# NEMT Profit per Vehicle Calculator (2027): What One Van Earns Each Month

Canonical URL: https://nemtguide.com/tools/nemt-profit-per-vehicle-calculator/ · Updated 2026-09-28

This calculator shows what one NEMT vehicle earns in a month after every cost. It multiplies trips by pay per trip, then subtracts the cost of the miles driven with and without a rider, the driver's paid hours, and fixed costs such as insurance and the vehicle payment. With the example numbers, one van makes $1,760 a month, and its empty miles cost $440.

- Profit a month = trips × pay per trip, minus every mile driven, the driver's paid hours, and fixed costs.
- Empty miles earn nothing. In the example, each extra empty mile per trip costs $88 a month.
- Once the driver's shift is paid for, each extra trip a day adds $935 a month to the example van.
- Use what trips were paid, not what was billed, so denials and no-shows show up in the answer.
- Leave the IRS mileage rate out of vehicle cost per mile when the payment and insurance are already in fixed costs.

Use the calculator on the web page: https://nemtguide.com/tools/nemt-profit-per-vehicle-calculator/

## What the profit per vehicle calculator does

The calculator works out what one vehicle earns in a month after every cost it carries. It takes the trips the vehicle runs and what they pay. Then it subtracts the miles it drives with a rider, the empty miles between riders, the driver's paid hours, and the fixed bills that come due however many trips run.

The headline is the profit a month. Under it are the revenue, the costs, the profit margin, the profit per trip, and the cost of the empty miles on their own. That last number is the one most owners never see, because empty miles hide inside the fuel bill.

Use it if you run one van and want to know whether it really pays. Use it if you run several, to find the van that drags the others down, or before you add one. And use it before you accept a new contract rate, to see what that rate does to a month.

Count trips the way payers do: each one-way ride is one trip, so a round trip is two. MTM Health's standard agreement defines a trip as one-way transportation from pickup to drop-off. Arizona's fee-for-service manual, revised July 31, 2026, has NEMT providers bill the number of trips and the number of loaded miles as the units of service.

## How to use the calculator

1. Pick one vehicle and one recent month.
2. Enter the paid trips it ran on an average working day: the month's paid trips ÷ its working days. A no-show is not a paid trip.
3. Enter the days that month the vehicle ran trips.
4. Enter the average pay per trip: payments received for the month's trips ÷ the trips paid.
5. Enter the average trip miles, with the rider on board, and the average empty miles per trip.
6. Enter what a mile costs you in fuel, tires, and repairs.
7. Enter the hours you pay the driver each working day and what an hour costs you.
8. Enter the vehicle's fixed costs for a month.
9. Read the profit at the top. The rest of the results show where the money went.

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 vehicle loses money, the calculator says so and shows the loss.

## What each number means

| Box | What to enter | Where to find it |
|---|---|---|
| Trips a day | Paid one-way trips on an average working day | Last month's paid trips ÷ working days |
| Working days a month | Days the vehicle ran trips | Your schedule or trip logs |
| Average pay per trip | What one trip pays across all your payers, mileage included | Payments received ÷ trips paid |
| Average trip miles | Loaded miles, with the rider on board | Loaded miles billed ÷ trips paid |
| Average empty miles | Miles with no rider, per paid trip | (Odometer miles minus loaded miles) ÷ trips paid |
| Vehicle cost per mile | Fuel, tires, and repairs for each mile | Several months of those bills ÷ the miles driven |
| Driver hours a day | Hours you pay the driver, waits and gaps included | Timesheets ÷ working days |
| Driver cost per hour | Hourly pay plus payroll taxes and benefits | Your payroll reports |
| Fixed costs a month | Payment, insurance, registration, and a share of office costs | Loan statements, policies, and your office bills ÷ vehicles |

Dividing the empty miles by paid trips does two jobs at once. The drive out to every pickup and the drive to a rider who never came both land in the cost of the trips that did pay.

