S0215 Billing Code: NEMT Mileage per Mile, Ambulatory Rides, and State Rates

What S0215 means

CMS lists S0215 in the national HCPCS code set as “Non-emergency transportation; mileage, per mile.” The October 2026 quarterly file shows it has been in the code set since 2002, with coverage code I, which means Medicare does not pay it.

Like S0209, it 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 it anyway, so each one decides which rides may use it, what it pays, and which modifiers go with it.

One unit is one mile, and only loaded miles count. The descriptor names no vehicle. That is the difference from the vehicle mileage codes: S0209 is for wheelchair vans and T2049 is for stretcher vans. In practice S0215 usually carries the miles of rides for riders who can walk, after a base code such as A0100 (taxi), A0120 (mini-bus or other transportation system), or T2003 (per trip).

Which states pay S0215 for walk-on rides

These are fee-for-service rates from each state’s own schedule. Brokers and health plans pay their own contract rates.

Program	S0215 per mile	What the schedule pairs it with	Effective
Arizona AHCCCS	$1.28, or $1.63 with TN outside the Phoenix and Tucson areas	The same schedule lists A0100 and A0120 base codes. Rideshare companies get $0.67, or $0.92 with TN, on the health plans’ capped schedule.	October 1, 2026
Nebraska Medicaid	$1.85	The same schedule lists T2003 at $19.69 per trip, and every base rate includes the first five loaded miles	July 1, 2026
North Dakota Medicaid	$0.72	The July 1, 2025 schedule listed S0215 right after the taxi code, for miles greater than 15, at $0.70	July 1, 2026
South Dakota Medicaid	$1.04	Community transportation by taxi (A0100) or mini-bus (A0120), only on trips outside the city of 21 miles or more one way	July 1, 2026
New York Medicaid	Set by county, for the taxi, livery, and van category	New York City $2.93, Nassau $3.62, Suffolk $3.87, Monroe $3.47, Albany $1.34	Fee schedule dated April 5, 2026

North Dakota’s current schedule does not repeat the 15-mile note. Ask the state which miles its $0.72 rate covers before you bill.

New York’s fee schedule says its 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. The county rates above are the plain lines with no modifier. Several upstate lines date from December 31, 2022, and the New York City, Nassau, and Suffolk lines from April 1, 2022. See the New York state guide.

Programs that bill walk-on miles another way

Many programs do not use S0215 for walk-on rides. Billing it there gets the line denied.

Program	How it pays walk-on miles	Effective
Indiana	A0425 with U3 at $1.67 a mile, after the first 10 miles of each one-way trip. S0215 is nonreimbursable.	Module version 6.1, August 19, 2025. Rate January 1, 2026.
Illinois	A0425 at $0.91 a mile for taxis and $1.03 for service cars in Cook, DuPage, Kane, Lake, McHenry, and Will counties	January 1, 2026
Louisiana	T2003 at $13.50 per trip leg plus $1.10 a mile from mile zero, both on the T2003 line of the schedule	Schedule effective October 1, 2025
Texas fee-for-service	T2003 is the recommended code for demand response rides, and the handbook lists no mileage code for them	September 2026 handbook
Oregon Health Plan	Lists S0215 as ground mileage for non-emergency ambulance trips, and A0100 for sedan and taxi rides	Guide last updated December 22, 2025

If your fee schedule has no S0215 line for your provider type, bill the mileage code it lists. See NEMT billing codes.

Other uses of S0215

Because the descriptor is general, two states use S0215 outside the usual walk-on ride.

• Texas mileage paid to individuals. The Medical Transportation Program handbook (September 2026) lists S0215 as the recommended code for individual transportation participants. These are family members, friends, neighbors, or riders who drive their own car. They register with TMHP but do not enroll as Medicaid providers, and they mail the H3017 service record within 95 days of the ride. See Medicaid mileage reimbursement.
• Nevada secure behavioral health rides. Under Nevada Medicaid’s billing guide (updated July 27, 2026), a non-emergency secure behavioral health transport goes on two lines: T2003 with 1 unit, then S0215 with one unit per mile, both with the UA modifier. Only providers enrolled as provider type 35, specialty 987, may bill them.

How to count S0215 miles

Each payer counts and limits the miles its own way. These rules decide your units.

Program	Rule
Arizona	Drop-off odometer reading minus pickup odometer reading, on the AHCCCS Daily Trip Report. Trips go on line 1 and loaded miles on line 2 of the same claim.
New York	Tenths of a mile since August 1, 2019. Rounding up may be treated as fraud. On a shared ride, the miles from the first pickup to the last drop-off go on the first rider’s claim.
South Dakota	Whole miles rounded to the nearest mile, one mileage allowance per trip however many riders are on board.
North Dakota	Map miles from the pickup to the medical or dental facility.
Nebraska	Loaded mileage pays when the trip is six miles or more. The first five loaded miles are part of the base rate.

Miles you drive with no rider on board are deadhead miles and are not billable on S0215. For the full method, see NEMT mileage billing.

Modifiers used with S0215

The official meanings come from the October 2026 HCPCS file. Each state decides which ones it accepts.

Modifier	Official meaning	How a state uses it with S0215
TN	Rural/outside providers’ customary service area	Arizona: trips that start outside the Phoenix and Tucson metro areas pay $1.63 instead of $1.28
UA	Medicaid level of care 10, as defined by each state	Nevada: required on both the T2003 and S0215 lines of a secure behavioral health transport
TK	Extra patient or passenger, non-ambulance	South Dakota puts TK on the A0100 or A0120 line for an extra rider and still pays one S0215 allowance per trip

New York lists other modifiers on S0215 by county, and its schedule warns that they may not match their usual meaning. Use only the modifiers on your own schedule. See U modifiers.

Worked examples

These use each state’s published rates. The trips and distances are example numbers.

Program and trip	Base line	S0215 line	Total
Arizona, outside the Phoenix and Tucson areas, 20 loaded miles one way by mini-bus	A0120 TN: $7.27	20 x $1.63 = $32.60	$39.87
South Dakota, 30 miles one way outside the city, one rider	A0120 TN: $7.80	30 x $1.04 = $31.20	$39.00
South Dakota, same trip with a second rider	Add A0120 TN TK: $3.90	No second mileage line	$42.90
Nebraska, 14 loaded miles on a T2003 trip	T2003: $19.69	9 paid miles x $1.85 = $16.65	$36.34

Nebraska’s base rate already covers the first five loaded miles, so only miles 6 through 14 pay. Ask Nebraska Medicaid or your health plan how to enter the units, and confirm that its schedule pairs S0215 with your trip code.

Mistakes that get S0215 lines denied

• S0215 where the state does not pay it. Indiana calls it nonreimbursable, and Illinois uses A0425.
• S0215 on a wheelchair or stretcher van trip. Those miles go on S0209 or T2049 where the state uses them.
• Short trips in South Dakota. S0215 pays only on trips outside the city of 21 miles or more one way.
• Miles for every rider on a shared ride. Most programs pay one set of miles per trip.
• Rounded-up miles in New York. Report tenths of a mile.
• Base and miles on separate claims. Arizona denies split billing.

For fixes, see NEMT claim denials.