What Is a WAV? Wheelchair Accessible Vehicle Specs and NEMT Rules

What makes a vehicle a WAV

A wheelchair accessible vehicle lets a rider roll aboard and ride in their own wheelchair. Three things set it apart from a regular van: a way up (a lift or a ramp), a place to ride (a securement station that holds the chair still), and a belt made for the rider. CMS says that when a Medicaid member uses a wheelchair, the state must make sure the provider carries them in a wheelchair-accessible vehicle (SMD 23-006, September 28, 2023).

For NEMT, the working definition comes from the ADA. Federal rules call a vehicle accessible when it meets 49 CFR Parts 37 and 38, and brokers such as MTM Health in Virginia inspect against those specs. These are the main requirements for vans and buses, as in force in September 2026:

Part of the vehicle	What 49 CFR Part 38 requires
Boarding	A lift or ramp, with room for the rider to reach a securement station (38.23)
Lift	A design load of at least 600 pounds. Controls interlocked so the vehicle cannot move unless the lift is stowed, and an emergency way to lower an occupied lift if the power fails. A platform with at least 30 by 48 inches of clear space from 2 to 30 inches above its surface.
Ramp	Holds 600 pounds if it is 30 inches or longer, 300 pounds if shorter. At least 30 inches wide, with side barriers at least 2 inches high, and no steeper than 1:4 when deployed to the ground.
Wheelchair stations	At least one on a vehicle 22 feet or shorter, at least two on a longer one. Each has a clear floor area of 30 by 48 inches.
Securement	On vehicles rated under 30,000 pounds, holds 2,500 pounds per tie-down leg and 5,000 pounds per chair, and keeps the chair from moving more than 2 inches
Rider belt	A seat belt and shoulder harness at every station, never used in place of securing the chair
Door height	At least 56 inches above the raised lift or the top of the ramp on vehicles 22 feet or shorter, and 68 inches on longer ones (38.25)

The lift label

Platform lifts also fall under two federal motor vehicle safety standards. FMVSS 403 covers lifts built on or after April 1, 2005, and FMVSS 404 covers vehicles with lifts built on or after July 1, 2005. Each lift is certified and labeled either “DOT-Public Use Lift” or “DOT-Private Use Lift.”

Lift type	Test load	Where it is required
Public use lift	600 pounds, the same as the ADA design load	Required on buses, school buses, and multipurpose passenger vehicles rated over 10,000 pounds, other than motor homes
Private use lift	The maker’s rated load or 400 pounds, whichever is greater	Allowed only on lighter vehicles

A private use lift rated under 600 pounds falls short of the ADA design load, so check the label before you buy a used van.

A newer guideline that is not yet required

The U.S. Access Board updated its guidelines for buses and vans in a final rule effective January 13, 2017. Compliance is not required until DOT adds the changes to its own standards, and as of September 2026 the Access Board says the update is not yet part of DOT’s enforceable vehicle standards. So 49 CFR Part 38 is still the spec brokers check. The wheelchair van guide covers what the update would change.

Common types of WAV

Type	How the rider boards	What the rules say
Lowered-floor minivan	A fold-out ramp at the side or the rear	Georgia names these and requires them to meet ADA rules. Check the door opening against the 56-inch federal door rule.
Full-size van	A powered platform lift at the side or the rear	Georgia requires a hydraulic or electro-mechanical lift in full-size vans and buses, mounted without weakening the vehicle’s structure
Raised-roof van	A lift or ramp, with more headroom inside	Georgia asks every wheelchair vehicle for at least 56 inches floor to ceiling in the passenger area, and New Jersey asks for 58 inches above each wheelchair position
Small bus	A lift, with two or more stations	A vehicle longer than 22 feet needs at least two securement stations

The door matters as much as the body. A side-entry van loads the rider onto the curb, and a rear-entry van loads behind the vehicle. For a ramp deployed to a 6-inch curb, the steepest slope allowed runs from 1:4 to 1:12, depending on how high the floor sits above the curb (49 CFR 38.23). New Jersey requires a mobility assistance vehicle to have a curb-side doorway in the front half of the body, plus a second doorway at the rear or on the driver’s side. For the trade-offs, see wheelchair ramp vs lift, lowered floor van, and minivan vs full size wheelchair van.

What NEMT programs require for WAVs

States and brokers build on the federal specs.

