NEMT Billing Codes in 2027: HCPCS Codes, Modifiers, and State Rates

A NEMT claim describes each ride in code: what kind of vehicle carried the rider, how far they rode, and anything extra, such as an attendant or a second rider. The codes are the same in every state. What each one pays, and which ones a state accepts at all, is set by the state Medicaid program, its health plans, and its brokers.

How NEMT billing codes work

NEMT codes belong to HCPCS Level II, the national code set CMS maintains for services outside the physicians’ CPT codes, such as ambulance rides. Each code is one letter followed by four digits.

A NEMT claim usually has two lines:

1. A base line for the ride, such as A0130 for a wheelchair van or T2003 for a flat per-trip charge. See NEMT base rate.
2. A mileage line for the loaded miles, such as S0209 for wheelchair van miles.

Some programs pay extra lines for wait time, an attendant, or a second rider. Each line carries the code, up to four two-character modifiers in box 24D of the CMS-1500, and the number of units in box 24G, under the NUCC instructions (version 13.0, July 2025). A paper CMS-1500 holds six service lines.

Medicare does not pay any of the NEMT codes. In the October 2026 HCPCS file, updated September 23, 2026, each one carries coverage code I, “not payable by Medicare.” That leaves the rules to Medicaid, so the same code can pay very different amounts across state lines. For the full claim cycle, see how to bill Medicaid for NEMT.

Every NEMT HCPCS code in one table

These are the official descriptions from the October 2026 HCPCS file. “Set by your state” means the code’s description names no unit, so your fee schedule decides whether one unit is a one-way trip, a round trip, or something else.

Code	Official description	Unit in the code	Common use
A0080	Non-emergency transportation, per mile, vehicle provided by volunteer (individual or organization), with no vested interest	Per mile	Mileage for a volunteer driver
A0090	Non-emergency transportation, per mile, vehicle provided by individual (family member, self, neighbor) with vested interest	Per mile	Mileage for the rider, a relative, or a neighbor who drives
A0100	Non-emergency transportation; taxi	Set by your state	Taxi rides
A0110	Non-emergency transportation and bus, intra or inter state carrier	Set by your state	Bus fares
A0120	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems	Set by your state	Minibus and other transportation systems, such as South Dakota’s community transportation trips
A0130	Non-emergency transportation: wheelchair van	Set by your state	Wheelchair van base rate
A0140	Non-emergency transportation and air travel (private or commercial) intra or inter state	Set by your state	Plane tickets to distant care
A0160	Non-emergency transportation: per mile, case worker or social worker	Per mile	Mileage for a caseworker who drives the rider
A0170	Transportation ancillary: parking fees, tolls, other	Set by your state	Parking and tolls
A0180	Non-emergency transportation: ancillary: lodging-recipient	Set by your state	The rider’s lodging on an overnight trip
A0190	Non-emergency transportation: ancillary: meals-recipient	Set by your state	The rider’s meals
A0200	Non-emergency transportation: ancillary: lodging escort	Set by your state	An escort’s lodging
A0210	Non-emergency transportation: ancillary: meals-escort	Set by your state	An escort’s meals
S0209	Wheelchair van, mileage, per mile	Per mile	Wheelchair van loaded miles
S0215	Non-emergency transportation; mileage, per mile	Per mile	Loaded miles on other rides
T2001	Non-emergency transportation; patient attendant/escort	Set by your state	An attendant or an accompanying adult
T2002	Non-emergency transportation; per diem	Per day	Daily rates, such as Indiana’s waiver transportation
T2003	Non-emergency transportation; encounter/trip	Per trip	One flat charge per ride, used in Texas and Indiana
T2004	Non-emergency transport; commercial carrier, multi-pass	Set by your state	Indiana’s code for extra walk-on (ambulatory) riders
T2005	Non-emergency transportation; stretcher van	Set by your state	Stretcher van base rate
T2007	Transportation waiting time, air ambulance and non-emergency vehicle, one-half (1/2) hour increments	Per half hour	Wait time where it is paid
T2049	Non-emergency transportation; stretcher van, mileage; per mile	Per mile	Stretcher van loaded miles

The oldest of these codes date to 1982, and the newest, T2049, was added July 1, 2004. Every one carries action code N, “no maintenance,” in the October 2026 file, so none changed that quarter.

The volunteer, family, and caseworker mileage codes (A0080, A0090, A0160) usually pay people for driving their own cars, not transportation companies. The lodging and meal codes cover the costs of long trips, which 42 CFR 440.170(a) counts as part of Medicaid transportation. See rural NEMT for how those trips are billed.

Ambulance codes that show up on NEMT claims

A few ambulance codes appear on van claims or next to them, depending on the state.

