Baltimore County Medical Assistance Transportation: Who Drives the Trips and How to Get Them (2027)

Baltimore County runs its Medicaid rides through the Department of Health’s Medical Assistance Transportation Program. County staff screen each rider, then the work splits by service level among three companies on County Council contracts: Transdev for shared ambulatory rides, Hart to Heart for wheelchair vans and ambulances, and ProCare for some standing dialysis riders. A new company reaches these trips by bidding when a contract comes up or by subcontracting under Hart to Heart.

Who arranges Medical Assistance rides in Baltimore County

Maryland pays for Medicaid rides through grants to local programs under COMAR 10.09.19, here the county Department of Health, and each grantee screens requests and buys rides in its own area. The Maryland guide explains that grant system and the state plan page CMS approved on May 20, 2026.

The county calls its program “last resort” transportation for riders who walk, use a wheelchair, or travel by stretcher and have no other way to an appointment. A rider must live in Baltimore County, have eligible, non-restrictive Medical Assistance, and have absolutely no other way there. County staff screen for other resources at the start, then quarterly or when a rider’s situation changes, and a medical certification is due at least once a year.

The program office at 6401 York Road books wheelchair and ambulance trips at 410-887-2828, weekdays from 8:30 a.m. to 3:45 p.m. Ambulatory riders get county approval first and then book with Transdev themselves. Trips go in one to seven days ahead and at least 24 hours before the appointment, and ambulatory riders who already use MTA Mobility may use the program only in extreme circumstances.

This is a large program. MDH’s October 2019 report counted 203,058 paid trips in Baltimore County in fiscal 2019, more than any other Maryland jurisdiction, at an average of $40.77 a trip. The county’s 2022 contract summary counted 203,285 Medical Assistance recipients living in the county in fiscal 2021. Baltimore City runs a separate program with its own companies.

Three contracts carry the county’s trips

Transdev: shared ambulatory rides

Transdev Services, formerly Veolia Transportation Services, has driven the county’s ambulatory rides under an agreement dated June 1, 2009, awarded from bid B-087 to the lower of two bids. On June 5, 2023 the County Council approved a third amendment that renews the contract a year at a time from July 1, 2023 until MDH starts a statewide brokered program. As of October 2026 the county’s page still sends approved riders to Transdev, and the legislature’s 2026 budget analysis gives MDH’s statewide NEMT dispatch and claims system an estimated completion date of 2030.

The 2023 amendment covered about 175,000 one-way trips a year for 7,325 clients, mostly weekdays between 6 a.m. and 6 p.m., to care such as dialysis and substance use treatment. Transdev schedules the trips, handles complaints, and covers after-hours trips as needed. Its vehicles assigned to the county carry signs reading BACO MA.

Hart to Heart: wheelchair vans and ambulances

Hart to Heart Ambulance Service holds the wheelchair van and ambulance contract the Council approved on September 6, 2022. It runs one year with four automatic one-year renewals and an optional 120-day extension, about five years and four months in all, at an estimated $2,450,000 a year. Hart to Heart was the only bidder, and the contract carried a 15% minority and women business participation requirement.

It covers trips to appointments, rides home from emergency visits and hospital stays, and transfers between hospitals, 24 hours a day, for county riders and for other riders the county assigns. For fiscal 2023 the county estimated 11,990 wheelchair van trips and 4,151 basic life support ambulance trips, plus 57 advanced, specialty care, and neonatal ambulance trips. The county’s page says Hart to Heart may use subcontractors for both wheelchair and ambulance rides. See how to subcontract NEMT trips.

ProCare: standing dialysis riders

By January 2025 the Health Department told the Council that Hart to Heart could not cover all of its riders. Purchasing informally asked four companies to help, ProCare Ambulance of Maryland was the only one to answer, and the department negotiated its rates. The Council approved the noncompetitive contract on January 21, 2025.

ProCare’s contract allows wheelchair van and ambulance trips, but the department said ProCare would carry only riders with standing dialysis orders. It ran through September 5, 2026 and renews automatically for one more year unless the county gives notice, with an optional 120 days on top, at an estimated $4,964,400 for the whole term. See dialysis transportation for how standing trips work.

What the county pays its ride contractors

Each contract pays a base rate per one-way trip plus a mileage charge on long trips, and the rates differ widely between contracts. Hart to Heart and ProCare add their mileage rate for every mile past 20, and Transdev adds its rate per mile on trips over 20 miles. These are the rates in each Council item:

Contract	Service	Base, one way	Per mile over 20 miles
Transdev, FY2025	Shared ambulatory ride	$35.55	$5.16
Hart to Heart, 2022	Wheelchair van	$64.06	$3.50
Hart to Heart, 2022	Basic life support ambulance	$398.89	$8.00
ProCare, 2025	Wheelchair van	$200.00	$8.00
ProCare, 2025	Basic life support ambulance	$475.00	$10.00

Transdev bills $32.25 for an approved escort in fiscal 2025. Each contract lets the company ask for a raise before a renewal, capped at the lower of CPI-U or 5%, so today’s rates may be higher. Under its amendment, Transdev may also offer new pricing, and if the two sides cannot agree it can end the contract on 90 days’ notice.

