# VA Special Mode Transportation: The Rules for Wheelchair Van and Stretcher Rides

Canonical URL: https://nemtguide.com/glossary/va-special-mode-transportation/ · Updated 2026-09-30

VA special mode transportation is VA's term for rides in an ambulance, ambulette, wheelchair van, or other vehicle specially designed for disabled riders, set out in 38 CFR Part 70. VA pays for one when the ride is medically required, the veteran qualifies and cannot pay for it, and VA approved it in advance or it was an emergency. Most rides are bought through local VA contracts.

- Special mode means an ambulance, ambulette, wheelchair van, or other vehicle designed for disabled riders. A taxi, bus, or adapted private car does not count.
- A VA clinician decides the ride is needed, and VA must approve it before the trip unless it is an emergency.
- Today VA pays the actual cost of an approved ride. A rule that would cap rides without a contract at Medicaid rates is delayed to February 16, 2029.
- Most rides are bought by each VA medical center under its own contract, often ordered through the VetRide vendor portal.
- Contracts set strict invoice deadlines and trip records, and bar billing the veteran, Medicare, or Medicaid.

## What counts as special mode

VA's beneficiary travel rule defines a special mode of transportation as "an ambulance, ambulette, air ambulance, wheelchair van, or other mode of transportation specially designed to transport disabled persons" ([38 CFR 70.2](https://www.ecfr.gov/current/title-38/section-70.2)). The same definition says what is left out: modes not specifically designed for disabled riders, and privately owned vehicles that were modified or fitted with adaptive equipment.

| Counts as special mode | Does not count |
|---|---|
| Ambulance, ground or air | Bus, subway, or train |
| Ambulette | Taxi |
| Wheelchair van | Airplane |
| Another vehicle specially designed to carry disabled riders | A privately owned car or van with a lift, ramp, or hand controls added |

For a NEMT company, that usually means your [wheelchair accessible vehicles](https://nemtguide.com/glossary/wheelchair-accessible-vehicle/) and [stretcher vans](https://nemtguide.com/glossary/stretcher-van/). Sedan and ambulatory rides are not special mode, even when VA buys them. See [levels of service](https://nemtguide.com/glossary/level-of-service/) for how those vehicles line up with Medicaid's categories.

## Who qualifies for a special mode ride

VA pays for a special mode ride only when three things are true ([38 CFR 70.4(d)](https://www.ecfr.gov/current/title-38/section-70.4)):

1. **The travel is medically required.** VHA Directive 1601B.05 (January 20, 2022) leaves that decision to a VHA clinician acting within their scope of practice.
2. **The veteran cannot pay for it.** Under 38 CFR 70.10(c), that includes a veteran with a service-connected rating of at least 30 percent, one traveling for care of a service-connected condition, and one whose income is at or below the maximum VA pension rate.
3. **VA approved the ride before it happened, or it was a medical emergency.** For an emergency ride without approval, an application within 30 days of the trip counts as on time ([38 CFR 70.20(c)](https://www.ecfr.gov/current/title-38/section-70.20)).

The veteran must also be eligible for VA travel pay under 38 CFR 70.10. The list includes veterans traveling for a service-connected condition, veterans rated 30 percent or more, veterans receiving a VA pension or with income below the pension limit, and veterans going to a scheduled compensation and pension exam. An attendant is eligible too when the veteran is medically determined to need one. See the [VA beneficiary travel guide](https://nemtguide.com/guides/va-beneficiary-travel/) for the full list.

Special mode rides skip the travel deductible ([38 CFR 70.31(b)](https://www.ecfr.gov/current/title-38/section-70.31)). Compare a veteran who drives: VA's travel pay page (updated July 24, 2026) lists 41.5 cents a mile, minus a $3 deductible each way, with deductibles capped at $18 a month.