Code	Official description	Where it shows up
A0425	Ground mileage, per statute mile	Indiana bills van mileage with it, adding U3 for walk-on rides and U5 for wheelchair rides. It pays $1.67 a mile as of January 1, 2026.
A0380	BLS mileage (per mile)	Medi-Cal bills wheelchair van and litter van mileage with it
A0428	Ambulance service, basic life support, non-emergency transport (BLS)	Stretcher rides that need an ambulance crew. South Dakota pays $280.09 as of July 1, 2026, and Ohio’s appendix lists $203.75.
A0424	Extra ambulance attendant, ground (ALS or BLS) or air (fixed or rotary winged)	Indiana’s code for an added attendant on an ambulance. Ohio’s appendix lists $18.00.

Indiana does not use van codes for stretcher rides. Since July 1, 2023, fee-for-service members who need a stretcher, basic life support, or advanced life support are scheduled directly with enrolled ambulance providers, and those claims go to the state’s claims contractor, Gainwell.

NEMT modifiers

A modifier is a two-character code added after the procedure code. It changes what the line means: where the ride went, who was on board, or what kind of trip it was.

Origin and destination modifiers

These come from Medicare’s ambulance rules, and many Medicaid programs use them on van rides. The first letter is where the ride started and the second is where it ended, entered as one two-character modifier. Home to a freestanding dialysis center is RJ, and the ride back is JR.

Letter	Meaning in the Medicare Claims Processing Manual, chapter 15 (November 14, 2025)
D	Diagnostic or therapeutic site other than P or H when these are used as origin codes
E	Residential, domiciliary, custodial facility (other than 1819 facility)
G	Hospital based ESRD (kidney dialysis) facility
H	Hospital
I	Site of transfer (for example, an airport or helicopter pad) between modes of ambulance transport
J	Freestanding ESRD facility
N	Skilled nursing facility
P	Physician’s office
R	Residence
S	Scene of accident or acute event
X	Intermediate stop at physician’s office on way to hospital (destination code only)

Some pairs match other national modifiers. RR also means a rental, and HR also means “family/couple with client present.” The Medicare manual says that on an ambulance transportation code, the pair can only mean origin and destination.

Indiana requires the pair on both the base line and the mileage line. Ohio’s appendix to rule 5160-15-28, in effect since August 1, 2026, lists the pairs it pays without manual review and adds U4 for a workplace, U7 for a school, and U5 for any other point. See origin and destination modifiers for worked pairs and common mistakes.

Other modifiers on NEMT claims

Modifier	Official meaning (HCPCS, October 2026)	How states use it
TK	Extra patient or passenger, non-ambulance	South Dakota: an additional Medicaid rider. Indiana: an accompanying adult on a wheelchair van ride.
TN	Rural/outside providers’ customary service area	Arizona: any trip that starts outside the Phoenix and Tucson metro areas. South Dakota: a trip outside city limits.
TT	Individualized service provided to more than one patient in same setting	Indiana: the second and later wheelchair or taxi riders on one trip
TP	Medical transport, unloaded vehicle	Arizona bars any claim for unloaded miles, so check whether your program pays empty trips at all
U1 to UD	Medicaid level of care 1 to 13, as defined by each state	Texas: U1 metro or urban county, U2 rural county, U3 micro or suburban county, on T2003
UN to US	Two, three, four, five, or six or more patients served	Medi-Cal: shared wheelchair van rides, billed on the first rider’s claim
UJ	Services provided at night	Medi-Cal: rides between 7 p.m. and 7 a.m.
QM and QN	Ambulance service provided under arrangement, or furnished directly, by a provider of services	Medi-Cal: a dry run bills DS followed by QN. South Dakota: A0130 with QM is a secure van pickup at an inpatient hospital discharge that the hospital arranged.
SE	State and/or federally-funded programs/services	Indiana: rides for Medical Review Team services
XE	Separate encounter	Indiana: each extra trip for the same rider on the same day
GM	Multiple patients on one ambulance trip	Ambulance claims only

Two CPT modifiers also appear. South Dakota uses 59, distinct service, for extra trips on the same day. Medi-Cal lets you add 76, repeat service, to later trips on the same day. Indiana told providers on August 19, 2025 to stop using 76 on transportation claims and use XE instead.

The same modifier can mean different things

The U modifiers are defined by each state, and some states reuse other letters too. Never copy a modifier from one state’s claim to another’s.