### Average pay per trip from a fee schedule

If the vehicle is not running yet, build the pay per trip from your contract or your state's fee schedule: the base rate plus loaded miles times the mileage rate. Here is what a 10-mile trip pays on two state fee-for-service schedules, and what 176 of those trips bring in, the monthly trips in the calculator's example.

| Fee schedule and trip | Base rate | 10 loaded miles | Pay per trip | 176 trips a month |
|---|---|---|---|---|
| Arizona mini-bus or other vehicle, Phoenix or Tucson metro (A0120 plus S0215) | $6.64 | 10 × $1.28 = $12.80 | $19.44 | $3,421 |
| Arizona wheelchair van, metro ([A0130](https://nemtguide.com/glossary/a0130/) plus S0209) | $11.15 | 10 × $1.54 = $15.40 | $26.55 | $4,673 |
| Arizona wheelchair van, rural (TN modifier) | $12.21 | 10 × $1.66 = $16.60 | $28.81 | $5,071 |
| Ohio wheelchair van, fee-for-service maximum (A0130 plus S0209) | $31.00 | 10 × $1.30 = $13.00 | $44.00 | $7,744 |

The Arizona rates took effect October 1, 2026. AHCCCS treats every trip that starts outside the Phoenix and Tucson metro areas as rural. The Ohio amounts are the maximums in the appendix to rule 5160-15-28, effective August 1, 2026, and have not changed since January 1, 2024. Ohio pays the lesser of your charge or that maximum, and its managed care plans pay what their provider agreements say.

Brokers and health plans set their own rates in their contracts, so use the rates you are actually paid. The guide to [NEMT reimbursement rates](https://nemtguide.com/guides/nemt-reimbursement-rates/) shows where to find them, and the [Arizona state guide](https://nemtguide.com/states/arizona/) covers how that program works. Whatever the rate, a Medicaid provider accepts the program's payment, plus any copay the state plan requires, as payment in full ([42 CFR 447.15](https://www.ecfr.gov/current/title-42/section-447.15)), so you cannot bill the member the difference.

### Empty miles

Empty miles are cost with no pay. CMS says miles with no member on board generally cannot be paid, though states may build their cost into the rate, and that includes the drive back after a no-show (SMD 23-006, September 28, 2023). Arizona's manual bars any claim for unloaded mileage. Ohio rule 5160-15-26, in effect since July 1, 2021, allows no payment for a transport with no Medicaid member in the vehicle and no separate payment for the drive to the pickup or from the drop-off.

That is why the calculator shows their cost on its own line. In the example, 5 empty miles on each of 176 trips at 50 cents a mile cost $440 a month. The glossary entry on [deadhead miles](https://nemtguide.com/glossary/deadhead-miles/) shows how they build up over a day.

### Driver hours and cost per hour

Enter the hours you pay, not the hours with a rider aboard. Under [29 CFR 785.15](https://www.ecfr.gov/current/title-29/section-785.15), an employee who is engaged to wait is working, so a driver waiting at a clinic for a will-call return is on the clock. Under 29 CFR 785.16, time counts as off duty only when the driver is completely relieved, is told in advance that they may leave and when to come back, and has long enough to use the time for their own purposes.

Then add payroll taxes to the hourly pay. For 2026, the employer pays 6.2% Social Security tax on wages up to $184,500 and 1.45% Medicare tax, 7.65% in all (IRS Publication 15). A driver paid $18 an hour costs $18 × 1.0765 = $19.38 an hour before unemployment taxes and workers' compensation. Federal unemployment tax adds 0.6% of the first $7,000 of each employee's wages with the full state credit, and workers' compensation and state unemployment rates vary by state.

Long shifts can bring overtime. As a general standard, federal law treats hours over 40 in a workweek as overtime (29 CFR 778.101) and requires at least one and a half times the regular rate for them (29 CFR 778.107), unless an exemption applies. If drivers run 10-hour days five days a week, blend the rate. At $18 an hour, 40 hours at $18 and 10 hours at $27 average $19.80 an hour before payroll taxes. The [driver cost calculator](https://nemtguide.com/tools/nemt-driver-cost-calculator/) works this out for you.

### Vehicle cost per mile

Enter only what each mile burns and wears out: fuel, tires, oil, and repairs. The payment and insurance belong in fixed costs.

For fuel, divide the price of a gallon by your miles per gallon. The U.S. average for regular gasoline was $4.478 a gallon for the week of September 21, 2026 (EIA). At an example 15 miles per gallon, that is about 30 cents a mile before tires and repairs.

Do not enter the IRS standard mileage rate here. The business rate is 76 cents a mile from July 1, 2026, and it is built from a study of the fixed and variable costs of running a car, with 35 cents of the 2026 rate treated as depreciation (Notice 2026-10). With the payment and insurance already in fixed costs, it counts them twice. The [cost per mile calculator](https://nemtguide.com/tools/nemt-cost-per-mile-calculator/) works out your own numbers. Use its fuel and repair costs ÷ miles here, not its full vehicle cost per mile.

