Billing codes
S0209 Billing Code: Wheelchair Van Mileage, Units, Modifiers, and State Rates
S0209 is the HCPCS code for wheelchair van mileage: one unit for each loaded mile, billed on its own line after the A0130 wheelchair van base charge. Medicare does not pay it, so each state sets the rate. Arizona pays $1.54 a mile in the Phoenix and Tucson areas from October 1, 2026, Nebraska $1.85 and North Dakota $2.57 from July 1, 2026.
- S0209 pays the loaded miles of a wheelchair van trip, one unit per mile, on the line after A0130.
- Medicare does not pay S0209, so your state Medicaid program, health plan, or broker sets the rate and the rules.
- On the state schedules below, the standard S0209 rate runs from $1.30 a mile in Ohio to $4.50 in Broome County, New York, as of 2026.
- Indiana, Illinois, and Medi-Cal bill wheelchair van miles with ambulance mileage codes instead, so check your fee schedule first.
- Payers count miles differently: tenths of a mile in New York, whole miles past city limits in South Dakota, and miles after the first five in Nebraska.
What S0209 means
CMS lists S0209 in the national HCPCS code set as “Wheelchair van, mileage, per mile.” The October 2026 quarterly file shows it was added on January 1, 2002, with coverage code I, which means Medicare does not pay it.
S0209 is an S code. The CMS file’s processing note says S codes were set up by private insurers for private payer use and are not valid for Medicare. State Medicaid programs adopted S0209 anyway, so its rate, units, and modifiers come from your state fee schedule, health plan, or broker contract.
The code pays distance, not the trip. One unit is one mile, and only loaded miles count: the miles with the rider on board. The trip itself goes on a separate base line, A0130, “Non-emergency transportation: wheelchair van.” Miles driven to the pickup or back to base are deadhead miles, and S0209 does not pay them.
How S0209 pairs with A0130
A wheelchair van claim usually has two lines: A0130 with the number of trips, then S0209 with the number of loaded miles. Arizona’s billing manual (revised July 31, 2026) puts the trips on line 1 and the miles on line 2, and it denies a claim that sends the base and the miles separately.
Not every program uses S0209 for wheelchair van miles. Use the mileage code on your own schedule.
| Program | Mileage code with A0130 | Effective |
|---|---|---|
| Arizona AHCCCS | S0209 | October 1, 2026 |
| Nebraska Medicaid | S0209 | July 1, 2026 |
| North Dakota Medicaid | S0209 | July 1, 2026 |
| South Dakota Medicaid (secure van) | S0209 | July 1, 2026 |
| Ohio Medicaid | S0209 | Appendix enacted July 10, 2026 |
| New York Medicaid (ambulette) | S0209, rate set by county | Fee schedule dated April 5, 2026 |
| Indiana Medicaid | A0425 with U5 for nonambulatory service | Module version 6.1, August 19, 2025 |
| Illinois Medicaid (medicar) | A0425 | January 1, 2026 |
| Medi-Cal | A0380, which Medi-Cal uses for wheelchair and litter van miles | Manual page updated August 2020 |
For the base rates that go with these miles, see the A0130 page and NEMT reimbursement rates.
S0209 rates by state
These are fee-for-service maximums from each state’s own schedule. Brokers and health plans pay their own contract rates, but the state rate is a useful benchmark when you negotiate.
| Program | S0209 per mile | Rule that changes the pay | Effective |
|---|---|---|---|
| Ohio | $1.30 | Pays the lower of your charge and the schedule amount | Amount dated January 1, 2024, in the appendix enacted July 10, 2026 |
| Arizona | $1.54, or $1.66 with TN outside the Phoenix and Tucson areas | Rideshare companies get $0.81, or $1.00 with TN, on the health plans’ capped schedule | October 1, 2026 |
| Nebraska | $1.85 | The base rate includes the first five loaded miles | July 1, 2026 |
| North Dakota | $2.57 | The July 1, 2025 schedule listed S0209 for miles greater than 15 | July 1, 2026 |
| South Dakota | $2.61 | Paid only outside city limits, counted from the point the trip leaves them | July 1, 2026 |
North Dakota’s current schedule does not repeat the 15-mile note, so ask the state which miles its $2.57 rate covers before you bill.
New York ambulette mileage by county
New York sets S0209 fees county by county. Its fee schedule, dated April 5, 2026, says the fees apply to the fee-for-service broker and may reflect network negotiations, that its modifiers may not match their usual use, and that other payers should not assume a service definition from its codes. Plain S0209 lines, with no modifier, for some counties:
| County | S0209 per mile | Since |
|---|---|---|
| Broome | $4.50 | June 21, 2024 |
| Saint Lawrence | $4.30 | May 30, 2024 |
| Onondaga | $3.75 | June 21, 2024 |
| New York City | $3.60 | April 1, 2022 |
| Westchester | $3.50 | August 16, 2024 |
| Nassau and Suffolk | $3.00 | May 20, 2024 |
| Albany, Erie, and Monroe | $3.00 | August 1, 2024 |
Other counties have their own lines and modifiers on the same schedule. See the ambulette page and the New York state guide.
