No-Fault Medical Transportation in 2027: Billing Auto Insurers for Rides After a Crash

How no-fault insurance pays for rides to treatment

In a no-fault state, a person hurt in a car crash claims medical bills from an auto policy’s personal injury protection, usually called PIP, without first proving who caused the crash. Some of those states count the rides to doctor visits, physical therapy, and surgery follow-ups as part of the claim. That turns an injured person who cannot drive into a paying rider whose bills go to an insurance adjuster.

For a small NEMT company, this is work outside Medicaid, much like workers’ comp transportation: an insurer pays, a claim number ties every ride together, and an adjuster decides what is covered. The rules come from each state’s insurance law, and they differ a lot. One state pays a reasonable charge with no fee schedule, another pays from a capped daily allowance, and another names only ambulances.

This page covers rides you give to someone hurt in their own crash. When a rider is hurt in your van, your own policy’s coverage is the question, covered in medical payments coverage and PIP.

What PIP pays for rides in five states

The rules split three ways. Michigan, Minnesota, and New Jersey treat rides as part of medical care. New York pays them from a small daily allowance. Florida names ambulances and not other rides.

State	What PIP pays for rides	Coverage amount
Michigan	Reasonable charges for non-emergency rides, with no fee schedule	$50,000 (Medicaid enrollees), $250,000, $500,000, or unlimited, as chosen
Minnesota	Ambulance and all other transportation to covered care	At least $20,000 of medical expense per person
New Jersey	Ambulance or other transportation, as a medical expense	The policy’s PIP limit
New York	Up to $25 a day for other necessary expenses, including rides to care, for one year	Inside $50,000 of basic economic loss
Florida	Medically necessary ambulance service; other rides are not named	$10,000 at 80% ($2,500 with no emergency medical condition)

Ask the adjuster which limit the policy carries and how much is left. In Michigan, a policyholder with Medicare Parts A and B may drop PIP medical coverage entirely when the spouse and relatives at home have qualifying health coverage or PIP of their own (MCL 500.3107d). In every state, a long recovery can use up a small limit. Other no-fault states write their own rules, so read your state’s PIP law before you take a claim there.

Michigan: reasonable charges, no fee schedule

Michigan pays PIP benefits for “allowable expenses consisting of reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person’s care, recovery, or rehabilitation” (MCL 500.3107(1)(a)). For services after July 1, 2021, a separate fee schedule in MCL 500.3157 caps what PIP pays physicians, hospitals, clinics, and similar providers.

The state’s Department of Insurance and Financial Services (DIFS) settled where rides fit in Bulletin 2021-38-INS, issued October 11, 2021. Services not provided by physicians, hospitals, clinics, or like persons are not subject to the fee schedule, and the bulletin lists non-emergency medical transportation by name. Those charges only have to be reasonable under 3107(1)(a). An insurer that applied the fee schedule to them had to reprocess the claims, and DIFS tells a provider who thinks a bill was processed wrong to ask the insurer for reconsideration.

The rest of the Michigan rules shape how you bill:

• Payment clock. Benefits are overdue 30 days after the insurer receives reasonable proof of the fact and amount of the loss, and overdue amounts earn 12% simple interest a year. If your bill arrives more than 90 days after the ride, the insurer gets 60 extra days (MCL 500.3142).
• Lawsuit deadline. A suit for benefits must start within one year of the crash, unless the insurer got written notice of the injury within that year or already paid. Then it may start within one year of the latest expense, but it cannot recover any loss incurred more than one year before the suit was filed. The clock pauses while a specific claim waits for a formal denial (MCL 500.3145).
• Write to the adjuster. An insurer that pays benefits in good faith to the person it believes is entitled is discharged to that extent, unless it was notified in writing of someone else’s claim (MCL 500.3112). Send your notice before the insurer pays the rider for your rides.
• No assignments of future rides. An agreement to assign a right to benefits payable in the future is void (MCL 500.3143), so a form signed at intake does not cover rides you have not given yet.
• Records review. Anyone who provides services to a person covered by PIP after July 1, 2020 is deemed to agree to send records for the insurer’s utilization review and to follow DIFS decisions (MCL 500.3157a).
• Appeals. A provider may appeal an insurer’s finding of overuse or an inappropriate cost to DIFS within 90 days of the disputed decision, on the department’s form (Mich Admin Code R 500.65(1), as quoted by the Court of Appeals on June 27, 2024).

See the Michigan NEMT guide for the state’s Medicaid side.

New York: $25 a day, paid to the rider

Basic no-fault in New York pays up to $50,000 per person across medical expenses, lost earnings, and other necessary expenses (Insurance Law 5102(a)). Medical expenses include ambulance service. Rides in a car or van fall under other expenses: all other reasonable and necessary expenses, up to $25 a day for not more than one year from the crash. The same $25 covers the rider’s other costs too, such as hiring a housekeeper. The letter insurers must send when they offer optional coverage gives “necessary transportation expenses to and from a health service provider” as an example (11 NYCRR 65-1.2).