## How VA pays for special mode rides

| Question | Rule as of September 2026 |
|---|---|
| How much does VA pay? | "The actual cost of a special mode of transportation" ([38 CFR 70.30(a)(4)](https://www.ecfr.gov/current/title-38/section-70.30)) |
| Who gets paid? | Usually the veteran, but VA may pay the ride company directly "upon satisfactory evidence" that it gave or paid for the ride ([38 CFR 70.32(b)](https://www.ecfr.gov/current/title-38/section-70.32)) |
| Can VA pay before it checks eligibility? | Yes. VA may pay the ride company first for an emergency special mode ride to or from a VA facility, when someone claims the veteran is eligible ([38 CFR 70.32(a)(2)](https://www.ecfr.gov/current/title-38/section-70.32)) |
| How far? | Generally from home to the nearest VA facility where the care could be given, and back. Other trips need VA's decision, such as to a non-VA facility VA approved. |
| What does VA check before paying a vendor? | VHA Directive 1601B.05 requires the facility's business office to verify the veteran attended the appointment, review whether riders on vendor invoices were authorized for special mode, and block mileage pay for the same appointment |

A change is on the books but delayed. VA's rule of February 16, 2023 ([88 FR 10032](https://www.federalregister.gov/documents/2023/02/16/2023-03013/change-in-rates-va-pays-for-special-modes-of-transportation)) sets prices for special mode rides VA buys without a contract. Where VA has a contract with the vendor, the contract's terms govern instead.

| Mode | What VA would pay without a contract under the delayed rule |
|---|---|
| Ambulance | The lesser of the actual charge or the Medicare ambulance fee schedule amount |
| Wheelchair van and other non-ambulance modes | The lesser of the vendor's actual charge, the Medicaid rate posted in the state where the vendor is based, or the Medicaid rate posted in the state where the ride happened |

VA has pushed the effective date back twice, most recently to February 16, 2029 ([89 FR 88888](https://www.federalregister.gov/documents/2024/11/12/2024-25975/changes-in-rates-va-pays-for-special-modes-of-transportation-delay-of-effective-date-from-february), November 12, 2024). In the 2023 rule, VA estimated that over 99 percent of its payments to vendors in NAICS codes 621999 and 485991 are made under a contract.

## How VA medical centers buy special mode rides

Each VA medical center buys its rides under its own contract, issued by its regional contracting office on SAM.gov. The work statement in each solicitation sets the rules you live by. These three 2026 solicitations show the pattern.

| Solicitation | How rides are ordered | How and when you invoice |
|---|---|---|
| Spokane, Washington, RFQ 36C26027Q0022 (September 1, 2026) | Through the VetRide Vendor Portal. Only VA staff named by the contracting officer may place orders, and nursing homes and other outside callers may not. | Within 15 calendar days of service, electronically in VetRide, with no patient information on the invoice |
| Altoona, Pennsylvania, 36C24426R0021 (April 29, 2026) | Through VetRide, which the vendor must staff to monitor 24 hours a day | Within 30 calendar days of service, as an electronic CMS-1500 in VetRide |
| Edward Hines Jr. VA Hospital, Illinois, 36C25226Q0498 (June 11, 2026) | Through VetRide or other VA-approved software. The vendor keeps at least two dispatchers on site to receive daily manifests. | Within 30 calendar days of service. A weekly itemized trip report is reviewed first, then invoiced. |

Altoona's CMS-1500 must show the contract number, the service dates in box 24, the authorization numbers, the pickup and drop-off locations, the base rate, the veteran's name and full Social Security number in box 1a, the diagnosis codes, the HCPCS codes, and the name of the VA official who authorized the ride. For bidding on these contracts, see [VA transportation contracts](https://nemtguide.com/guides/va-transportation-contracts/).

## What a special mode vendor must document

VA pays only for rides it can match to an authorized order and a kept appointment, so your trip records carry the payment. These records appeared in the 2026 solicitations above.