Modifier	What it means, by state
U3	Texas: a micro or suburban county, on T2003. Indiana: walk-on ride mileage and wait time. Ohio: a wheelchair van service given in an ambulance.
U5	Indiana: wheelchair ride mileage and wait time. Ohio: a pickup or drop-off point not otherwise listed, which always goes to manual review.
U6	Indiana: an extra attendant on a wheelchair van. Ohio: the medical service was not available when the vehicle arrived.
UA and UB	Indiana: taxi rides of 0 to 5 miles (UA) and 6 to 10 miles (UB). Ohio: a second trip (UA) and a third trip (UB) on the same day, in the same kind of vehicle, to or from the same kind of place.
TK	South Dakota: an additional Medicaid rider. Indiana: an accompanying adult on a wheelchair van ride.

What the same ride pays in five states

These are fee-for-service amounts from each state’s own schedule. Brokers and health plans pay their own contract rates, but these schedules are a useful benchmark. See NEMT reimbursement rates and Medicaid fee schedule.

Service	State and code	Rate	Effective
Walk-on base, per trip	Indiana T2003	$12.71	January 1, 2026
Any demand response ride, per leg	Texas T2003	$33.83 urban (U1), $62.31 suburban (U3), $79.63 rural (U2)	September 1, 2026
Minibus or other system, base	Arizona A0120	$6.64, or $7.27 rural (TN)	October 1, 2026
Community transportation, one-way trip	South Dakota A0120	$5.20 in the city, $7.80 outside it (TN)	July 1, 2026
Walk-on miles	Indiana A0425 with U3	$1.67, only on trips over 10 miles one way	January 1, 2026
General NEMT miles	Arizona S0215	$1.28, or $1.63 rural	October 1, 2026
Community transportation miles	South Dakota S0215	$1.04, only outside the city on trips of 21 miles or more one way	July 1, 2026
Wheelchair base	Arizona A0130	$11.15, or $12.21 rural	October 1, 2026
Wheelchair base	Ohio A0130	$31.00	January 1, 2024
Wheelchair base	Indiana A0130	$31.79	January 1, 2026
Wheelchair base	South Dakota A0130 (secure van)	$43.39	July 1, 2026
Wheelchair miles	Ohio S0209	$1.30	January 1, 2024
Wheelchair miles	Arizona S0209	$1.54, or $1.66 rural	October 1, 2026
Wheelchair miles	Indiana A0425 with U5	$1.67, only on trips over 10 miles one way	January 1, 2026
Wheelchair miles	South Dakota S0209	$2.61, counted from the city limits	July 1, 2026
Stretcher base	Arizona T2005	$49.09, or $86.70 rural	October 1, 2026
Stretcher base	South Dakota T2005	$109.66	July 1, 2026
Stretcher miles	Arizona T2049	$1.54, or $1.66 rural	October 1, 2026
Wait, per half hour	Arizona T2007	$4.59	October 1, 2026
Wait, per half hour	Indiana T2007 with U3 or U5	$7.43, only on trips of 50 miles or more one way, after the first 30 minutes	January 1, 2026
Attendant	Ohio T2001	$15.00	January 1, 2024
Attendant	Indiana T2001 (accompanying adult on T2003)	$6.36	January 1, 2026

Notes on the schedules:

• Arizona. Trips that start in the Phoenix or Tucson metro areas are urban. Every other trip is rural and carries TN.
• Texas. The demand response schedule lists only T2003, with no mileage code. TMHP’s July 2021 notice says Texas pays the per-leg rate for each seat the state authorized on that leg.
• Indiana. The state deducts the first 10 miles of each one-way walk-on or wheelchair trip, but you still bill every mile. Most fee-for-service rides are brokered by Verida, whose rate schedule is based on this fee schedule and may be negotiated with each provider.
• Ohio. Rule 5160-15-28 pays the lower of your charge and the appendix amount for the date of the ride. The appendix took effect August 1, 2026, and its transportation amounts last changed January 1, 2024.
• South Dakota. You bill your usual and customary charge, and the fee schedule is the most it pays.

How to code a NEMT trip, step by step

1. Find who pays. A state claims system, a broker, and a health plan can each use different codes for the same ride. See how to bill NEMT brokers.
2. Open the fee schedule for the date of the ride. Rates and codes change on each state’s own schedule, so use the one in effect on the date of service.
3. Pick the base code for the level of service that was authorized. Medi-Cal requires the modifiers on the authorization and the claim to match. In a federal audit of New York City NEMT payments (September 2022), one payment was unallowable because the level of service billed was never authorized.
4. Add the mileage line. Bill loaded miles in whole numbers. Indiana rounds 15.5 miles up to 16 and 15.4 miles down to 15, and South Dakota asks for standard rounding with no decimals.
5. Add the modifiers your payer lists. Put the origin and destination pair, the rural modifier, and any extra-rider or level-of-care modifier in the order your manual gives, up to four per line.
6. Add extra lines only where they are paid. Wait time (T2007), an attendant (T2001), and extra riders each follow the state’s own rules.
7. Set the units. Trips go on the base line, miles on the mileage line, and half hours on the wait line. Arizona wants every trip for one member on one date on one claim: base on line 1, loaded miles on line 2, and wait time on line 3.
8. Match the claim to the trip record. The addresses, times, and miles must agree with your trip log and the authorization.