Three rules decide how you get paid:

• The money goes to the rider. The regulation pays benefits directly to the applicant, or by assignment to providers of health care services covered as medical expenses under 5102(a)(1) (11 NYCRR 65-3.11(a)). Rides fall under other expenses, so expect the rider to pay you and claim the money back. Treat these as private-pay rides, and hand over an itemized receipt for every trip.
• Deadlines fall on the rider. Notice of the crash is due within 30 days, and written proof of claim for other necessary expenses within 90 days after the service, unless the rider gives a clear and reasonable excuse (11 NYCRR 65-1.1).
• The payment clock. Benefits are overdue if not paid within 30 calendar days after the insurer receives proof of claim, and overdue benefits earn 2% a month (11 NYCRR 65-3.8 and 65-3.9).

At $25 a day, a wheelchair round trip can cost more than the allowance. Tell the rider what the insurer will likely cover and what they will owe before the first ride. The New York NEMT guide covers Medicaid rides in the state.

New Jersey and Minnesota: rides count as medical care

New Jersey

New Jersey’s PIP rule defines medical expense to include “reasonable and necessary expenses for ambulance services or other transportation,” subject to the limits in the approved policy forms (N.J.A.C. 11:3-4.2, text effective October 17, 2016). The ambulance exhibit of the state’s PIP fee schedule lists only ambulance codes, in the A0425 to A0436 range, and no wheelchair van or car codes.

For a service the fee schedules do not cover, the insurer pays a reasonable amount considering fees for similar services in the region, and with no similar service listed, no more than the usual, customary, and reasonable fee (N.J.A.C. 11:3-29.4(e)). You show your usual fee with explanations of benefits from other payers that show what you billed and what they paid. The insurer compares that with its own experience, may use national fee databases as evidence, and must name the database, its edition date, the geozip, and the percentile it used.

An insurer with an approved decision point review plan can require precertification for the services on its list, though not within 10 days of the crash (N.J.A.C. 11:3-4.2 and 11:3-4.7). Ask the insurer or its PIP vendor whether rides need approval before the first trip.

Minnesota

Minnesota’s medical expense benefits reimburse all reasonable expenses for necessary “ambulance and all other transportation expenses incurred in traveling to receive other covered medical expense benefits” (Minnesota Statutes 65B.44, subdivision 2). Every policy carries at least $40,000 per person, of which $20,000 is for medical expense.

Benefits are paid monthly as the loss accrues and are overdue if not paid within 30 days after the insurer receives reasonable proof. The insurer may pay medical expense benefits directly to whoever supplied the service, and overdue payments earn 15% simple interest a year (65B.54).

Florida: PIP names ambulances only

Florida PIP pays 80% of reasonable expenses for medically necessary care, up to $10,000, if initial care starts within 14 days of the crash. The limit drops to $2,500 when the treating provider finds no emergency medical condition. The statute names medically necessary ambulance services and pays only for care from the provider types it lists, such as physicians, hospitals, and licensed emergency transportation services (section 627.736(1)). A wheelchair van or car ride is not among them.

How to bill an auto insurer for a ride, step by step

1. Take the claim details at intake. Insurer, claim number, adjuster’s name, phone, and email, the crash date, the policyholder, and the treating provider with the appointment schedule.
2. Confirm coverage in writing. Ask the adjuster whether rides are covered, at what rate, how much of the limit is left, and whether rides need approval first.
3. Get the reason in writing. Michigan pays only for reasonably necessary services, so ask the treating provider for a short note on why the patient cannot drive or ride other transportation.
4. Send written notice of your claim to the adjuster before the first ride, with your company name, tax ID, and billing address.
5. Bill each ride separately. List the date, pickup and drop-off addresses, loaded miles, wait time, and level of service. If the adjuster wants codes, use the ones you bill elsewhere, such as T2003 for a trip and T2007 for waiting time.
6. Bill within weeks, not months. In Michigan, a bill sent more than 90 days after the ride slows payment, and the one-year-back rule cuts off old rides. In New York, the rider’s proof is due within 90 days.
7. Charge everyone the same. Use one rate sheet for private-pay, facility, and insurance rides, and keep paid invoices and other payers’ explanations of benefits as proof of your usual fee.
8. Track the 30-day clock on every bill, and ask for interest when payment is late.
9. Dispute in writing. Ask the insurer to reconsider first. In Michigan, you may appeal a cost or overuse decision to DIFS within 90 days.

When the rider also has Medicaid

Medicaid pays after other coverage. When a state knows another payer is liable at the time a claim arrives, it generally rejects the claim and returns it to the provider so the other payer can be billed first (42 CFR 433.139). The third party liability guide shows how that looks on a claim.

Keep the two channels apart. A ride the injured person books through a Medicaid broker is a broker trip: you bill the broker under your agreement, and you never bill the same ride to an auto insurer as well. MTM Health’s standard agreement, in the January 1, 2023 version Pennsylvania posts, says you look solely to MTM for payment (section 6.C). A ride the adjuster approves is an insurance ride, billed to the insurer. In Michigan, a Medicaid enrollee may have chosen the $50,000 PIP limit (MCL 500.3107c), so that limit can run out during a long recovery.