Deadhead Miles Cost Calculator (2027): What Empty NEMT Miles Cost You

What the deadhead cost calculator does

Deadhead miles are the miles a vehicle drives with no rider on board. CMS calls them “no load miles” or “unloaded miles,” and says they generally cannot be paid as a direct service (SMD 23-006, September 28, 2023). They still burn fuel, wear the van, and take your driver’s time.

A normal day has empty miles in several places:

• The drive out. From the lot to the first pickup.
• Between trips. From each drop-off to the next pickup.
• After a no-show. CMS counts the drive back after a member does not appear as unloaded miles. See no-show.
• Back to base during a long appointment, and out again for the ride home.
• Errands without the rider. Arizona’s fee-for-service manual (revised July 31, 2026) says a prescription pickup for a member is unloaded mileage and cannot be billed.
• The drive home. From the last drop-off to where the van parks at night.

The calculator adds up what those miles cost you in a day and in a year. It counts only the costs that grow with each extra mile: fuel, wear, and driver time. Insurance and the van payment stay out, because one more empty mile does not change them. The cost per mile calculator covers those.

Use it to price a far pickup before you accept it, to set the service area you give each broker, and to see which van or weekday wastes the most miles.

How to use the calculator

1. Pick one vehicle and one normal working day.
2. Enter every mile it drove that day: the odometer at the end of the shift minus the odometer at the start.
3. Enter the miles with a rider on board, added up from the day’s trip records.
4. Enter your fuel price and the vehicle’s real miles per gallon.
5. Enter what a mile of tires, oil, brakes, and repairs costs you.
6. Enter what an hour of driver time costs you, with payroll taxes, and the usual speed between trips.
7. Enter the days a month you run trips.

The results change as you type. Reset to example puts the example numbers back, and Show the formula lists every step of the math. If the miles with a rider come out higher than all the miles driven, the calculator asks you to check both numbers.

What each number means

Box	What to enter	Where to find it
Miles driven a day	Every mile on the odometer, lot to lot	Odometer readings at the start and end of the shift
Miles with a rider a day	Pickup to drop-off miles	The loaded miles on the day’s trip records, added up
Fuel price per gallon	What you pay for a gallon	Fuel card statement or receipts
Miles per gallon	The vehicle’s real average	Miles driven ÷ gallons bought over a month
Wear per mile	Tires, oil, brakes, and repairs for each mile	A year of shop invoices ÷ a year of miles
Driver cost per hour	Hourly pay plus payroll taxes and benefits	Payroll records
Average speed driving empty	Speed between a drop-off and the next pickup	Empty miles ÷ hours spent driving empty, from GPS or trip times
Working days a month	Days you run trips	Your schedule

The free trip log template records the odometer at the start and end of the shift and at each pickup and drop-off, so the first two boxes come from the same sheet.

Fuel price and miles per gallon

Use what you actually pay. For comparison, EIA’s weekly survey for September 21, 2026 put regular gasoline at $4.478 a gallon across the U.S., up $1.305 from a year before, and on-highway diesel at $6.529. Prices differ a lot by region. Here is what the fuel alone costs for 50 empty miles a day in a van getting 15 miles per gallon, over 264 working days a year:

Region, week of September 21, 2026	Price per gallon	Fuel for 50 empty miles a day	A year
Gulf Coast, regular	$3.972	$13.24	$3,495
East Coast, regular	$4.285	$14.28	$3,770
Midwest, regular	$4.386	$14.62	$3,860
U.S. average, regular	$4.478	$14.93	$3,942
West Coast, regular	$5.600	$18.67	$4,929
U.S. average, diesel	$6.529	$21.76	$5,745

For miles per gallon, measure your own from fuel receipts and odometer readings. EPA ratings are for the vehicle as built. The gas-only 2026 Chrysler Pacifica, Chrysler Voyager, and Honda Odyssey are rated 22 miles per gallon combined and 19 in the city, the V6 Kia Carnival 21 combined, and the front-wheel-drive Toyota Sienna hybrid 36 combined. A conversion adds weight, and many full-size vans have no rating at all: cargo vans with a gross vehicle weight rating over 8,500 pounds, and passenger vans rated 10,000 pounds or more, are exempt from testing. The fuel cost calculator works out what one van spends on fuel in a month and a year.

Driver cost per hour

Hourly drivers are paid for empty driving. Federal wage rules count travel from job site to job site during the workday as hours worked (29 CFR 785.38). The same rule counts the drive back to your lot when the driver has to return the van there.

Start with the hourly wage and add your share of payroll taxes. The employer pays 6.2% Social Security tax and 1.45% Medicare tax, 7.65% in all (IRS Topic 751, updated September 24, 2026). An $18 hourly wage costs you $19.38 before unemployment tax, workers’ compensation, and benefits. If you drive the van yourself, enter what you would pay a driver, so the answer still holds once you hire one.

Wear per mile and the IRS rate

Enter only the costs that rise with miles: tires, oil changes, brakes, and repairs. Do not use the IRS standard mileage rate here. The business rate is 72.5 cents a mile for January 1 to June 30, 2026, and 76 cents from July 1, 2026, a change the IRS tied to recent increases in the price of fuel (Announcement 2026-11). It is built from an annual study of the fixed and variable costs of running a car, and 35 cents of the 2026 rate is depreciation (Notice 2026-10). Using it here counts fuel twice and adds costs that do not grow with one more empty mile.