### Fixed costs

Fixed costs stay the same however many trips the vehicle runs:

- **The loan or lease payment.** If the vehicle is paid off, add a monthly amount toward the next one, such as the price you paid ÷ the months you plan to keep it.
- **Insurance.** Brokers set minimum limits. MTM Health's standard agreement, in the January 1, 2023 version Pennsylvania posts, asks for at least $500,000 of commercial auto liability and $500,000 per occurrence of general liability.
- **Registration, inspections, and permits,** with yearly fees ÷ 12.
- **The vehicle's share of the office.** Divide dispatch pay, phone, rent, and other office bills by the number of vehicles.
- **Your own pay,** if you need the business to pay you for running 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 |
|---|---|---|
| Trips a month | 8 trips × 22 days | 176 |
| Revenue a month | 176 trips × $50 | $8,800 |
| Mileage cost | 176 trips × (10 + 5) miles × $0.50 | $1,320 |
| Driver cost | 8 hours × $20 × 22 days | $3,520 |
| Costs a month | $1,320 + $3,520 + $2,200 fixed costs | $7,040 |
| Profit a month | $8,800 minus $7,040 | $1,760 |
| Profit margin | $1,760 ÷ $8,800 × 100 | 20% |
| Profit per trip | $1,760 ÷ 176 trips | $10.00 |
| Cost of empty miles | 176 trips × 5 miles × $0.50 | $440.00 |

The empty miles are part of the $1,320 mileage cost, shown on their own so you can see them. Without them, the van would make $2,200.

Two more numbers come straight from the example. The driver is paid for 8 × 22 = 176 hours, so the van brings in $8,800 ÷ 176 = $50 for each hour it is staffed. That is its revenue per vehicle hour. And $7,040 of costs ÷ 176 trips = $40, the pay per trip it needs just to break even at 8 trips a day.

## What moves the profit most

Each table keeps every other box at its example value and changes one number.

| Trips a day | Trips a month | Profit a month | Profit margin |
|---|---|---|---|
| 6 | 132 | -$110.00 | -1.7% |
| 7 | 154 | $825.00 | 10.7% |
| 8 | 176 | $1,760 | 20% |
| 10 | 220 | $3,630 | 33% |
| 12 | 264 | $5,500 | 41.7% |

Once the driver's 8 hours are paid, each extra trip a day adds $935 a month: $50 of pay minus $7.50 of miles, times 22 days. That holds only while the shift has room. If more trips need more driver hours, raise the hours too.

| Average pay per trip | Profit a month | Profit margin |
|---|---|---|
| $40.00 | $0.00 | 0% |
| $45.00 | $880.00 | 11.1% |
| $50.00 | $1,760 | 20% |
| $55.00 | $2,640 | 27.3% |

Every $5 of pay per trip is worth $880 a month to this van. Check a new rate here before you accept it.

| Average empty miles | Cost of empty miles | Profit a month |
|---|---|---|
| 0 | $0.00 | $2,200 |
| 5 | $440.00 | $1,760 |
| 10 | $880.00 | $1,320 |
| 15 | $1,320 | $880.00 |

Every empty mile added to each trip costs $88 a month. Grouping pickups by area, planning return legs before the day starts, and taking trips near your last drop-off all cut this number without adding a ride.

## How to use the answer

- **Decide whether a van pays.** If the profit is thin or negative, the tables above show which lever moves it most.
- **Compare vehicles.** Run each one for the same month. The one with the most empty miles or the fewest trips a day is where to start.
- **Plan the next van.** A second van brings its own fixed costs and needs its own trips. The [break-even calculator](https://nemtguide.com/tools/nemt-break-even-calculator/) shows the trips it needs, and the [fleet size calculator](https://nemtguide.com/tools/nemt-fleet-size-calculator/) shows whether your trip volume calls for it.
- **Check a contract.** Change the pay per trip to the new rate, and the trip miles to the new service area.
- **Plan your cash.** Profit is not cash in the bank. MTM Health's standard agreement pays uncontested invoices within 30 days of electronic submission and refuses claims sent more than 90 days after the ride, or after the limit its client sets. The cash reserve calculator and the guide to NEMT cash flow show how much to hold while you wait.
- **Remember taxes.** The profit here is before income taxes.