Worked examples

These use each state’s published rates. The trips, distances, and times are example numbers.

Arizona: a rural wheelchair round trip

A wheelchair rider outside the Phoenix and Tucson metro areas rides 30 loaded miles to a clinic and 30 miles home on one date. The driver waits 90 minutes, because the clinic is too far to return to base. Rates start October 1, 2026.

Line	Code and modifier	Units	Rate	Amount
1	A0130 TN	2 trips	$12.21	$24.42
2	S0209 TN	60 miles	$1.66	$99.60
3	T2007 TN	3 half hours	$4.59	$13.77
Total				$137.79

The day’s mileage is under 100, so no prior authorization is needed. The AHCCCS Daily Trip Report goes with the claim. On a paper claim, the pickup and drop-off addresses go in box 19.

Texas: one rural leg with two seats

Texas authorizes each one-way leg separately, with its own authorization number and its own claim. Under TMHP’s July 2021 notice, each leg pays once per seat the state authorized. For a rural county leg with two authorized seats, bill T2003 with U2: 2 seats times $79.63 is $159.26 at the September 1, 2026 rate. The ride home is a second leg with a second authorization and claim.

On paper, the Texas handbook (September 2026) recommends place of service 09, and TexMedConnect uses 99. Every Medical Transportation Program claim uses diagnosis code Z753.

Indiana: a shared walk-on ride

Two members from the same county ride together 14 loaded miles to the same clinic. Indiana pays full base and mileage for the first member and half the base for the second, at January 1, 2026 rates:

Member	Line	Units	Paid
First	T2003 with the origin and destination pair	1	$12.71
First	A0425 U3 with the same pair	14 miles billed, 4 paid after the 10-mile deduction	$6.68
Second	T2004 with the pair, no mileage	1	$6.36
Total			$25.75

If the first member takes a second, separate trip later that day, Indiana adds XE to that trip’s lines.

Where the codes go on the claim

On the CMS-1500, the procedure code and up to four modifiers go in box 24D, and units go in box 24G. On the electronic 837P, eMedNY’s transportation billing guidelines (August 5, 2026) map the procedure code to loop 2400 SV101 and the units to SV104. See the CMS-1500 for NEMT and 837P.

Two other codes ride along on every claim:

• Place of service, in box 24B of the CMS-1500. New York uses 99, “other place of service,” for non-emergency trips on its own claim form. Medi-Cal uses 21, inpatient hospital, when a hospital inpatient rides to an appointment and back. See place of service codes for NEMT.
• Diagnosis, in box 21. Texas requires Z753 on Medical Transportation Program claims. Check your manual for the code your program wants.

How codes and rates change

CMS posts a new HCPCS file every quarter, dated January, April, July, and October. The NEMT codes rarely change: none did in the October 2026 file. Download the file from the CMS quarterly update page to check any code’s current description.

State rates move more often. In the last year, Indiana’s rates took effect January 1, 2026, South Dakota’s July 1, 2026, Texas’s September 1, 2026, and Arizona’s take effect October 1, 2026. Recheck your rate sheet each time your state posts a new fee schedule, and read your broker or health plan notices for changes to their codes.

Coding mistakes that get NEMT claims denied

• A base code that does not match the authorization. Bill the level of service that was approved.
• A mileage code your state does not pay. Indiana calls S0215 nonreimbursable, and Medi-Cal bills van miles with A0380.
• Split billing. Arizona denies a base-only claim followed by a mileage-only claim, and denies extra claims for the same date as duplicates.
• Unloaded miles. Arizona bars them. South Dakota pays them only on community transportation trips outside city limits of 21 miles or more one way, when the driver returns to the point of origin or goes to pick up a discharged rider.
• Decimal miles. Indiana and South Dakota want whole miles.
• The wrong same-day modifier. Indiana wants XE, not 76, for a second trip on the same day.
• A missing origin and destination pair on the mileage line. Indiana requires it on both lines.

On the remittance, these usually show up as adjustment reason code 4 (“The procedure code is inconsistent with the modifier used”), 182 (“Procedure modifier was invalid on the date of service”), 16 (missing information or a billing error), or 18 (exact duplicate). See claim adjustment reason codes and NEMT claim denials for how to fix and resubmit, and our state guides for your state’s rules.