Service levels and vehicles
What Is a Stretcher Van? Who Rides, How It Differs From an Ambulance, and Billing
A stretcher van is a non-emergency vehicle that carries a rider lying down on a secured stretcher. It serves people who cannot sit up for the trip but are stable and need no medical care on the way. It is not an ambulance: no emergency lights and no medical monitoring. Medicaid programs bill it as T2005, and Medicare does not pay for it.
- A stretcher van carries a stable rider lying down who needs no medical monitoring. A rider who needs care on the way belongs in an ambulance.
- It goes by other names: a litter van in California, a stretcher car in federal rules, and a stretcher ambulette in New York.
- Rules set the crew and the gear, such as two CPR-certified attendants in Illinois and a crash-tested stretcher mount in MTM Health's Virginia network.
- Trips bill T2005 plus mileage where covered: $109.66 in South Dakota (July 1, 2026), against $280.09 for a basic non-emergency ambulance trip.
- Louisiana, New Jersey, and Indiana fee-for-service do not use stretcher vans for NEMT, so check your state before you buy one.
What a stretcher van is
A stretcher van is a van equipped to carry a rider lying flat or reclined on a stretcher that is locked to the vehicle. It is non-emergency transportation: the rider is stable, and the crew gives no medical care on the way. MTM Health’s Virginia handbook (approved August 10, 2026) describes it as service for members who must travel lying down but do not need medical monitoring, and calls it nonemergency transportation distinct from ambulances.
Programs use several names for the same service:
| Name | Where it is used |
|---|---|
| Stretcher car | The federal NEMT brokerage rule, 42 CFR 440.170 |
| Stretcher van | Illinois licensing rules, Arizona, Virginia, and most fee schedules |
| Litter van | Medi-Cal in California |
| Stretcher ambulette | New York |
Some states license the vehicle separately from Medicaid. Illinois licenses stretcher van providers through its Department of Public Health, at $25 per vehicle, for a four-year license kept valid by a yearly inspection (77 Ill. Adm. Code 515.835, amended November 1, 2024). Illinois Medicaid then pays for the stretcher as an add-on to a medicar (wheelchair van) trip.
Who rides in a stretcher van
A stretcher van rider has to lie down for the trip and needs nothing more. Medi-Cal’s manual says a litter van is appropriate when the rider:
- must travel lying on their back or front, because they cannot sit for the length of the trip,
- needs special equipment or more space than a car, taxi, or public transit offers, and
- is stable and needs no constant observation, so does not need an ambulance’s services, equipment, or staff.
Its examples are a rider in a spica cast, a bed-bound rider, a stable rider after surgery who cannot sit upright for the trip, and a rider with a chronic condition who uses oxygen but needs no monitoring. New York’s policy manual describes the same rider: confined to bed, unable to sit in a wheelchair, and needing no medical attention or monitoring during transport.
Illinois lists who may not ride (77 Ill. Adm. Code 515.845):
- a rider going to a hospital for emergency treatment,
- a rider who needs active medical monitoring, including isolation precautions, oxygen that is not self-administered, continuous airway management, suctioning, or IV fluids on the way,
- a rider likely to have complications that need care on the way, and
- a rider whose condition keeps them from cooperating with the crew, such as some riders with dementia or a risk of wandering off.
Run a stretcher trip only when the stretcher level is on its authorization: MTM Health’s Virginia handbook bars changing the assigned mode without approval. CMS requires states to use the least costly mode that suits the rider’s condition (SMD 23-006, September 28, 2023), so a rider who can sit in a wheelchair for the trip goes by wheelchair accessible vehicle instead. Georgia’s broker must get a medical necessity certification or letter of medical necessity, and should have it in place before the third scheduled stretcher trip (manual version July 1, 2026). See medical necessity form.
Stretcher van vs ambulance
| Stretcher van | Non-emergency ambulance | |
|---|---|---|
| The rider | Stable, lying down, needs no monitoring | Needs monitoring or care on the way, or other transport is unsafe |
| Crew | Trained attendants: two in Illinois, a driver and an assistant in New York | An ambulance crew. Indiana requires two attendants on every ambulance. |
| Care on the way | None | Basic or advanced life support |
| Oxygen | Only oxygen the rider manages alone | Medi-Cal sends riders newly placed on oxygen, or who need it monitored, by ambulance |
| Markings | No red or blue emergency lights in Illinois. No ambulance wording or Star of Life in Virginia unless licensed by the state EMS office. | Licensed as an ambulance, such as by Virginia’s Office of Emergency Medical Services |
| Medicare | Not paid: T2005 and T2049 carry coverage code I | Covered when the patient’s condition makes other transport unsafe (42 CFR 410.40) |
| Billing codes | T2005 base, plus T2049 or another mileage code | A0428 basic life support base, plus A0425 mileage |
| South Dakota Medicaid rate, July 1, 2026 | $109.66, plus $2.61 a mile outside city limits | $280.09, plus $9.00 a mile |
Medicare’s rules show where the line sits. A patient counts as bed-confined only if they cannot get up from bed without help, cannot walk, and cannot sit in a chair or wheelchair. Even then, bed confinement is one factor in whether an ambulance is medically necessary, not the only one (42 CFR 410.40). The NEMT vs ambulance guide covers the handoff in more detail, and does Medicare cover NEMT covers Medicare riders.
What a stretcher van must carry
Two rule sets show what inspectors look for.
