NEMT Cost per Mile Calculator (2027): What One Mile Really Costs You

What the cost per mile calculator does

Cost per mile is what your company spends to move one vehicle one mile, once every monthly bill is counted. The calculator adds a month of fuel, repairs, insurance, the vehicle payment, other vehicle costs, and driver pay. Then it divides by the miles the vehicle drove that month.

It shows five things. The headline is the full cost per mile, driver included. Under it are the vehicle’s share, the driver’s share, how the vehicle’s share compares with the IRS standard mileage rate, and the month’s total cost.

Use it to check whether a broker’s rate covers your miles, to price private-pay rides, and to spot the van that costs more than the rest of your fleet. Run it once for each vehicle. A sedan and a wheelchair van have very different numbers, and an average hides the expensive one.

Count every mile. CMS says miles with no member on board generally cannot be paid, and that includes the drive back after a rider does not show up (SMD 23-006, September 28, 2023). Those miles still burn fuel and wear the vehicle, so the calculator spreads every cost over every mile.

How to use the calculator

1. Pick one vehicle and one full recent month, so each monthly bill is counted once.
2. Enter the miles it drove: the odometer at the end of the month minus the odometer at the start.
3. Enter what the vehicle cost that month in fuel, maintenance and repairs, insurance, the loan or lease payment, and other costs.
4. Enter the driver pay for that vehicle, with payroll taxes and benefits.
5. Enter the IRS standard mileage rate for the dates you drove.
6. Read the cost per mile at the top. Under it are the vehicle and driver shares, the share of the IRS rate, and the month’s total.

The results change as you type. Reset to example puts the example numbers back, and Show the formula lists every step of the math.

What each number means

Box	What to enter	Where to find it
Miles a month	Every mile the vehicle drove, empty miles included	Odometer readings on your first and last trip logs of the month
Fuel a month	Everything spent on fuel for this vehicle	Fuel card statement or receipts
Maintenance and repairs a month	Oil changes, tires, brakes, and repairs	A year of shop invoices ÷ 12
Insurance a month	This vehicle’s share of auto and liability premiums	The yearly premium for this vehicle ÷ 12
Vehicle payment a month	The loan or lease payment	Your loan or lease statement. Enter 0 if the vehicle is paid off.
Other vehicle costs a month	Registration, inspections, cleaning, tolls, and parking	Receipts, with yearly fees ÷ 12
Driver pay a month	Wages plus payroll taxes and benefits for this vehicle’s driver	Your payroll reports
IRS standard mileage rate	The IRS business rate for the dates you drove	irs.gov, standard mileage rates

Repairs arrive in lumps. A month with new tires looks expensive and a month with none looks cheap, so a year of shop bills divided by 12 gives a number that holds.

Insurance works the same way. Brokers set minimum limits in their agreements. MTM Health’s standard agreement, in the January 1, 2023 version Pennsylvania posts, asks for at least $500,000 of commercial auto liability, combined single limit, and $500,000 per occurrence of commercial general liability. Spread the auto premium across the vehicles it covers. The guide to NEMT insurance costs covers what drives the premium.

Driver pay a month

Add the employer’s payroll taxes to the wages. For 2026, IRS Publication 15 lists Social Security tax at 6.2% of wages up to $184,500 and Medicare tax at 1.45% of all wages, 7.65% in all for the employer. Federal unemployment tax is 0.6% of the first $7,000 of each employee’s wages when you get the full state credit. Workers’ compensation and state unemployment rates vary by state.

For example, a driver paid $3,344 in wages for the month costs you $3,344 × 1.0765 = $3,599.82 before unemployment taxes and workers’ compensation. That is close to the $3,600 example in the calculator. If two drivers share one vehicle, add both of their pay for the hours they drove it.

A worked example

The calculator opens with example numbers. They show how the math works. They are not market rates, so replace them with your own.