Program	Added rules for wheelchair vehicles
MTM Health, Virginia (handbook approved August 10, 2026)	The specs in 49 CFR Part 38. Four working securements, a working interlock, and a vehicle-mounted lap and shoulder belt at each station. A spare wheelchair, with a seat at least 20 inches wide, on vans that take hospital discharges. A record of each lift’s maker, model, age, and rated capacity. Inspections twice a year.
Georgia (NEMT manual, July 1, 2026)	56 inches floor to ceiling, an interlock that needs park and the emergency brake while the lift or ramp is out, ADA tie-downs at every position, and inspections every six months. Riders on scooters are asked to move to a passenger seat.
New Jersey mobility assistance vehicles (N.J.A.C. 8:40)	A ramp or automatic lift rated for at least 500 pounds, with a manual backup that works within five minutes. A four-point forward-facing restraint that keeps the chair from moving more than one inch. No stretchers.
Louisiana (Medicaid manual section issued July 14, 2025)	ADA restraints, tie-downs, lifts, and ramps. Drivers at companies with WAVs take wheelchair securement training in person, renewed at least every two years.
Arizona AHCCCS (billing manual revised July 31, 2026)	Doors wide enough to load a wheelchair, a lift built to load and unload wheelchair riders safely, and restraints that secure the chair during the trip

The driver matters too. Under 49 CFR 37.165, staff must help riders with securement systems, ramps, and lifts when needed or asked, even if that means leaving the driver’s seat. Train every driver on securement before their first wheelchair trip. See the wheelchair securement guide and the wheelchair securement checklist.

Who rides in a WAV

A WAV serves a rider who travels seated in a wheelchair and is stable enough to need no medical care on the way. Medi-Cal’s manual describes a rider who cannot sit in a car, taxi, or public transit for the trip, must travel in a wheelchair or cannot get from home to a car without help, and is stable enough not to need an ambulance. Its examples include riders with paraplegia, dialysis patients, riders with severe mental confusion, and riders on oxygen who need no monitoring. Arizona adds that the rider must need a wheelchair and be physically unable to use other modes.

A rider who must lie down needs a stretcher van. A rider who can walk to the car is an ambulatory trip, even when you send a WAV.

The DOT rules in 49 CFR 37.165 apply to public and private transportation companies alike:

• Carry larger chairs when you can. If a chair and rider are larger or heavier than the Part 38 design standard but your lift and vehicle can hold them, you must carry them. You may decline when the combined weight is over the lift’s rating, or when carrying them is shown to be unsafe.
• Secure every chair. You may require the rider to let you secure the wheelchair.
• Never refuse over the fit. You may not deny a ride because the chair cannot be secured satisfactorily by your system.
• Offer a seat, never require one. You may suggest the rider move to a vehicle seat, but you cannot make them.

For heavier riders and chairs, see bariatric transportation, and for the full federal picture, ADA requirements for NEMT.

How WAV trips are billed

Most programs bill a wheelchair trip as A0130, “Non-emergency transportation: wheelchair van,” plus a mileage line. The HCPCS code for wheelchair van mileage is S0209, but some states use others.

Program	Base rate	Mileage	Effective
Arizona AHCCCS fee-for-service	A0130: $11.15, or $12.21 outside the Phoenix and Tucson areas with TN	S0209: $1.54, or $1.66 with TN	October 1, 2026
Indiana fee-for-service	A0130: $31.79	A0425 with U5: $1.67, paid only past the first 10 miles of a trip over 10 miles one way	January 1, 2026
Illinois medicar	A0130: $30.00	A0425: $1.03 in Cook, DuPage, Kane, Lake, McHenry, and Will counties, $1.61 in Madison and St. Clair, $0.80 in the rest of the state	January 1, 2026
South Dakota secure van	A0130: $43.39	S0209: $2.61, only outside city limits	July 1, 2026
Medi-Cal	A0130: $20.30, or $26.43 at night with UJ	A0380: $1.50	Rate page updated September 2023

Medicare does not pay A0130 or S0209: the October 2026 HCPCS file gives both coverage code I. See A0130 and S0209 for modifiers and claim examples, and wheelchair van cost for what the vehicle costs to buy.

Other names for a WAV

Name	Where it is used
Wheelchair van	The federal NEMT brokerage rule (42 CFR 440.170) and most fee schedules
Ambulette	New York: a special-purpose vehicle for non-emergency transport with wheelchair-carrying capacity, stretcher-carrying capacity, or the ability to carry disabled riders
Mobility assistance vehicle (MAV)	New Jersey, licensed by the Department of Health
Medicar	Illinois: transport for a rider confined to a wheelchair who needs a lift or ramp and wheelchair lockdown
Secure van	South Dakota’s fee schedule
Nonambulatory service (NAS)	Indiana, for members who must travel in a wheelchair