NEMT Fuel Surcharges in 2027: How to Raise Private-Pay and Facility Prices When Fuel Climbs

Fuel moves every week, but the price on your rate sheet stays put until you change it. A fuel surcharge lets the part of your price that pays for gas follow the pump without a new price list each time. A yearly escalator clause does the same for everything else that gets more expensive. This page covers both for the prices you set yourself, and shows where the law limits how you charge and quote them.

For Medicaid and broker rates, which someone else sets, see NEMT rate increases. To cut the fuel you burn in the first place, see how to reduce NEMT fuel costs.

Who you can charge a fuel surcharge, and who you cannot

You can add a surcharge only where you set the price, or where a contract allows one.

• Private riders and families. Riders who pay out of pocket, and adult children paying for a parent’s rides. Your rate sheet is the contract, so the surcharge rule goes on it.
• Facilities. Hospitals, nursing homes, dialysis centers, and day programs that pay you directly. The surcharge goes into the agreement, and changes follow its notice terms.
• Counties and agencies. Some public contracts allow a fuel surcharge on request. Hamilton County, Ohio does in a NEMT contract it approved in 2026, described below.

Medicaid members are off limits. Under 42 CFR 447.15, a Medicaid provider accepts the agency’s payment, plus any copay the state plan sets, as payment in full. A fuel fee on a covered ride breaks that rule. Minnesota’s statute ties its Medicaid NEMT mileage rates to EIA’s gas price instead (Minnesota Statutes 256B.0625, subdivision 17), and the fuel costs guide covers how long that lasts.

Regulated rates come first. In Pennsylvania, paratransit rates must follow the tariff on file with the Public Utility Commission (52 Pa. Code 29.355, current through August 8, 2026), so a surcharge has to be in the tariff before you bill it. The rate sheet template covers states that set or file transportation prices.

How to build a fuel surcharge tied to EIA prices

The U.S. Energy Information Administration (EIA) surveys pump prices every Monday at 8:00 a.m. local time and publishes them around 10:00 a.m. Eastern on Tuesday, or Wednesday after a federal holiday. The prices include all taxes. For gasoline, EIA posts the U.S. average, nine regions, nine states (California, Colorado, Florida, Massachusetts, Minnesota, New York, Ohio, Texas, and Washington), and ten cities. EIA says it does not calculate or regulate surcharges, and that many carriers build their formulas on its weekly prices.

For the week of September 28, 2026, regular gasoline averaged $4.465 a gallon across the U.S., from $3.924 on the Gulf Coast to $5.724 on the West Coast. On-highway diesel averaged $6.382. The next release is October 6, 2026.

Write these six terms down first

1. The index. Name the exact EIA series: regular gasoline or on-highway diesel, and the region or state closest to you, such as “Midwest (PADD 2)”.
2. The base price. The gallon price your current rates already cover. Pick it from your last price change, not from today’s pump.
3. The trigger. The price at which the surcharge starts. A trigger a little above the base keeps small swings off your invoices.
4. The formula. One of the methods in the table below.
5. The reset date. When the surcharge is recalculated, such as the first of each month using the latest weekly price.
6. The way down. Say plainly that the surcharge shrinks as prices fall and ends at the base. Hamilton County’s contract, below, lets the county end it when prices fall back.

Choose a formula

Each method below starts from the gap between the index and your base price. The examples use EIA’s Midwest regular gasoline price of $4.291 for the week of September 28, 2026, and an example base of $3.50, a gap of 79.1 cents a gallon.