Step	Math	Result
Vehicle costs a month	$900 fuel + $300 repairs + $600 insurance + $900 payment + $150 other	$2,850
Vehicle cost per mile	$2,850 ÷ 3,000 miles	$0.95
Driver cost per mile	$3,600 ÷ 3,000 miles	$1.20
Cost per mile, driver included	$0.95 + $1.20	$2.15
Vehicle cost as a share of the IRS rate	$0.95 ÷ $0.76 × 100	125%
Costs a month	$2,850 + $3,600	$6,450

The fuel box is 3,000 miles ÷ an example 15 miles per gallon × $4.50 a gallon. That is close to the U.S. average for regular gasoline of $4.478 for the week of September 21, 2026 (EIA).

In this example the driver costs more per mile than the vehicle does. Driver pay follows hours, not miles. A day of short trips in heavy traffic, or long waits at a dialysis center, raises the driver’s cost per mile even though the vehicle barely moved.

Fuel cost per mile at September 2026 prices

Fuel is the vehicle cost that moves fastest. EIA’s weekly survey put regular gasoline at $4.478 a gallon for the week of September 21, 2026, $1.305 more than a year earlier. On-highway diesel was $6.529 that week. EIA also reports gasoline prices by region, for nine states, and for ten cities, which are closer to what you pay.

Fuel cost per mile = price of a gallon ÷ miles per gallon

Miles per gallon	Fuel cost per mile at $4.478	Fuel for 3,000 miles
12	$0.37	$1,119.50
15	$0.30	$895.60
18	$0.25	$746.33
22	$0.20	$610.64
36	$0.12	$373.17

EPA rates the 2026 Chrysler Pacifica, Chrysler Voyager, and Honda Odyssey, each with a gasoline V6, at 22 miles per gallon combined, the Kia Carnival V6 at 21, and the two-wheel-drive Toyota Sienna, a hybrid, at 36. Those ratings are for the vehicle as built. FuelEconomy.gov says an extra 100 pounds can cut fuel economy by about 1%, so a ramp, a lift, and securement gear all count. It also says cargo vans with a gross vehicle weight rating over 8,500 pounds and passenger vans rated at 10,000 pounds or more are not tested, so many full-size vans have no EPA rating at all.

The best number is your own. Fill the tank, write down the odometer, and at the next fill divide the miles driven by the gallons bought. The fuel cost calculator turns that into a monthly fuel budget.

Idling adds cost with no miles

FuelEconomy.gov says idling can use a quarter to a half gallon of fuel an hour, depending on engine size and air conditioning. At $4.478 a gallon, an hour of idling a day costs $1.12 to $2.24, or about $25 to $49 over 22 working days. The miles box does not move, so every idle hour raises your cost per mile. Keep the engine running when a rider needs heat or air conditioning, and turn it off during long waits with no one on board.

Comparing your cost with the IRS rate

The IRS publishes a business standard mileage rate each year, and changed it partway through 2026.

Miles driven	Business rate per mile	Where the IRS set it
January 1 to December 31, 2025	70 cents	IR-2024-312
January 1 to June 30, 2026	72.5 cents	Notice 2026-10
July 1 to December 31, 2026	76 cents	Announcement 2026-11

The IRS raised the rate on July 1, 2026 because of recent increases in the price of fuel (Announcement 2026-11). The rate comes from a study of the fixed and variable costs of operating a car that an independent contractor does for the IRS each year, and 35 cents of each 2026 business mile is treated as depreciation (Notice 2026-10).

The calculator divides your vehicle cost per mile by the IRS rate:

• Under 100%. Your vehicle costs less per mile than the IRS rate assumes for a car.
• Over 100%. It costs more. The example’s 125% means $0.95 a mile against 76 cents.

The comparison leaves the driver out on purpose. The IRS rate covers a vehicle, not the person driving it, so it is compared with the vehicle cost alone.

Can you deduct the IRS rate for your vans?

The standard mileage rate is a tax choice with limits. IRS Publication 463 (2025) and Topic no. 510 set them out:

• Five or more vehicles. You cannot use the standard rate for any of them if you use five or more at the same time, as in a fleet. Vehicles used at different times do not count as used at the same time.
• Depreciation already taken. You cannot use it for a vehicle you took a section 179 deduction, special depreciation, or MACRS depreciation on.
• The first year decides. For a vehicle you own, you must choose the standard rate in the first year it is used in the business. For a leased vehicle, you must use it for the whole lease.
• Actual expenses instead. You can deduct the business share of depreciation or lease payments, registration, licenses, insurance, repairs, gas, garage rent, tires, oil, tolls, and parking.
• Loan interest. A self-employed owner can deduct the business share of the interest on a vehicle loan, even with the standard rate.

