Billing codes
T2049 Billing Code: Stretcher Van Mileage, Loaded Miles, and State Rates
T2049 is the HCPCS code for stretcher van mileage: one unit for each loaded mile, billed on its own line after the T2005 trip charge. Medicare does not pay it. Rates vary: Arizona pays $1.54 a mile from October 1, 2026, or $1.66 in rural areas, North Dakota $2.57, and South Dakota $2.61, but only for miles outside city limits.
- T2049 pays a stretcher van's loaded miles, one unit per mile, and goes with the T2005 base charge.
- Medicare does not pay T2049, and Indiana Medicaid does not cover it.
- Published rates run from $1.5251 a mile in Greene County, New York, to $3.50 in Broome County, New York, with Arizona at $1.54 or $1.66 from October 1, 2026.
- Programs measure miles differently: odometer miles in Arizona, map miles in North Dakota, tenths of a mile in New York, and whole miles past city limits in South Dakota.
- On a shared ride, most programs pay one set of miles, not one set per rider.
What T2049 means
CMS lists T2049 in the national HCPCS code set as “Non-emergency transportation; stretcher van, mileage; per mile.” It has been in the code set since July 1, 2004. The October 2026 quarterly HCPCS file gives it coverage code I, which means Medicare does not pay it.
T2049 is the mileage half of a stretcher van claim. The trip itself goes on T2005, one unit per trip, and the miles go on T2049, one unit per loaded mile. A loaded mile is one driven with the rider on board. Because Medicare does not use the code, each Medicaid program, health plan, or broker sets its own rate and its own way of counting miles.
A stretcher van carries a rider who must lie down but needs no medical care on the way. North Dakota’s NEMT manual (January 2026) describes it as a vehicle with a stretcher for a person who does not need medical monitoring, aid, care, or treatment during the trip. New York’s manual describes stretcher riders as confined to bed, unable to sit in a wheelchair, and needing no medical attention on the way.
What states pay for T2049
| Program | T2049 rate per mile | Effective |
|---|---|---|
| Arizona AHCCCS fee-for-service | $1.54 in the Phoenix and Tucson metro areas, $1.66 elsewhere with the TN modifier | October 1, 2026 |
| North Dakota Medicaid | $2.57 | July 1, 2026 |
| South Dakota Medicaid | $2.61 per whole mile, only outside city limits | July 1, 2026 |
| New York Medicaid, by county | $3.50 in Broome, $3.00 in Albany, Chenango, Erie, and Monroe, $2.525 in Allegany and Orleans, $2.323 in Westchester, $1.919 in Oswego, $1.5251 in Greene | Effective between April 1, 2022 and August 1, 2024, depending on the county, on the schedule dated April 5, 2026 |
| Indiana Medicaid | Not covered | Fee schedule updated June 9, 2026 |
| Medi-Cal fee-for-service | Not used. Litter van miles bill A0380 at $1.50 a mile. | Rate page updated September 2023 |
| Illinois Medicaid | Not used. A stretcher rides in a medicar: A0130 at $30.00, a T2005 stretcher add-on ($9.31 in Cook and the five collar counties, $11.64 elsewhere), and miles on A0425. | January 1, 2026 |
New York’s schedule says its fees apply to its fee-for-service broker and may reflect network negotiations. Only some counties list a T2049 rate, and Herkimer lists $0. Broker and health plan contracts set their own rates, so check your rate sheet before you quote a stretcher trip. See NEMT mileage billing for the other mileage codes, and stretcher transport cost for pricing private pay trips.