Illinois (77 Ill. Adm. Code 515.840). No sedans, limousines, recreational vehicles, or small SUVs, and room for two attendants and a direct view of the stretcher passenger. A wheeled litter at least 75 inches long and 22 inches wide, fastened with a crash-stable quick-release three-point fastener, and three sets of straps plus over-shoulder straps for the rider. A crash-stable bracket for each oxygen cylinder, voice contact with dispatch, a loading light, a 5-pound ABC fire extinguisher, two sets of pillows, sheets, and blankets, and no red or blue emergency lights. Only one stretcher passenger at a time.
MTM Health, Virginia (handbook approved August 10, 2026). A stretcher that meets GSA KKK-A-1822E and can hold the rider flat or in Fowler’s position (sitting partly up), with a non-porous mattress at least three inches thick and chest, hip, knee, and upper torso restraints with quick-release buckles. A crash-tested mount, with riders loaded headfirst. The rider’s own oxygen secured to AMD Standard 003, and a scoop, Reeves, or stair chair stretcher when the rider needs one. Inspections twice a year.
The stretcher van requirements guide compares more states. The stretcher chair and bariatric stretcher entries explain related equipment, and NEMT stretcher training covers the crew.
How stretcher van trips are billed
CMS lists T2005 as “Non-emergency transportation; stretcher van” and T2049 as “Non-emergency transportation; stretcher van, mileage; per mile.” Each program sets its own rate and rules.
| Program | Base | Mileage | Effective |
|---|---|---|---|
| Arizona AHCCCS fee-for-service | T2005: $49.09 in the Phoenix and Tucson areas, $86.70 elsewhere with TN | T2049: $1.54, or $1.66 with TN | October 1, 2026 |
| South Dakota | T2005: $109.66, plus $54.83 for each added rider with TK | T2049: $2.61, only outside city limits | July 1, 2026 |
| Medi-Cal litter van | T2005: $26.29, or $32.42 at night with UJ | A0380: $1.50 | Rate page updated September 2023 |
| Illinois, stretcher on a medicar trip | The A0130 medicar base of $30.00, plus T2005 for the stretcher: $9.31 in Cook, DuPage, Kane, Lake, McHenry, and Will counties, $11.64 elsewhere | A0425 on the medicar trip | January 1, 2026 |
| Indiana fee-for-service | Not covered | Not covered | Stretcher trips go directly to an enrolled ambulance provider for dates of service on or after July 1, 2023 |
Here is one trip worked through. A 20-mile stretcher trip that starts outside the Phoenix and Tucson areas bills T2005 TN at $86.70 and T2049 TN at 20 × $1.66 = $33.20, for $119.90 at October 1, 2026 rates. Medi-Cal adds a treatment authorization request with a prescription. See T2005 and T2049 for modifiers and more claim examples, and stretcher transport cost for private-pay pricing.
Where stretcher vans are not used for NEMT
- Louisiana. Its Medicaid manual lists stretcher vans among the vehicle types that are not allowed (section issued July 14, 2025).
- New Jersey. A licensed mobility assistance vehicle may not carry stretchers or riders who must travel lying down (N.J.A.C. 8:40). Under the same chapter, a basic life support ambulance carries a wheeled stretcher for them.
- Indiana fee-for-service. T2005 and T2049 are not covered, and stretcher trips are scheduled with ambulance providers outside the state’s broker.
Before you add stretcher service, confirm that your state and each broker you work with pay for it. The stretcher transportation business guide walks through the licensing, crew, and rate math.
Frequently asked questions
Is a stretcher van the same as an ambulance?
No. A stretcher van is non-emergency transportation for a stable rider who needs no care on the way. An ambulance carries a medical crew and equipment for riders who need monitoring or treatment. MTM Health's Virginia handbook (approved August 10, 2026) says stretcher vans are distinct from ambulances, may not carry anyone who needs basic or advanced life support, and may not show ambulance wording, the Star of Life, or emergency lights unless the provider holds a state EMS license.
Does Medicare pay for a stretcher van?
No. The October 2026 CMS HCPCS file gives T2005 and its mileage code T2049 coverage code I, not payable by Medicare. Medicare covers a non-emergency ambulance only when the patient's condition makes other transportation unsafe, and it counts bed confinement as one factor, not the only one (42 CFR 410.40). A stretcher van ride for a Medicare-only patient is paid by someone else, such as the rider, the family, or a facility.
Can a stretcher van carry a rider on oxygen?
Only oxygen the rider manages on their own. Illinois bars stretcher vans from carrying riders who need supplemental oxygen that is not self-administered. New York lets a stretcher ambulette carry a rider who self-administers oxygen, but its staff may not help with the supply and the vehicle may not carry oxygen supplies. MTM Health's Virginia handbook requires the rider's oxygen to be secured to AMD Standard 003.
How many staff ride on a stretcher van?
Usually two. Illinois requires at least two trained attendants, both CPR certified and trained on stretchers, with one staying with the passenger (77 Ill. Adm. Code 515.845, amended November 1, 2024). New York requires a driver and at least one assistant, who sits in the passenger compartment. Check your state and broker rules before you plan a one-person crew.
Does a stretcher trip need a doctor's order?
Often. Medi-Cal requires a treatment authorization request with a legible prescription for non-emergency medical transportation, except a transfer from an acute care hospital to a long term care facility. Georgia's broker must get a medical necessity certification or a letter of medical necessity, and should have it in place before the third scheduled stretcher trip (manual version July 1, 2026).