See pickup window for how on-time arrival is measured.

## The steps before you mark a no-show

Follow the same steps every time, so your record shows each one:

1. **Arrive inside the pickup window and mark your arrival.** MediTrans has drivers mark "Arrived" in its portal when they reach the pickup.
2. **Make your presence known.** Texas requires the driver to tell the member the ride has arrived. CareOregon has drivers make their presence known.
3. **Wait the full time,** counted from the scheduled pickup time.
4. **Call or text the rider.** MTM Health in Virginia and MediTrans both ask for an attempt to reach the member before leaving.
5. **Call dispatch before you drive away.** CareOregon says drivers may not leave a pickup without telling dispatch of the no-show. At a stop with wait time, its brokerage may approve a longer wait or confirm the no-show.
6. **Mark the no-show with the time.** Use the broker portal or app the way your broker requires.
7. **Keep the record.** Note your arrival time, the calls you made, and who you spoke with. New York requires trip records, including the driver's no-show note, to be kept for six years from the date of payment.

The [no-show policy template](https://nemtguide.com/templates/nemt-no-show-policy/) turns these steps into a written policy for your drivers. The [trip documentation guide](https://nemtguide.com/guides/nemt-trip-documentation/) covers the full record.

## Rider no-show, late cancellation, and provider no-show

| Term | What happened | Whose miss it is |
|---|---|---|
| Rider no-show | The rider was not there or would not board after an on-time arrival and the full wait | The rider's |
| Cancel at the door | The rider cancels when the driver arrives | The rider's. MTM Health handles it like a no-show. |
| Late cancellation | The rider cancels after the notice deadline, before the driver arrives | The rider's. Rules differ by broker. |
| Provider no-show, or missed trip | Your vehicle never arrived | Yours |

This split matters because brokers score you on your misses, not the rider's. CareOregon's manual says brokerages must tell member no-shows apart from provider no-shows, and providers are not held accountable for member no-shows. MTM Health's Virginia handbook holds vendor no-shows under 0.25 percent of trips. A clean record of each rider no-show is what keeps it from counting as yours.

## Does a no-show get paid?

Usually not. Federal Medicaid funds do not pay for transportation to a rider who does not appear (CMS SMD 23-006, September 28, 2023). Louisiana's manual says scheduled trips with no transport are not billable, and Texas Medicaid's Medical Transportation Program handbook (September 2026) says providers cannot bill Texas Medicaid or its clients for missed appointments. MTM Health's Missouri and Wisconsin pages say it does not pay providers for no-shows.

There are exceptions. Georgia's manual has the broker pay for the "A" leg when a member fails to board and the provider arrived on time. Medi-Cal fee-for-service lets ground providers bill a dry run, with modifiers DS and QN, when they respond but do not carry the rider. The [guide to billing for no-shows](https://nemtguide.com/guides/billing-for-no-shows/) covers the details, and the no-show cost calculator shows what they cost you each month.

## What happens to a rider after repeated no-shows

CMS says states may not deny rides because of no-shows or lateness, even when they happen often. States may add steps for those riders instead, such as requiring them to confirm the ride the night before or the morning of. CMS says the state should send the rider a letter before it limits rides in any way.

Programs apply that in their own ways:

- **Georgia.** After a member has at least two no-shows, late arrivals for pickup, or cancellations at pickup, the broker sends a warning letter by certified mail. Members have the right to at least two warning letters before any action.
- **Oklahoma.** Modivcare's SoonerRide page says a member with three no-shows in 90 days risks being placed on mileage reimbursement only.

Your part is prevention. MTM Health's Missouri and Wisconsin pages ask providers to confirm each ride with the member the day before, and to make sure the trip is canceled if the member will not be going. The [guide to reducing NEMT no-shows](https://nemtguide.com/guides/how-to-reduce-nemt-no-shows/) has more.

## Frequently asked questions

### How long does a NEMT driver have to wait before a no-show?

It depends on the program. Texas Medicaid health plans require at least 10 minutes after the scheduled pickup time, and Georgia's manual says the driver need not wait more than 10 minutes. New York and CareOregon in Oregon require at least 15 minutes. MediTrans in Louisiana asks for 15 minutes at a home and 20 at a facility. Your broker agreement sets the rule you follow.

### Does the wait start when I arrive early?

No. Georgia's NEMT manual (July 1, 2026) says that if the provider arrives early, the 10-minute wait starts at the scheduled pickup time. MTM Health's Virginia handbook says members may not be required to board before the scheduled pickup time. Arriving early is fine, but the no-show clock runs from the time on the trip.

### Can a NEMT company charge a Medicaid rider a no-show fee?

No. CMS says states and providers may not impose a charge on a Medicaid member for a no-show (SMD 23-006, September 28, 2023). A Medicaid provider accepts the Medicaid payment as payment in full under 42 CFR 447.15. No-show fees belong only in private-pay policies, for riders and payers outside Medicaid.

### Is a cancellation at the door a no-show?

Usually it is treated like one. MTM Health's Missouri and Wisconsin pages answer "a no show or cancels at the door during pick-up" as one question, and the answer is that MTM does not pay providers for no-shows. Georgia counts a reservation canceled at the time of pickup along with no-shows when it sends warning letters to riders. A cancellation made before the driver sets out is a cancellation or a late cancellation instead.

### What is the difference between a no-show and a missed trip?

A no-show is the rider's miss: the vehicle came and the rider was not there. A missed trip, or provider no-show, is yours: the vehicle never arrived. Texas defines a provider no-show as a provider failing to show up for a scheduled pickup or return. Brokers track provider no-shows as a performance measure, and MTM Health's Virginia standard is under 0.25 percent of trips.

## Official resources

- [CMS: Medicaid Transportation Coverage Guide (SMD 23-006)](https://www.medicaid.gov/federal-policy-guidance/downloads/smd23006.pdf)
- [Texas HHSC: NEMT Services Handbook, Uniform Managed Care Manual Chapter 16.4](https://www.hhs.texas.gov/sites/default/files/documents/16-4.pdf)
- [New York Medicaid: Transportation Policy Manual](https://www.emedny.org/ProviderManuals/Transportation/PDFS/Transportation_Manual_Policy_Section.pdf)
- [MTM Health: Virginia transportation provider handbook](https://www.mtm-inc.net/wp-content/uploads/2018/12/VA-Provider-Handbook-2026.pdf)