NEMT Wait Time Billing in 2027: Who Pays T2007, How to Count Units, and What to Record

Waiting at a clinic costs you driver time and a van that earns nothing. Whether anyone pays you back depends on the payer. Federal rules let Medicaid pay for waiting only in limited cases, so many programs and brokers pay nothing extra, and the ones that do pay small amounts under strict rules.

Can you bill for NEMT wait time?

Only when the payer pays for it. Wait time has its own national codes, but no payer is required to pay them.

Code	What CMS calls it	Used for
T2007	Transportation waiting time, air ambulance and non-emergency vehicle, one-half (1/2) hour increments	Wheelchair vans, stretcher vans, and other NEMT vehicles
A0420	Ambulance waiting time (ALS or BLS), one half (1/2) hour increments	Ground ambulances

Both codes count one unit for each 30 minutes. The October 2026 HCPCS file from CMS gives both coverage code I, which means Medicare does not pay them. On Medicaid trips, wait time is paid, where it is paid at all, by state programs and the plans and brokers that work for them. See NEMT billing codes for the base and mileage codes that go on the same claim.

What federal Medicaid rules allow

CMS sets the limits in its Medicaid Transportation Coverage Guide (SMD 23-006, September 28, 2023). States generally may not cover long wait times as a separate service, because the rider is not in the vehicle while the driver waits. CMS also says it can cost less for a second driver to make the return trip than for the first driver to wait.

The guide leaves states two ways to pay for waiting:

• Build it into the trip rate. CMS says long waits carry real costs that rates must take into account.
• Pay it separately in limited cases. Since September 28, 2023, a state may pay wait time when the distance and travel time make it more economical for the driver to stay at the medical provider. The state must submit a state plan amendment to CMS before it claims federal funds for these payments.

That is why a T2007 line is paid in some programs and denied in others.

Which programs pay NEMT wait time

Program	Pays wait time?	Rate and effective date	Main limits
Arizona AHCCCS fee-for-service	Yes, on T2007	$4.59 per 30 minutes, urban or rural (October 1, 2026)	No wait under 30 minutes, on a one-way trip, or to a service 10 miles away or less. Same vehicle and driver both ways.
Indiana Medicaid fee-for-service	Yes, on T2007 with U3 (ambulatory) or U5 (wheelchair)	$7.43 per 30 minutes (January 1, 2026)	Only past the first 30 minutes, only when the member rides 50 miles or more one way, and only with the van parked outside the provider
Medi-Cal fee-for-service	Yes, on T2007 for wheelchair and litter vans, A0420 for ambulances	Up to $11.30 per 30 minutes on T2007 (rate page updated September 2023) and up to $19.76 on A0420 (August 2020)	Only past the first 15 minutes, 90 minutes at most, and only while waiting to load the patient
Kansas Medicaid	No	None	The state plan says payment for waiting time is not allowed (amendment KS 21-0020, effective October 1, 2021)
Illinois Medicaid	No	None	The transportation handbook (March 11, 2024) lists charges for waiting time among the costs it does not pay
North Carolina county NEMT	Not as a Medicaid cost	Whatever the county agrees to	A county that agrees to pay a vendor for driver wait time must have it invoiced separately from Medicaid transportation costs (MA-2910, revised March 16, 2026)

Arizona

AHCCCS’s fee-for-service billing manual (Chapter 14, revised July 31, 2026) lets you bill only the time the driver actually waited at the medical destination. The distance must have made it not feasible to return to your base or to where the trip started. When several members ride together, wait time is paid for one member only, and none is paid if the odometer changes between drop-off and pickup.

Every trip for one member on one date goes on one claim: the base rate on line 1, loaded miles on line 2, and wait time on line 3. Any added lines deny, and so does a second claim for the same date. The Arizona state guide covers the rest of the program.

Indiana

Indiana’s Transportation Services module (version 6.1, published August 19, 2025) pays waiting time only when the provider parks outside the medical provider to wait and the member rides 50 miles or more one way. The first 30 minutes are never paid, but you must report the whole wait or Indiana cannot price the claim. On a shared ride, only the first member’s wait is paid.

