# Texas Raises Demand Response NEMT Rates About 4.5% After Its 2026 Fee Review

Canonical URL: https://nemtguide.com/news/texas-nemt-fee-review/ · Updated 2026-09-30

On August 31, 2026, the Texas Medicaid & Healthcare Partnership (TMHP), the state's Medicaid claims administrator, posted the results of the Texas Health and Human Services Commission's (HHSC) 2026 biennial calendar fee review. For Medical Transportation Program (MTP) demand response rides on or after September 1, 2026, the per-leg [T2003](https://nemtguide.com/glossary/t2003/) rate rose about 4.5% in every area type. Two days later, TMHP posted a separate mileage increase for individual drivers, to 76 cents a mile from July 1, 2026.

## What the fee review changed

| Code | Area type | Rate through August 31, 2026 | Rate from September 1, 2026 | Increase |
|---|---|---|---|---|
| T2003 U1 | Metro (urban) county | $32.38 | $33.83 | $1.45, or 4.48% |
| T2003 U3 | Micro (suburban) county | $59.64 | $62.31 | $2.67, or 4.48% |
| T2003 U2 | Rural county | $76.22 | $79.63 | $3.41, or 4.47% |

These are the same amounts HHSC proposed in attachment A(7) of its hearing packet, so the rates were adopted as proposed. TMHP's static fee schedule for demand response providers, printed September 14, 2026, lists all three with a fee effective date of September 1, 2026. Rides before that date keep the old rates.

## Who gets the new T2003 rates

The rates pay demand response transportation service (DRTS) providers and transportation network companies (TNCs) enrolled with TMHP. MTP arranges these rides for fee-for-service Medicaid clients, the Children with Special Health Care Needs (CSHCN) Services Program, and Transportation for Indigent Cancer Patients (TICP), and it prior authorizes every fee-for-service ride.

Health plan trips are separate. The MTP Handbook (September 2026) says it does not apply to managed care, and TMHP's notice reminds providers that health plan procedures differ. If you drive for a plan's ride vendor, your rate is set in your agreement with that vendor. See [MTM Health in Texas](https://nemtguide.com/brokers/mtm-health/texas/) and [SafeRide in Texas](https://nemtguide.com/brokers/saferide-health/texas/).

## How a T2003 claim is paid

TMHP's July 20, 2021 notice sets the method. The state's ride system authorizes each one-way leg and gives it its own authorization number. You file a claim for each leg, and TMHP pays the leg rate times the number of seats HHSC authorized. At the September 1, 2026 rates, that works out as follows:

| Trip | Math | Payment |
|---|---|---|
| Metro (U1), one rider, round trip | 2 legs x $33.83 | $67.66 |
| Metro (U1), two authorized seats, round trip | 2 legs x 2 seats x $33.83 | $135.32 |
| Micro (U3), one rider, one way | 1 leg x $62.31 | $62.31 |
| Rural (U2), one rider, round trip | 2 legs x $79.63 | $159.26 |

T2003 pays a flat amount per leg, with no separate mileage line. Within an area type, a short leg and a long leg pay the same, so check your [cost per trip](https://nemtguide.com/guides/nemt-cost-per-trip/) against each rate.

## How Texas sets these rates

HHSC reviews Medicaid rates for all acute care services every two years, and each review can raise, lower, or keep a rate. The MTP method sits in 1 TAC 355.8561. HHSC's notice for this review covered MTP rides along with surgery, drug, vision, and other code groups. It held the public hearing on May 26, 2026, in Austin and online, and took written comments until 5 p.m. that day. HHSC said it intends to submit a state plan amendment to update the fee schedules.

T2003 has now risen twice in two years. The last change came from a special review at a November 12, 2024 hearing, applied to rides back to November 1, 2024, with affected claims reprocessed.

| Dates of service from | U1 metro | U3 micro | U2 rural |
|---|---|---|---|
| June 1, 2021, when TMHP began processing DRTS claims | $27.06 | $49.85 | $63.71 |
| November 1, 2024 | $32.38 | $59.64 | $76.22 |
| September 1, 2026 | $33.83 | $62.31 | $79.63 |

Each rate is now about 25% above its 2021 level.

## Mileage for individual drivers rose on July 1

TMHP's September 2, 2026 notice raised [S0215](https://nemtguide.com/glossary/s0215/), the per-mile rate for individual transportation participants (ITPs), from $0.73 to $0.76 for rides on or after July 1, 2026. TMHP will reprocess the affected claims it finds, and providers do not need to appeal unless a claim is denied for another reason after reprocessing.

S0215 pays only ITPs, the clients, relatives, and friends who drive in their own car. It does not pay demand response companies. Under 1 TAC 355.8561, ITP mileage follows the vehicle mileage rate the legislature sets for state employees, and the Texas Comptroller lists 76 cents a mile for July 1 to December 31, 2026. For the January 2026 change, see [the 73-cent update](https://nemtguide.com/news/texas-mtp-rate-update/).

## What Texas NEMT providers should do now

1. **Check your Remittance and Status reports.** Each T2003 line for a ride on or after September 1, 2026 should pay the new rate times the authorized seats. If one pays the old rate, call the TMHP Contact Center. See [how to read a remittance advice](https://nemtguide.com/guides/read-remittance-advice/).
2. **Bill each leg with its own authorization number.** Use T2003 with U1, U2, or U3, diagnosis code Z753, benefit code MTP, and place of service 09 on paper or 99 in TexMedConnect.
3. **Use the right taxonomy.** The MTP Handbook recommends 343800000X for demand response providers and 347C00000X for TNCs.
4. **File on time.** MTP claims are due within 95 days of the date of service for in-state providers and 365 days for out-of-state providers.
5. **Recheck your prices elsewhere.** Compare the new per-leg rates with what health plan vendors and facilities pay you. [NEMT reimbursement rates by state](https://nemtguide.com/guides/nemt-reimbursement-rates/) shows how Texas compares.

Not a DRTS contractor yet? HHSC's open enrollment HHS0016482 for demand response transportation takes applications until September 15, 2027, at 5 p.m. Central. It builds a statewide network of regional contractors. The [Texas state guide](https://nemtguide.com/states/texas/) covers enrollment, insurance, and permits.

## Key dates

| Date | What happened |
|---|---|
| June 1, 2021 | TMHP begins processing DRTS claims under T2003 |
| November 1, 2024 | T2003 rises for rides from this date, after a special review heard on November 12, 2024 |
| September 15, 2025 | HHSC opens DRTS open enrollment HHS0016482 |
| May 26, 2026 | HHSC holds the public rate hearing on the fee review |
| July 1, 2026 | S0215 rises to $0.76 a mile for rides from this date |
| August 31, 2026 | TMHP announces the September 1 rates |
| September 1, 2026 | New T2003 rates take effect |
| September 2, 2026 | TMHP posts the S0215 increase and says it will reprocess affected claims |

## Who to contact

- **TMHP Contact Center:** 800-925-9126, for claims, payments, and rates
- **HHSC Provider Finance, Acute Care Services:** PFDAcuteCare@hhs.texas.gov, for questions about the fee review
- **MTP ride line for clients:** 877-633-8747, at least 2 business days before the appointment, or 5 for a trip outside the client's county