1. **The order.** Spokane's ordering officer gives the mode, required arrival time, the veteran's name, pickup and delivery points, any medical staff or equipment needed, and the last four digits of the Social Security number.
2. **Times for every leg.** Hines wants the VA ticket number, scheduled pickup, departure, and arrival times, vehicle number, and vehicle class on its weekly report.
3. **Miles as VA measures them.** Spokane pays miles by VA's own mapping calculation, rounded to the nearest mile, and does not pay separately for miles from your base to the pickup. Hines lists "VA Calculated Mileage" on each trip. Build [deadhead miles](https://nemtguide.com/glossary/deadhead-miles/) into your rates.
4. **Changes in real time.** Spokane requires notes in VetRide, in real time, whenever a trip departs from its order, such as extra miles for a road closure, wait time, or the reason for a no-load. VA may hold payment until the trip is reconciled.
5. **Wait time and no-shows, with the reason.** Spokane pays wait past the first 30 minutes only after VA approves it, and pays a [no-show](https://nemtguide.com/glossary/no-show/) as the base rate plus the one-way miles driven. Hines wants the circumstances documented whenever you bill an attempted pickup or wait time, and Altoona whenever you bill wait time.
6. **Check-in and check-out.** At Hines, drivers sign the veteran in and out on VA's log with the veteran's name, date and time, vehicle identification number, driver's name, and company name.
7. **Incidents.** Spokane wants a phone call within 1 hour of an accident or safety problem and a written report by the close of the next business day. Hines wants a written report within 24 hours and requires you to keep the records of each accident for three years.
8. **Driver and vehicle files.** Expect to show driver's licenses, first aid certificates, TB test results, and each vehicle's maintenance file on request. Spokane contract staff are fingerprinted for a Special Agreement Check and checked again each year.

Contract payments usually close the ride. The Spokane terms say VA's payment "extinguishes any and all liability" of the veteran, and that veterans, third-party insurers, Medicare, and Medicaid are never billed. VA pays only for travel to VA care or care VA authorized, so rides to other care go to the veteran's other coverage, such as Medicaid or a Medicare Advantage ride benefit. See [who pays for NEMT](https://nemtguide.com/guides/who-pays-for-nemt/).

## Frequently asked questions

### Does VA pay for wheelchair van rides for veterans?

Yes, when the ride qualifies as special mode transportation. Under 38 CFR 70.4(d), the travel must be medically required, the veteran must be unable to pay for it, and VA must approve it before the trip, unless it was for a medical emergency. The veteran must also be eligible for VA travel pay under 38 CFR 70.10.

### Who decides that a veteran needs a wheelchair van or stretcher?

A VA clinician. VHA Directive 1601B.05 (January 20, 2022) allows special mode when a VHA clinician, acting within their scope of practice, finds it clinically required. VA's travel pay page (July 24, 2026) says a VA provider decides whether the veteran's condition requires an ambulance or specially equipped vehicle. A ride company cannot make that call.

### Can I bill the veteran, Medicare, or Medicaid for a VA ride?

Not for a ride under a VA contract. The September 2026 Spokane solicitation says VA's payment extinguishes the veteran's liability and that veterans, third-party insurers, Medicare, and Medicaid are never to be billed. In its 2023 rule, VA wrote that its contracts make VA's payment the payment in full.

### What does VA pay for a special mode ride without a contract?

As of September 2026, the regulation in force says VA pays the actual cost of an approved special mode ride (38 CFR 70.30(a)(4)), and VA may pay the ride company directly on proof that it gave the ride. A 2023 rule would pay the lowest of your charge and the posted Medicaid rates for non-ambulance rides without a contract, but VA has delayed it to February 16, 2029.

### Is a sedan or taxi ride for a veteran special mode?

No. The definition in 38 CFR 70.2 leaves out modes not specifically designed for disabled riders, naming bus, subway, taxi, train, and airplane. A modified privately owned vehicle does not count either. Some VA contracts still buy sedan rides, as the 2026 Hines solicitation did, but under separate rates.

## Official resources

- [eCFR: 38 CFR Part 70, the beneficiary travel and special mode rules](https://www.ecfr.gov/current/title-38/chapter-I/part-70)
- [VHA Directive 1601B.05, Beneficiary Travel](https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9632)
- [VA: How veterans request rides, including special mode](https://www.va.gov/resources/how-to-request-rides-to-va-health-appointments/)
- [SAM.gov: Search contract opportunities (filter by Veterans Affairs and NAICS 485991)](https://sam.gov/search/?index=opp)