Most fee-for-service rides in Indiana go through the state’s broker, Verida. The module says Verida’s rate schedule is based on the Indiana fee schedule and that Verida can negotiate higher or special rates with each provider. Rides exempt from the broker, such as stretcher and hospital-to-hospital trips, bill Indiana Medicaid directly.

Medi-Cal

Medi-Cal’s ground transportation manual (waiting time page updated August 2020) pays waiting time past the first 15 minutes, billed on T2007 for wheelchair van and litter van trips. You may bill 3 units at most, the 90 minutes after the first 15, except for neonatal ambulance transports. You must justify the wait and write the clock times it began and ended in the Additional Claim Information field (Box 19) or on an attachment.

Only time spent waiting to load the patient counts. Medi-Cal pays no waiting time on a transfer from an acute care facility to a level A nursing facility.

How brokers handle wait time

When your trips come from a broker or health plan, the state fee schedule is only a starting point, and your contract decides whether waiting is paid.

• MTM Health. Its standard provider agreement, in the January 1, 2023 version Pennsylvania posts, pays the rates in the agreement’s rate sheet, Schedule A. MTM’s Missouri provider page says rates are set with each provider individually, as of September 2026.
• Verida in Indiana. Its rates start from the Indiana fee schedule, which includes T2007, and it can agree to special rates.
• CareOregon in Oregon. Its provider manual (version 1.3, February 2024) marks some trips as needing wait time, such as a pharmacy stop or a visit to a substance use treatment clinic. The wait at that stop cannot run past 15 minutes unless the brokerage approves more. If the driver cannot wait longer, the brokerage confirms a no-show.

Before you sign or renew a broker agreement, get these answers in writing:

1. Is wait time paid, and on which code?
2. How long is the unpaid period, and is there a cap?
3. How are partial units rounded?
4. Who approves a wait, and when: at booking or on the day?
5. What proof does the claim need?
6. On a shared ride, is the wait paid for one rider or each rider?

See how to bill NEMT brokers and how to negotiate broker rates.

How to count billable wait time

Each program counts the same wait differently. Here is one 2-hour wait at each program’s rate: Arizona’s from October 1, 2026, Indiana’s from January 1, 2026, and Medi-Cal’s from its page updated September 2023.

The same 2-hour wait	Arizona	Indiana	Medi-Cal
Unpaid part	None, once the wait reaches 30 minutes	The first 30 minutes	The first 15 minutes
Units on the claim	4	4, the whole wait	3, the cap
Units paid	4	3	3
Pay	4 × $4.59 = $18.36	3 × $7.43 = $22.29	3 × $11.30 = $33.90
The trip must also	Be a round trip to a service more than 10 miles away	Be 50 miles or more one way	Show the clock times in Box 19

Indiana gives the clearest rounding rule. Bill one unit per 30 minutes, round a leftover of 15 minutes or more up, and round a leftover under 15 minutes down. A 45-minute wait is 2 units, and a wait of 1 hour 10 minutes is also 2 units. Arizona says to bill only the time actually waited, and Medi-Cal counts from minute 16. If your broker gives no rounding rule, ask for one in writing.

When the driver leaves, there is no wait

If the driver drops the rider off and leaves, the return is a new trip, not a wait. Indiana’s bulletin BT2025119 (August 19, 2025) bills each return after the driver leaves as an added trip with the XE modifier. The same bulletin says a trip where the driver stays and waits is a single trip, so never split its legs with XE. See wait and return trips.