How loaded miles are counted on stretcher trips
| Rule | Arizona | North Dakota | South Dakota | New York |
|---|---|---|---|---|
| How miles are measured | Drop-off odometer minus pickup odometer, in statute miles | Map miles from the pickup to the medical or dental facility | Miles from the point the trip leaves city limits to the destination | Actual loaded miles |
| Rounding | Not stated | Not stated | Whole miles, standard rounding, no decimals | Tenths of a mile since August 1, 2019, and never rounded up |
| Shared ride | Each member’s direct-route miles, on that member’s claim | Bill for only one member | One mileage allowance per trip, on one rider’s claim | Miles from the first pickup to the last drop-off, on the first rider’s claim |
| Other rules | Every trip for one member on one date goes on one claim | Prior approval on form SFN 1507, and a trip ticket (SFN 296) from providers who bill T2049 | The provider must have legal authority to run trips outside city limits | Only loaded miles are ever paid |
Miles without the rider on board are deadhead miles. North Dakota does not cover them unless the department approves them after an email request to its NEMT administrator. CMS’s transportation guide (SMD 23-006, September 28, 2023) says unloaded miles generally cannot be paid, though a state may build their cost into its rates.
Examples of T2049 on a claim
North Dakota. A stretcher van takes a member 40 map miles from home to a clinic. At July 1, 2026 rates, the claim bills T2005 at $97.37 and T2049 for 40 miles at $2.57, which is $102.80, for $200.17. Keep the approved SFN 1507 on file and send the SFN 296 trip ticket.
New York, Albany County. A stretcher ambulette carries a member 12.4 loaded miles. The schedule dated April 5, 2026 lists T2005 at $101.00 and T2049 at $3.00 a mile, so the claim is $101.00 plus 12.4 x $3.00 = $37.20, for $138.20. Bill 12.4 miles, not 13.
South Dakota. A 25-mile trip leaves city limits after 4 miles. Only the 21 miles outside city limits count, so T2049 pays 21 x $2.61 = $54.81 on top of the T2005 base of $109.66, for $164.47 at July 1, 2026 rates.
Before you bill T2049
- Confirm the trip is authorized as stretcher. North Dakota needs an SFN 1507. On a broker trip, get the broker’s trip number.
- Find the right mileage code. Your fee schedule may use T2049, or another code such as A0380 in Medi-Cal or A0425 in Illinois.
- Measure miles the way your payer does. Odometer, map miles, or miles past city limits give different totals.
- Round only as your payer allows. New York wants tenths, and South Dakota wants whole miles.
- Bill one set of miles on a shared ride, unless your payer bills each rider separately, as Arizona does.
Frequently asked questions
What base code goes with T2049?
T2005, "Non-emergency transportation; stretcher van," one unit per trip. As of October 1, 2026, Arizona pays $49.09 in the Phoenix and Tucson areas and $86.70 elsewhere. North Dakota pays $97.37 and South Dakota $109.66, both as of July 1, 2026. Not every program pairs them: Medi-Cal bills litter van miles on A0380 at $1.50 a mile, and Illinois bills stretcher miles on A0425.
Does Medicare pay the T2049 billing code?
No. The October 2026 CMS HCPCS file gives T2049 coverage code I, which means not payable by Medicare. CMS added the code on July 1, 2004. Stretcher van miles are paid by state Medicaid programs and the health plans and brokers that work for them, each under its own fee schedule or contract.
Do I get paid for driving to pick up a stretcher rider?
Generally no. T2049 counts loaded miles, with the rider on board. North Dakota does not cover unloaded miles unless the department approves them after you email its NEMT administrator, and you attach that approval email to the claim. CMS guidance says unloaded miles generally cannot be paid, though a state may build their cost into its rates or pay them in limited cases through a state plan amendment.
How do I bill T2049 when two riders share the van?
Usually one set of miles for the trip. South Dakota pays one mileage allowance per trip, billed on one rider's claim. North Dakota lets you bill for only one member. New York counts miles from the first pickup to the last drop-off, on the first rider's claim. Arizona is different: each member's claim carries the direct-route miles between that member's own pickup and drop-off.
Should I round stretcher van miles?
Follow your payer. New York has required loaded miles in tenths of a mile since August 1, 2019, and rounding up can be treated as fraud. South Dakota wants whole miles with standard rounding, and no decimals. Arizona takes the drop-off odometer reading minus the pickup reading.