Method	How you figure it	Example
Cents per mile	Gap ÷ your miles per gallon, added to each loaded mile	79.1 cents ÷ 15 mpg = 5.3 cents a mile
Percent of the fare	Fuel’s share of your price × the percent the index sits above base	12% share × 22.6% = 2.7% of the fare
Flat charge per trip	A set amount for each full step the index sits above base	$1 a one-way trip per full 50 cents: $1
Gallons you bought	Gap × gallons bought that month, backed by receipts	79.1 cents × 500 gallons = $395.50 for the month

Cents per mile fits riders and families, because it scales with the trip and is easy to show on a receipt. On a 12-mile ride it adds 64 cents each way. The percent method fits a facility contract with many trip types, but you have to know fuel’s share of your price; the fuel cost calculator gives you the monthly fuel bill to work it out. A flat charge is the simplest to explain and the least exact. The gallons method suits a monthly invoice to a county or facility, and Hamilton County, below, measures it from a trigger 10 percent above its base instead of from the base itself.

Measure miles per gallon from your own fill-ups, because the fuel burned while a van waits at a clinic lowers it. Round the result to a tenth of a cent a mile or a whole percent, and publish the current surcharge with its effective date.

What to print on the rate sheet

One dated line is enough, and it lets any rider check your math. Using the example numbers, it would read: “Fuel surcharge for rides October 1 to 31, 2026: 5.3 cents per loaded mile. Based on EIA’s Midwest regular gasoline price of $4.291 for September 28, 2026, minus our base of $3.50, divided by 15 miles per gallon. Recalculated on the first of each month.” Put the same line on the rate sheet and on each receipt, and never call the surcharge a tax or a charge the law requires.

A real contract example: Hamilton County, Ohio

Hamilton County’s commissioners approved the county’s NEMT contracts for June 1, 2026 to May 31, 2028 on July 16, 2026. When bidders asked for a fuel escalation clause, Job and Family Services said no, but agreed to a fuel surcharge when gas prices pass a set baseline. The contract approved as Resolution J130-26 works this way:

• Baseline. $2.95 a gallon, which the winning bid described as the 2025 average of EIA’s first-Monday prices.
• Trigger. 10 percent above the baseline, so the surcharge starts above $3.245.
• Index. EIA’s Midwest (PADD 2) regular gasoline price. The county’s request form uses the price reported on the first Monday of each month.
• Amount. The price above the trigger times the gallons bought for the month, never more than the provider’s actual fuel cost.
• Paperwork. A separate monthly invoice on the county’s fuel surcharge form, with source documents for the gallons bought.
• Deadlines. No surcharge is paid until the county approves it in writing, and no request is approved for a month already invoiced.
• Review. Monthly. The county may change or end the surcharge when prices fall to or below the baseline.

If the index read $4.29 for a month, the surcharge would be $4.29 minus $3.245, or $1.045 a gallon. On 1,000 gallons, that is $1,045 for the month. The Hamilton County page covers the rest of these contracts.

Yearly price increases with a CPI escalator clause

Fuel is only part of what rises. Wages, insurance, and parts go up too, and a Consumer Price Index (CPI) clause raises your rates once a year by a set rule instead of a fresh negotiation. The Bureau of Labor Statistics (BLS) gives this guidance for escalation clauses (June 8, 2023):

• Name the exact series. Population, area, title, and base period, such as “CPI-U, U.S. city average, all items, 1982-84=100.”
• Use the national index. BLS recommends the U.S. city average because metro indexes are more volatile.
• Use data that is not seasonally adjusted. BLS calls seasonally adjusted data inappropriate for escalation, because it can be revised for up to five years.
• Pick a reference month and a schedule. Most clauses adjust once a year, in proportion to the percent change.
• Plan for the lag. Each month’s CPI comes out about two weeks after the month ends.
• Add a cap or floor if you want one. BLS will not write the clause for you.

All items CPI-U rose 3.4 percent in the 12 months through August 2026, not seasonally adjusted (released September 11, 2026). A clause using that change would raise a $45.00 facility base fee to $46.53. The September index is due October 14, 2026.