What to record for every wait you bill

Programs that pay waiting also audit it. AHCCCS says it audits mileage and wait time after payment and can ask for your records any time after the date of service. Keep these for every wait you bill:

1. The clock time the wait began and ended. Indiana wants start and stop times on the driver’s ticket. Medi-Cal wants them in Box 19 or on an attachment.
2. Proof the van stayed. Arizona compares the odometer at drop-off and at pickup. Indiana requires the van to be parked outside the provider.
3. The same driver and vehicle both ways. Arizona pays no wait when two vehicles or drivers split the round trip.
4. Why waiting made sense. Arizona pays only when a return to base was not feasible. Medi-Cal requires you to justify the wait.
5. Who else rode. On a shared ride, Arizona and Indiana pay the wait for one member only.
6. The authorization. Where a trip needs prior authorization, Indiana’s request lists the total waiting time for each trip, such as two hours.

Arizona’s Daily Trip Report carries the odometer readings, clock times, and signatures for each leg. The trip log template has columns for all of it, and the trip documentation guide covers the full record.

Why wait time claims get denied

What went wrong	The rule it breaks
Wait billed on a one-way trip	Arizona allows wait time on round trips only
The driver left and came back	Arizona denies a wait when the odometer changes. Indiana treats a leave-and-return as a separate trip.
Two vans or drivers split the round trip	Arizona pays no wait
The wait was inside the unpaid period	Arizona: under 30 minutes. Indiana: the first 30 minutes. Medi-Cal: the first 15 minutes.
The trip was too short	Arizona: a service 10 miles away or less. Indiana: under 50 miles one way.
Wait billed for each rider on a shared ride	Arizona and Indiana pay one member only
No start and stop times	Indiana and Medi-Cal require them
Wait on its own claim, or lines out of order	Arizona wants base, miles, and wait on one claim, in that order
More than 90 minutes billed	Medi-Cal pays 3 units at most
XE modifier on the legs of a trip with a wait	Indiana counts a trip with a wait as one trip

A denied line shows on your remittance advice with a reason code. See NEMT claim denials and how to read remittance advice.

Is waiting worth it?

Even where it is paid, waiting pays little per hour: $9.18 in Arizona (2 units × $4.59), $14.86 in Indiana, and $22.60 in Medi-Cal, at the rates above. Compare that with what an hour of your driver and van costs you.

Your driver’s time counts either way. Under federal wage rules, an employee who must stay with the van is “engaged to wait,” and that time is hours worked (29 CFR 785.15). The rule’s own truck driver example says a driver who waits for the return trip while taking care of the employer’s vehicle is working (29 CFR 785.16). The time is off the clock only when you tell the driver in advance that they are free until a set time, and the break is long enough to use for their own purposes. See NEMT driver pay and 1099 or W-2 drivers.

So decide trip by trip. This example uses made-up costs: a driver who costs you $25 an hour with payroll taxes, a van that costs $0.75 a mile to run, a clinic 30 miles from base, and a 2-hour visit.

Example trip	Wait at the clinic	Drive back to base and return
Empty miles	0	60
Van running cost at $0.75 a mile	$0	$45
Driver time at $25 an hour	2 hours, $50	About 2 hours, $50, unless paid trips fill the gap
Wait pay, if the payer pays 3 units at Medi-Cal’s rate	$33.90	$0
Cost of the gap	$16.10	$95, less what any gap trips earn

Leaving wins when the appointment is long and you can fill the gap with paid trips nearby. The dialysis transportation guide shows how that works on long treatments. Waiting wins when the clinic is far from base and the empty miles would cost more than the idle hour. CMS makes the same point: a second trip is sometimes cheaper, and sometimes even a long wait is the most economical way home. The wait time cost calculator runs these numbers, and deadhead miles and rural NEMT cover the empty-mile side.

Wait time on private-pay and facility trips

Outside Medicaid, you set the wait charge yourself. Put the free period, the unit, and the rate on your rate sheet, and quote the total before the ride. See how much to charge for NEMT and the rate sheet template. A facility that books round trips can agree to the same terms in its contract, as the facility contracts guide explains.

On a Medicaid trip, never ask the rider or the family to pay for the wait. A Medicaid provider must accept the program’s payment as payment in full under 42 CFR 447.15. MTM’s standard agreement also says you look only to MTM for payment and may not charge the member.