For more ways to raise the number, see how to make a NEMT business more profitable and [how much a NEMT business makes](https://nemtguide.com/guides/how-much-does-a-nemt-business-make/).

## Mistakes that skew a van's profit

- **Using what you billed instead of what you were paid.** A denied claim pays nothing. MTM's standard agreement also withholds pay for a trip, or charges a penalty, when a late pickup makes a member miss the appointment, and it guarantees no minimum number of trips.
- **Leaving out empty miles.** The drive to every pickup and every no-show counts, and Medicaid generally pays for none of it.
- **Paying for shifts but counting trip time.** If the driver is paid for 8 hours, enter 8 hours, even if the van carried riders for 5 of them.
- **Counting a cost twice.** Insurance in fixed costs and again inside a per-mile figure makes the van look worse than it is. The IRS rate stands in for insurance, depreciation, and lease payments (IRS Publication 463), so a per-mile figure built from it does exactly that.
- **Leaving out your own pay.** A van that only makes money while the owner drives it for free has a profit that ends when you hire a driver.
- **Forgetting that no-shows cost twice.** They take a drive and a slot in the day and usually pay nothing. The guide to [reducing NEMT no-shows](https://nemtguide.com/guides/how-to-reduce-nemt-no-shows/) covers what works.

## Frequently asked questions

### How much profit does one NEMT van make a month?

It depends almost entirely on how many paid trips it runs and what each trip pays, so enter your own numbers. With the example numbers, 8 trips a day for 22 days at $50 a trip, one van makes $1,760 a month, a 20% margin. The same van at 6 trips a day loses $110 a month, and at 10 trips a day it makes $3,630.

### Is a round trip one trip or two?

Two. Count each one-way ride as one trip, and use the pay and miles for one leg. Payers count it that way too. MTM Health's standard agreement defines a trip as one-way transportation from pickup to drop-off. Arizona's fee-for-service manual, revised July 31, 2026, bills two trips for the same member on the same day as two units of the base rate.

### What if I drive the van myself?

Enter the hours you drive and what you would pay a driver for them. The profit is then what the van earns on top of a fair wage for the driving. If you enter 0 for driver cost, the answer mixes your wage and the business's profit together, and it stops being true the day you hire a driver.

### Should I use the IRS mileage rate for vehicle cost per mile?

Not when the loan or lease payment and insurance are already in fixed costs. The IRS business rate, 76 cents a mile from July 1, 2026, is built from the fixed and variable costs of running a car, and 35 cents of the 2026 rate is depreciation. Using it here counts those costs twice. Enter only fuel, tires, and repairs per mile.

### Does Medicaid pay for empty miles or no-shows?

Generally not. CMS says miles with no member on board generally cannot be paid, though states may build their cost into the rate, and federal Medicaid funds are not available for a trip to a member who does not appear (SMD 23-006, September 28, 2023). Neither the state nor you may charge the member for a no-show. Count those drives as empty miles.

### Why is driver pay by the hour instead of by the trip?

Because you pay for the whole shift, not only the minutes with a rider aboard. Under 29 CFR 785.15, an employee who is engaged to wait is working. A driver waiting for a will-call return is usually on the clock even with nobody in the van. If you pay drivers by the trip instead, set driver hours a day to 1 and enter a day's trip pay, with payroll taxes, as the driver cost per hour.

### How is this different from the break-even calculator?

The break-even calculator tells you how many trips you need before the business makes any profit. This one starts from the trips a vehicle runs now and tells you what it earns. Use break-even to plan and this one to check how a van is actually doing.

## Official resources

- [AHCCCS: Ground transportation fee schedules by year](https://www.azahcccs.gov/PlansProviders/RatesAndBilling/FFS/transportationground.html)
- [CMS: Medicaid Transportation Coverage Guide (SMD 23-006)](https://www.medicaid.gov/federal-policy-guidance/downloads/smd23006.pdf)
- [IRS: Publication 15, Employer's Tax Guide](https://www.irs.gov/publications/p15)
- [eCFR: 29 CFR part 785, Hours worked (waiting time)](https://www.ecfr.gov/current/title-29/part-785)
- [EIA: Weekly gasoline and diesel prices](https://www.eia.gov/petroleum/gasdiesel/)