Borrow the federal government’s limits

Federal fixed-price contracts can carry an economic price adjustment clause, and FAR 52.216-4 (January 2017 version) makes a ready checklist for your own:

1. Notice. The contractor reports an increase within 60 days, with a proposal and supporting data.
2. A minimum change. No adjustment unless the net change is at least 3 percent of the contract price.
3. A cap. Increases add up to no more than 10 percent of the original unit price, with no limit on decreases.
4. No back-billing. No upward change for work done before the adjustment takes effect.
5. Records. The buyer may examine the cost records for up to 3 years after final payment.

Put the method in the agreement before the term starts. The federal personal services safe harbor protects facility payments only when, among its other terms, the method for setting them is set in advance, at fair market value, and not tied to referrals (42 CFR 1001.952(d)). A surcharge formula and a CPI clause written in at signing keep the method set in advance. Put any other mid-term change in a signed amendment your lawyer has reviewed. See anti-kickback rules for NEMT.

How to give notice of a price increase

Your agreement sets the notice period, so read it first. The facility transportation agreement template lets a rate change take effect only after a set number of days’ written notice and a new rate schedule signed by both sides.

1. Run your numbers. Rebuild your cost per hour and per mile as shown in how much to charge for NEMT.
2. Write one notice per customer group. Give the old price, the new price, the effective date, and the reason in one sentence.
3. Name the formula for a surcharge. Give the index and the math, so a rider or facility can check the charge against EIA’s weekly price.
4. Send facility notices early. Give at least the days the agreement requires, and get the new schedule signed before the date.
5. Tell standing riders before their next booking. A dialysis rider three times a week should hear it from you, not from a receipt.
6. Issue a new dated rate sheet. Keep every old sheet, so you can show what you charged on any date of service.

All-in price laws: when the surcharge belongs inside your quote

A fuel surcharge that every rider pays is a mandatory fee. Several states now require prices offered to consumers to include mandatory fees. All of them let you leave government taxes out of the quote.

• California. Since July 1, 2024, Civil Code 1770(a)(29), amended effective January 1, 2026, bars offering or displaying a price that leaves out mandatory fees. The Attorney General says listing one price and adding a percentage fee, or adding a variable fee later, does not comply. You may itemize what the total includes, and a business that does not yet know its total should wait to show a price until it does. For a ride, that means quoting the trip total once you have the miles. The law covers purchases for personal use and not for commercial use, which generally leaves facility contracts outside it.
• Minnesota. Since January 1, 2025, Statutes 325D.44, subdivision 1a, makes leaving mandatory fees or surcharges out of a price a deceptive practice. When the total depends on distance or time, you comply by clearly disclosing the factors that set the price, any mandatory fees, and that the total may vary.
• Colorado. Since January 1, 2026, C.R.S. 6-1-737, added by HB25-1090, requires the total price as a single number, shown more prominently than any other price. When a total cannot be known at the offer because it depends on distance or time, you may instead disclose the pricing factors, mandatory fees, and that the price may vary.
• Massachusetts. Since September 2, 2025, 940 CMR 38.04 requires the total price each time you show a price for personal or family use, and the nature, purpose, and amount of each fee when you first show the total. Unlike Minnesota and Colorado, it lists no exception for prices that depend on distance, and it bars telling a customer that a fee is required by law when it is not.

The Federal Trade Commission’s fee rule covers only live-event tickets and short-term lodging (16 CFR 464.1), not rides. In those four states, the clearest quote is a trip total with the current surcharge already in it, itemized on the receipt. Card processing fees follow their own rules, covered in taking payment for private-pay rides.

The IRS mileage rate is a signal, not an index

The IRS raised its business standard mileage rate from 72.5 cents to 76 cents a mile for July 1 through December 31, 2026, and said the change came from recent increases in the price of fuel (IRS raises the mileage rate). It confirms that fuel costs jumped. It is still a tax deduction rate built from many car costs, and it is usually set once a year. Tie your surcharge to EIA’s weekly price, and use the IRS change as a reason to review your base price.