Revenue per Vehicle Hour in NEMT: The Formula, Real Rates, and What Moves It

Two vans can run the same number of trips in a day and bring in very different money. Revenue per vehicle hour is the number that shows the difference. It ties what you billed to the hours you paid a driver and kept a van on the road.

How to calculate revenue per vehicle hour

Revenue per vehicle hour = revenue billed ÷ vehicle hours

Pick a period, such as a day, a week, or a month, and use the same one every time. Then fill in each half carefully.

Revenue billed. Count completed trips only, at the amount each payer actually pays: the fee schedule rate, your broker’s rate, or your private pay price. Leave out trips that were denied, and count a claim again only when it is paid on appeal. Add any payments for extras, such as wait time or an escort, where the payer pays them.

Vehicle hours. Count every hour a van is out with a driver on the clock, from clock-in to clock-out. That includes the drive to the first pickup, waits at clinics, gaps between trips, and the drive home. You pay for those hours. Under federal wage rules, an employee who waits while the employer controls the time is working (29 CFR 785.15).

A quick example: a wheelchair van billed $1,200 in a week, and its driver was on the clock 45 hours. Its revenue per vehicle hour was $1,200 ÷ 45 = $26.67.

Vehicle hours and revenue hours are not the same

Transit agencies report to the National Transit Database, and its definitions differ from the ones above. Its field definitions, in the 2022 to 2024 annual data, draw the line this way:

Measure	Includes	Leaves out
Vehicle revenue hours	Time in revenue service, plus layover and recovery time	Deadhead, operator training, maintenance testing, school bus and charter service
Actual vehicle hours	Revenue hours plus deadhead hours	Charter, school bus, training, maintenance testing
Deadhead	Leaving or returning to the garage, changing routes, and any time with no expectation of carrying passengers	Trips to fueling or maintenance facilities

The gap is real. Among the larger public demand response (dial-a-ride) services that reported both numbers for 2024, vehicle revenue hours were about 83 percent of all vehicle hours, and deadhead was the other 17 percent. So a per revenue hour figure from transit runs higher than the same service measured per clock hour. Measure your own vans per clock hour, because that is what you pay for.

What one trip pays by level of service

Level of service sets the base rate, and base rates differ widely. Here is what a 10-mile loaded trip pays under Arizona’s fee-for-service rates, effective October 1, 2026. Arizona pays higher rural rates, billed with the TN modifier, for trips that start outside the Phoenix and Tucson metro areas.

Level of service	Codes billed	Urban trip	Rural trip (TN)
Mini-bus or other transportation system	A0120 base plus S0215 per mile	$6.64 + $12.80 = $19.44	$7.27 + $16.30 = $23.57
Wheelchair van	A0130 base plus S0209 per mile	$11.15 + $15.40 = $26.55	$12.21 + $16.60 = $28.81
Stretcher van	T2005 base plus T2049 per mile	$49.09 + $15.40 = $64.49	$86.70 + $16.60 = $103.30
Waiting time	T2007 per half hour	$4.59, or $9.18 an hour	$4.59, or $9.18 an hour

Arizona pays loaded miles only, and its manual (revised July 31, 2026) bars any claim for unloaded mileage. Your own rates depend on your state and your broker or health plan agreement, so rebuild this table with the rates you are paid. See loaded miles and level of service.

A worked example: one wheelchair van, one shift

This example uses the urban Arizona wheelchair rates above. The shift length, trip counts, and miles are example numbers, not averages from any program.

Scenario for an 8-hour shift	Completed trips	Revenue billed	Revenue per vehicle hour
Base day: 8 trips of 10 loaded miles	8	8 × $26.55 = $212.40	$26.55
Two riders no-show, and nothing fills the time	6	6 × $26.55 = $159.30	$19.91
Two extra trips fit in, shared with riders already aboard	10	10 × $26.55 = $265.50	$33.19
Four long trips of 30 loaded miles instead	4	4 × ($11.15 + $46.20) = $229.40	$28.68

Three lessons come out of the table:

1. A no-show costs the whole hour. CMS says Medicaid does not pay for a trip when the rider does not show, and no-load miles generally cannot be paid, though states may build their cost into rates (SMD 23-006, September 28, 2023). See no-show.
2. Shared rides raise the number fastest. Arizona’s manual calls for a separate trip report for each member on a shared ride, with that member’s own pickup, drop-off, and direct-route miles, and its fee schedule lists no reduced rate for the extra rider.
3. Paid waiting beats an empty hour but not a loaded one. Two hours of paid waiting in Arizona bill 4 units, or $18.36. Two 10-mile wheelchair trips in the same time bill $53.10. Arizona pays wait time only when the distance made returning to base impractical. It does not pay for waits under 30 minutes, one-way trips, trips of 10 miles or less, round trips run with two vehicles or drivers, or waits where the odometer changes. See NEMT wait time billing.

What moves revenue per vehicle hour

Lever	Why it moves the number	What to do
Trip mix by level of service	Base rates differ several times over between levels	Know which levels your vans and drivers can run, and fill open hours with the higher-paying ones you are credentialed for
Loaded miles per trip	Mileage pays only with a rider aboard, on top of the base	Compare trips by pay per hour, not per trip. In the example above, four long trips beat eight short ones.
Empty miles	They take time and pay nothing	Group trips by area and time. See deadhead miles.
Shared rides	Some payers bill each rider separately	Pair riders going the same way where your payer allows it. MTM Health’s Virginia handbook caps extra ride time at 45 minutes over the average direct trip.
Extra-rider rules	Some payers pay the second rider less	South Dakota’s July 1, 2026 schedule pays an additional rider about half the base, such as $2.60 on a $5.20 in-city community trip, and one mileage allowance per trip. See the TK modifier.
No-shows and late cancellations	The hour is spent and nothing is billed	Confirm every ride the day before
Unpaid waits	You pay the driver while nothing is billed	Plan will-call returns before the day starts. See will-call trip.
Denied claims	Revenue you counted never arrives	Check each trip record before billing

How to read your number

There is no official NEMT standard for revenue per vehicle hour. Read it against three things:

• Your cost per vehicle hour. Take a month of one van’s costs, including driver pay and payroll taxes, fuel, insurance, the van payment, and repairs, and divide by that van’s vehicle hours. Revenue per hour below that line means each hour loses money. The profit per vehicle calculator does the math.
• Trips per vehicle hour. Revenue per hour tells you how much each hour earned, and trips per vehicle hour tells you how busy it was. A van with a high trip count and low revenue is usually running short, low-paying trips. A van with few trips and high revenue is usually running long or stretcher trips.
• Its own trend. Compare each van with its last four to eight weeks, not with one good day.

Public transit gives a sense of scale. Across all demand response services reporting to the National Transit Database for 2024, total operating expenses of $7.06 billion over 72.6 million vehicle revenue hours came to about $97 per revenue hour. Those services share rides by design, carry about 1.9 passengers per revenue hour, and include agency overhead in their costs, so treat the figure as context, not a target.

For the full weekly scorecard, see NEMT KPIs. For ways to push the number up, see how to increase NEMT profit and NEMT cost per trip.