What the county’s rider rules ask of the company that drives

The rider rules on the county’s page set the service each contractor delivers, and a subcontractor works to the same rules:

• Ready times. Transdev riders are ready 90 minutes before the appointment, and the vehicle has up to an hour after the ready time to arrive and 30 more minutes to reach the drop-off. Hart to Heart riders are ready an hour before, and county staff give the ready time.
• Waits. Transdev drivers go to the door and give the rider five minutes to board, then count a no-show and leave a slip if no one answers. Hart to Heart drivers wait up to 15 minutes. A late driver never turns a trip into a rider no-show.
• Returns. Transdev drivers go into the lobby and call the rider’s first name and last initial, and they have 45 minutes past the scheduled return time.
• Hours. Transdev runs Monday to Saturday from 5 a.m. to 7:30 p.m., and 6 p.m. is the latest appointment it accepts. Hart to Heart runs appointment trips Monday to Saturday from 5 a.m. to 8 p.m., and discharges and transfers every hour of every day.
• Shared rides. Wheelchair riders may share a van with other riders and escorts, and each ambulance carries one patient. See wheelchair vans for NEMT.
• Standing orders. Transdev subscriptions, repeat trips such as dialysis on the same days and times all month, must be renewed in the third week of each month.
• Escorts. The county cannot supply escorts. On Transdev rides, nursing home residents always ride with one, children 17 and under ride with an adult, and drivers refuse anyone not approved in advance.
• Cancellations and no-shows. Riders cancel at least 30 minutes before the ready time. Repeat no-shows bring a warning, then an Advance Confirmation Notice that makes the rider call the day before every trip, standing orders included.
• Weather. The county may cancel routine trips in bad weather and keep the most serious medical trips running.

Hospitals book discharges and transfers directly with Hart to Heart at 443-573-2037 on the day the patient leaves. See hospital discharge transportation.

What a clinic certifies on the county forms

The county posts three statewide forms, printed with its own address and fax number (410-377-8296), and the form sets the mode a company is sent to drive:

• The certification form (rev. July 24, 2018) is signed by a physician, physician assistant, nurse practitioner, or dentist and is valid for one year. It asks for the diagnosis spelled out, never an ICD code, and one mode. An ambulatory rider’s form must say why public transit, including paratransit, is not clinically appropriate, and a wheelchair rider’s form names the chair type: regular, electric, scooter, extra wide, or specialty.
• The ambulance questions on that form must all be answered: whether the patient can ride seated and secured in a sedan or wheelchair van, whether the patient is bed confined (unable to get out of bed without help, walk, or sit in a chair or wheelchair), and which listed condition calls for an ambulance.
• The transfer and discharge form (revised July 2018) may also be signed by a discharge nurse or social worker. It has a box for a wheelchair patient who needs an ambulance only because the patient’s own wheelchair is not at the hospital.
• The out-of-area form (rev. April 2018) reminds doctors that the program only has to drive a rider to the closest appropriate provider, not the one the rider prefers.

Incomplete forms go back to the provider and can delay the ride. See medical necessity form.

How a new company gets Baltimore County trips

1. Register on the county bid portal. Purchasing posts every county bid there, registration is free, and you pick your service codes to get notices. Purchasing is at 400 Washington Avenue, Room 148, in Towson.
2. Watch the end dates. Hart to Heart’s longest possible term runs into early 2028, ProCare’s renewal year, if the county kept it, ends September 5, 2027 before any extension, and Transdev’s runs until the statewide program starts. Any contract longer than two years or over $25,000 a year goes to the County Council, and the County Auditor posts notes on each item before the vote.
3. Get certified if you qualify. The county accepts minority and women business certification from MDOT and the Baltimore City Minority and Women’s Business Opportunity Office. Its overall goal for certified firms was 23% of discretionary spending, set to rise to 30% in fiscal 2026.
4. Ask Hart to Heart about subcontracting. It may subcontract wheelchair and ambulance rides, and a certified subcontractor helps it meet its 15% participation requirement.
5. Get known to Purchasing. When the county needed more dialysis capacity before January 2025, Purchasing asked four companies informally rather than posting a bid. For renewals and new awards it looks for good standing with SDAT, a current certificate of insurance, and a complete procurement affidavit.
6. Hold the right license. Van companies usually need Maryland PSC passenger carrier authority and for-hire driver licenses. Maryland’s ambulance definition exempts only wheelchair lift vans (COMAR 30.09.01.02), so ambulance and stretcher companies need a MIEMSS license. Baltimore County is outside the Washington area commission’s district, so trips that start there need no WMATC certificate. See NEMT vs ambulance.

Taxi rides for other Health Department clients

The county also buys taxi rides for clients of its Healthcare Access programs, such as HIV case management, who show the ride is a last resort. The Council’s October 5, 2026 agenda asks it to approve contracts with Jimmy’s II, LLC and The Independent Taxi Association from October 25, 2026, worth an estimated $440,000 combined over up to five years and four months. Fares follow the metered rates the PSC approves, since the PSC regulates taxicabs in Baltimore County, and these two were the only bidders.