Modifiers used with S0209
A modifier changes what the line means or what it pays. The official meanings below come from the October 2026 HCPCS file, and each state decides which ones it accepts on S0209.
| Modifier | Official meaning | How a state uses it with S0209 |
|---|---|---|
| TN | Rural/outside providers’ customary service area | Arizona: any trip that starts outside the Phoenix and Tucson metro areas pays $1.66 instead of $1.54 |
| U3 | Medicaid level of care 3, as defined by each state | Ohio: a wheelchair van service given in an ambulance vehicle, used only with A0130, S0209, and T2001 |
| U6 | Medicaid level of care 6, as defined by each state | Ohio: the medical service was not available when the van arrived |
| 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 |
| TK | Extra patient or passenger, non-ambulance | South Dakota puts TK on the A0130 line for an extra rider and pays one S0209 mileage allowance per trip |
Ohio’s appendix also lists the origin and destination pairs it pays on its wheelchair van codes without manual review. For the U modifiers in other states, see U modifiers.
How to count S0209 miles
Each payer measures and limits the miles its own way. These rules decide how many units you can bill.
| Program | How the miles are counted |
|---|---|
| Arizona | Drop-off odometer reading minus pickup odometer reading, on the AHCCCS Daily Trip Report. On a shared ride, each rider’s claim carries the direct-route miles between that rider’s own pickup and drop-off. |
| New York | Tenths of a mile since August 1, 2019. On a shared ride, the miles from the first pickup to the last drop-off go on the first rider’s claim only. |
| South Dakota | Whole miles, rounded to the nearest mile, only outside city limits, and one mileage allowance per trip however many riders are on board. |
| North Dakota | Map miles from the member’s pickup to the medical facility. You may bill for only one member per trip. |
| Ohio | Only the distance actually traveled. Miles more than 50 from the pickup are limited to 50 unless your records justify the distance, and shared miles are split in a reasonable, consistent way. |
| Nebraska | Loaded mileage is paid when the trip is six miles or more, and the first five loaded miles are included in the base rate. |
For the full method, see NEMT mileage billing.
Worked examples
These use each state’s published rates. The trips and distances are example numbers.
| Program and trip | Base line | S0209 line | Total |
|---|---|---|---|
| Arizona, Phoenix area, 8 loaded miles one way | A0130: $11.15 | 8 x $1.54 = $12.32 | $23.47 |
| Ohio, home to a doctor’s office, 12 loaded miles one way | A0130 with RP: $31.00 | 12 x $1.30 = $15.60 | $46.60 |
| Nebraska, 12 loaded miles one way | A0130: $46.12 | 7 paid miles x $1.85 = $12.95 | $59.07 |
| South Dakota, 30 miles one way, 22 of them outside city limits | A0130: $43.39 | 22 x $2.61 = $57.42 | $100.81 |
RP is Ohio’s origin and destination pair for residence to practitioner’s office. Nebraska’s base rate already covers the first five loaded miles, so only miles 6 through 12 pay. Ask Nebraska Medicaid or your health plan how to enter the units.
Mistakes that get S0209 lines denied
- The wrong mileage code. S0209 is not the wheelchair van mileage code in Indiana, Illinois, or Medi-Cal.
- Base and miles on separate claims. Arizona denies a base-only claim followed by a mileage-only claim.
- Empty miles. Driving to the pickup is not billable. North Dakota pays unloaded miles only with a written approval attached.
- Miles for every rider on a shared trip. Most programs pay one set of miles per trip.
- Rounded-up miles in New York. Report tenths of a mile.
- Miles inside South Dakota city limits. S0209 pays only from the point the trip leaves them.
- S0209 on a walk-on ride. A rider who can walk is billed at the ambulatory level in many states, with S0215 or another code for the miles.
For fixes and resubmissions, see NEMT claim denials and NEMT billing codes.
Frequently asked questions
What base code goes with S0209?
A0130, "Non-emergency transportation: wheelchair van," billed on the line before the miles. As of the dates on each schedule, A0130 pays $11.15 in urban Arizona (October 1, 2026), $18.05 in North Dakota and $46.12 in Nebraska (July 1, 2026), and $31.00 in Ohio (since January 1, 2024). Put the base and the miles on the same claim, because Arizona denies a base-only claim followed by a mileage-only claim.
Does Medicare pay the S0209 billing code?
No. The October 2026 CMS HCPCS file gives S0209 coverage code I, which means not payable by Medicare. Its processing note says S codes were created for private payers and are not valid for Medicare. Wheelchair van miles are paid by state Medicaid programs and the health plans and brokers that work for them.
Do I bill S0209 for the miles to the pickup?
No. S0209 counts loaded miles, with the rider on board. Ohio rule 5160-15-26 says travel to the pickup and from the drop-off is part of the service and is not paid separately. North Dakota pays unloaded miles only when the department approves them, and you attach the approval email to the claim.
How many S0209 units do I bill when two wheelchair riders share the van?
Usually one set of miles. South Dakota pays one mileage allowance per trip no matter how many riders are on board. North Dakota lets you bill for only one member. New York pays the miles from the first pickup to the last drop-off on the first rider's claim. Arizona is the exception: each rider's claim carries the direct-route miles between that rider's own pickup and drop-off.
Should I round S0209 miles up?
Only if your payer says so. New York has required loaded miles in tenths of a mile since August 1, 2019, and says rounded-up claims may be treated as fraud. South Dakota wants whole miles rounded to the nearest mile, with no decimals. Arizona takes the drop-off odometer reading minus the pickup reading.
Official resources
- CMS: HCPCS quarterly update files
- AHCCCS: Ground NEMT rates, effective October 1, 2026
- Nebraska DHHS: Medicaid provider rates and fee schedules
- North Dakota HHS: NEMT billing and policy manual
- South Dakota Medicaid: Transportation Services Fee Schedule
- Ohio: Appendix to rule 5160-15-28, transportation rates and modifiers
- eMedNY: NYS Medicaid Transportation Fee Schedule