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
Empty miles a day	150 miles driven minus 100 with a rider	50 miles
Share of miles driven empty	50 ÷ 150	33.3%
Fuel for empty miles	50 ÷ 15 miles per gallon × $4.50	$15.00
Wear for empty miles	50 × $0.20	$10.00
Driver time on empty miles	50 ÷ 25 mph = 2 hours, × $20	$40.00
Cost of empty miles a day	$15 + $10 + $40	$65.00
Cost of empty miles a year	$65 × 22 days × 12 months	$17,160

A third of this van’s miles earn nothing. Driver time is $40 of the $65, more than fuel and wear together.

What one empty mile costs

The day’s cost comes down to one number: what each empty mile costs you.

Cost per empty mile = fuel price ÷ miles per gallon + wear per mile + driver cost per hour ÷ average speed driving empty

In the example that is $0.30 + $0.20 + $0.80 = $1.30 a mile. Every empty mile you cut from a day is worth $1.30, or $343.20 a year at 264 working days. The table keeps the example rates and changes only the empty miles:

Empty miles a day	Share of 150 miles	Cost a day	Cost a year
20	13.3%	$26.00	$6,864
35	23.3%	$45.50	$12,012
50	33.3%	$65.00	$17,160
65	43.3%	$84.50	$22,308
80	53.3%	$104.00	$27,456

In the example, speed matters more than fuel price. Slow town driving stretches the driver time behind each empty mile. Here are the same 50 empty miles at different average speeds:

Average speed driving empty	Driver time	Cost a day	Cost a year
15 mph	3.3 hours	$91.67	$24,201
25 mph	2 hours	$65.00	$17,160
35 mph	1.4 hours	$53.57	$14,142
45 mph	1.1 hours	$47.22	$12,466

At the example rates, a pickup 5 miles away across a congested downtown at 15 mph costs more than one 8 miles away on open road at 45 mph. Price empty drives by the time they take, not only by the distance.

Is a far pickup worth it

A trip pays for its loaded miles and a base rate. Whatever is left after the loaded miles has to cover the empty drive to reach the rider. A quick check:

Empty miles a trip can carry = (what the trip pays minus loaded miles × cost per mile) ÷ cost per empty mile

Here is an 8-mile trip at Arizona’s fee-for-service rates effective October 1, 2026. It treats a loaded mile as costing the same $1.30 as an empty one, which is a simplification.

Trip starting in the Phoenix or Tucson metro area	Pay for 8 loaded miles	Loaded miles at $1.30	Left for the empty drive	Empty miles it covers
Ambulatory (A0120 plus S0215)	$6.64 + 8 × $1.28 = $16.88	$10.40	$6.48	About 5
Wheelchair van (A0130 plus S0209)	$11.15 + 8 × $1.54 = $23.47	$10.40	$13.07	About 10

At these example costs, a wheelchair pickup 12 empty miles away loses money before loading time, insurance, or the van payment is counted. The limit is lower once those are in. Your broker or health plan sets its own rates in your contract, so run the check with what you are actually paid. The guide to NEMT reimbursement rates shows where to find them, and the trip profit calculator works out one offered trip from start to finish.

How Medicaid treats empty miles

Medicaid fee schedules such as Arizona’s pay a base rate for each trip plus a rate for each loaded mile, the miles with the member on board. The empty miles are yours to carry.

Program	How empty miles are treated
CMS guidance (SMD 23-006, September 28, 2023)	Generally not payable. States may build the cost of empty miles and no-shows into their rates. A state may pay unloaded miles when the most appropriate and economical provider faces extraordinary costs, through a state plan amendment filed with CMS.
Arizona fee-for-service (manual revised July 31, 2026)	A provider may not submit any claim for unloaded mileage, including a prescription pickup.
North Dakota Medicaid (manual updated January 2026)	Not covered, but the department may approve unloaded miles in some cases. Email the NEMT Administrator with the Customer Support Center authorization and the miles requested. If approved, bill the total miles and attach the approval to the claim.
Indiana Medicaid (module version 6.1, August 19, 2025)	Ambulatory and wheelchair van trips get loaded mileage only over 10 miles one way, and the first 10 miles of each one-way trip are deducted.

Indiana’s rule leaves some loaded miles unpaid too, so the base rate there carries even more of the day’s driving. If you work through a broker, your agreement’s rate sheet sets what is paid.

How to use the answer

• Set a service area that fits your vans. Brokers assign trips partly by where you say you serve. Under the NEMT provider manual CareOregon uses in Oregon (version 1.3, February 2024), trips are assigned by the service area and hours you state, and a trip outside your service area is an acceptable reason to hand it back. Draw the line where the empty drive stops paying. See service area.
• Price private-pay pickups. A pickup fee can cover the drive out on private rides. The trip price calculator adds empty miles to the price, and the guide to private pay NEMT covers how to quote it.
• Check a rate before you sign. Put the yearly cost next to what a contract pays. The break-even calculator shows how many trips cover the rest of your costs.
• Decide wait or return. Driving back to base during a long appointment adds two empty drives. CMS notes that a long wait is sometimes the most economical way home. The wait time cost calculator shows what waiting costs and the trips the van could run instead, and rural NEMT works a long example.
• Plan the day around where vans end up. Chain each drop-off to a nearby pickup and place will-call returns before the day starts. The guide to NEMT route planning covers how.
• Cut no-show drives. Confirming rides the day before turns a wasted round trip into a free slot. See how to reduce NEMT no-shows.
• Compare vans and weekdays. Run the calculator for each vehicle each week. The one with the highest share of empty miles is where a route change pays off first.