T2004 Billing Code: Commercial Carrier Multi-Pass, Transit Passes, and Extra Riders

What T2004 means

CMS lists T2004 in the national HCPCS code set as “Non-emergency transport; commercial carrier, multi-pass.” The October 2026 quarterly file shows it was added on April 1, 2002. It carries coverage code I, which means Medicare does not pay it, and the file sets no national rate, unit, or modifier.

The file never says what “multi-pass” means, so states read it two ways:

• A pass good for many rides, such as a monthly bus or transit pass. Utah’s and Montana’s waivers use it this way.
• One trip carrying more than one passenger. Indiana uses it this way, for the second and later riders on a shared trip.

Oregon uses it for a third thing, train travel, and New York lists it among its ambulette codes. Always read T2004 in your own state’s fee schedule. See NEMT billing codes for the codes around it.

Federal rules expect passes to be part of the mix. Under 42 CFR 440.170(a)(4), the transportation a state’s NEMT broker may provide includes “wheelchair vans, taxis, stretcher cars, bus passes and tickets.” CMS’s transportation guide (SMD 23-006, September 28, 2023) says states may claim federal funds for bus, rail, ferry, or other public transit passes, as long as a pass costs no more than the single trips it replaces.

How states use T2004

Program	What T2004 pays for	Rate	Effective
Indiana Medicaid fee-for-service	Each extra member on the same walk-on trip	$6.36, with no mileage or waiting time	January 1, 2026
Utah Waiver for Individuals 65 and Older	Non-medical transportation: a public transit pass, billed each, with U3 required	No maximum rate listed	January 1, 2026
Utah New Choices Waiver	A public transit pass, with the U8 modifier	No more than what the pass actually costs	Provider attachment posted May 20, 2024
Montana Developmental Disabilities Program	“Transportation OTHER (taxi, bus pass, misc),” with SC for self-directed services	At cost	July 1, 2025, kept in the draft for July 1, 2026
Oregon Health Plan	Train travel	Prior authorization required, as for all NEMT	Guide last updated December 22, 2025
New York Medicaid fee-for-service	Ambulette trips in three counties	$12.625 Nassau, $36.36 Wayne, $64.60 New York City with TN	Fee file dated April 5, 2026

Indiana’s T2004 rate was $6.19 in 2025. Indiana’s transportation rates change again on January 1, 2027, under bulletin BT2026143 (August 27, 2026), which moves the fee schedule to 100 percent of the January 1, 2026 Medicare rates for transportation. The state posts a preview NEMT fee schedule for 2027 in its fee schedules application, and its managed care plans must match the new rates by January 1, 2027.

Other codes states use for bus passes

Many programs bill passes and fares without T2004:

Program	Code	How it pays	Effective
Oregon Health Plan	A0120	City bus transit, bus tickets, or passes	Guide last updated December 22, 2025
Louisiana Medicaid	A0110	A daily or monthly pass, priced by location at the usual and customary cost	Rate dated October 1, 2015, on the schedule effective October 1, 2025
North Carolina Medicaid (county-run)	A0110	Bus fares on intrastate or interstate carriers, billed by the vendor	MA-2910 revised March 16, 2026
Indiana Medicaid fee-for-service	Enrolled bus or train company (specialty 262)	The fare charged to the general public. Monthly passes may be approved when cheaper than other rides.	Module version 6.1, published August 19, 2025

Fixed-route buses are not the same as the origin-to-destination service ADA paratransit provides. See paratransit vs NEMT.

Indiana: T2004 for extra riders on a shared trip

Indiana’s Transportation Services module (version 6.1, published August 19, 2025) pays for shared rides this way. When you carry two or more members at once, from the same county to the same area, such as different buildings on one medical campus, the first member pays in full. Each additional member pays half the base rate, with no mileage or waiting time.

Type of ride	First member	Each additional member
Walk-on (commercial ambulatory)	T2003 base, A0425 U3 mileage, T2007 U3 waiting time if it applies	T2004 base only
Wheelchair (nonambulatory)	A0130 base, A0425 U5 mileage, T2007 U5 waiting time if it applies	A0130 TT base only

The module adds four rules:

• No shared-ride pay for ambulances or family-member vehicles.
• No extra pay when you do not charge your other customers for extra passengers.
• XE, not 59: if the same member has a solo trip (T2003) and a shared trip (T2004) on the same day, bill the shared trip with the XE modifier.
• One authorization: prior authorization for a base code covers its matching multiple-passenger code, so a last-minute change from a solo to a shared trip only needs the right code.

Example. Your van carries two walk-on members from the same county to the same dialysis clinic. At rates effective January 1, 2026, the first member bills T2003 at $12.71 plus every loaded mile on A0425 U3; Indiana deducts the first 10 miles of each one-way trip itself. The second member bills T2004 at $6.36 and nothing else. Most fee-for-service rides in Indiana are arranged through the broker Verida, so see the Verida broker guide and the Indiana state guide. For other states’ shared-ride rules, see the TK modifier.

New York and Oregon

New York’s fee-for-service transportation file, dated April 5, 2026, lists T2004 under ambulette in three counties: Nassau at $12.625 and Wayne at $36.36, both effective April 1, 2022, and New York City with the TN modifier at $64.60, effective May 30, 2024. The state’s code list, updated February 2011, defines T2004 for ambulettes as a one-way trip, next to A0130 for a local ambulette trip. The fee file says its fees apply to the fee-for-service broker and may reflect network negotiations, and warns other payers not to assume a service definition from its codes. See the New York state guide.

Oregon’s Medical Transportation Services Provider Guide, last updated December 22, 2025, lists T2004 for train travel and A0120 for city bus transit, bus tickets, or passes. Every non-emergency ride in the guide requires prior authorization. See the Oregon state guide.

How to bill a transit pass on T2004

1. Confirm the code. Use T2004 for a pass only where your program lists it that way, as Utah’s and Montana’s waivers do. Otherwise use the code your schedule names, such as A0110 or A0120.
2. Get the pass authorized. Utah’s New Choices Waiver lets you bill only the code authorized on the person’s care plan, for a service you are enrolled to provide. Indiana requires the member to agree to ride the bus before a monthly pass is approved.
3. Check that the pass saves money. Under SMD 23-006, a monthly pass should cost no more than the single trips it replaces that month.
4. Bill what the pass cost. Utah bars billing more than the actual cost of the pass, and Montana pays T2004 at cost.
5. Keep the receipt. Hold the invoice for every pass and the ride records for the days it covers.
6. Know the resale rule. Oregon’s OAR 410-136-3240, effective January 1, 2025, treats payment as an overpayment when a member sells or gives away tickets or passes.

Utah’s New Choices Waiver asks less of a company that only provides passes. Its driver’s license, vehicle registration, and insurance rules apply to providers of rides (T2003 and S0215), while every provider needs a current business license and Medicaid enrollment for non-medical transportation. See the Utah state guide.