Topic no. 510 suggests figuring the deduction both ways when you qualify for both. The mileage deduction calculator compares them, and the guide to NEMT business taxes covers depreciation. Ask your tax preparer before you choose, because the first-year choice limits later years.

What a mile pays compared with what it costs

Medicaid and brokers do not pay the IRS rate. Fee schedules pay a base rate for each trip plus a rate for each loaded mile, the miles with the rider on board. Here is what two state schedules pay per loaded mile.

Fee schedule	Code	Pay per loaded mile	In effect
Arizona, wheelchair van, trips starting in the Phoenix or Tucson metro area	S0209	$1.54	October 1, 2026
Arizona, wheelchair van, rural trips (TN modifier)	S0209	$1.66	October 1, 2026
Arizona, other NEMT mileage, metro	S0215	$1.28	October 1, 2026
Ohio fee-for-service maximum, wheelchair van	S0209	$1.30	Since January 1, 2024 (appendix to rule 5160-15-28, effective August 1, 2026)

A per-mile rate below your cost per mile does not by itself mean a trip loses money, because the trip also pays a base rate. So compare a whole trip. With the example cost of $2.15 a mile, a trip with 10 loaded miles and 5 empty miles costs 15 × $2.15 = $32.25 before office overhead.

What the 15-mile trip pays	Math	Pay
Arizona wheelchair van, metro	$11.15 base + 10 × $1.54	$26.55
Arizona wheelchair van, rural	$12.21 base + 10 × $1.66	$28.81
Ohio wheelchair van, maximum	$31.00 base + 10 × $1.30	$44.00

The $2.15 is the calculator’s example, not a cost measured in Arizona or Ohio, so put in your own cost per mile before you judge a rate. Ohio pays the lesser of your charge or that maximum on fee-for-service trips, and its managed care plans pay what their provider agreements say. Brokers and health plans in every state set their own rates, so use the rates in your contracts. The guide to NEMT reimbursement rates shows where to find them.

Cost per paid mile

If you want one per-mile number to hold against a rate sheet, divide your cost per mile by the share of miles that are paid.

Cost per paid mile = cost per mile ÷ (loaded miles ÷ total miles)

In the trip above, 10 of 15 miles are loaded. $2.15 ÷ (10 ÷ 15) = $3.23 for every mile you are paid for. The more deadhead miles you drive, the wider the gap. The guide to NEMT mileage billing explains which miles count as loaded and how payers check them.

How to use the answer

• Check a rate before you sign. Multiply your cost per mile by the total miles a typical trip takes, then compare it with what the trip pays. The cost per trip guide adds office overhead.
• Price private-pay rides. The trip price calculator splits vehicle cost per mile from driver time, which prices waits and loading better than one blended number.
• Compare vehicles. Run each vehicle for the same month. A van that costs far more per mile than the others may need repairs or replacing.
• Watch the trend. Run it every month. Fuel prices moved enough in 2026 for the IRS to change its rate midyear.
• Plan for the next van. A paid-off vehicle has no payment, but it still wears out. For planning, add a monthly amount toward its replacement to other vehicle costs.

Ways to lower your cost per mile

• Cut idling. Turn the engine off during long waits with no one on board.
• Keep tires at the right pressure. FuelEconomy.gov says it improves gas mileage by 0.6% on average and up to 3%, and each 1 psi drop in average pressure costs about 0.2%.
• Carry only what you need. Each extra 100 pounds can cost about 1% in fuel economy.
• Service on schedule. A preventive maintenance schedule and a maintenance log catch small problems before they become large repair bills.
• Buy fuel on a plan. The guide to cutting NEMT fuel costs covers fuel cards and route planning.

One caution. Cutting empty miles makes your company more profitable, but it can raise your cost per mile, because insurance, the payment, and driver pay are spread over fewer miles. Judge each change by what a trip costs, or by cost per paid mile, not by cost per mile alone. The profit per vehicle calculator shows the effect of empty miles on a month’s profit.