NEMT Revenue Calculator (2027): What Your Trips Bring In Each Month, by Payer

What the revenue calculator does

The calculator adds up what a month of trips brings in and shows how much comes from each kind of payer. It has three lines, one for each way NEMT trips get paid:

• Medicaid trips pay a base rate per trip plus a rate for each loaded mile. This line covers Medicaid fee-for-service, brokers, and Medicaid health plans, and any other payer that pays a set rate plus mileage.
• Private pay trips pay the price you charge riders and their families.
• Facility trips pay the price in your contract with a clinic, dialysis center, hospital, or care home.

The headline is revenue a month. Under it are the revenue from each line, revenue a year, and the average pay per trip across all of them.

Use it to see what one van or a whole fleet brings in, to test a new contract rate before you sign, or to plan your first months before you open. Revenue is what comes in before any costs. To see what is left after fuel, wages, and insurance, take these numbers to the profit per vehicle calculator.

How to use the calculator

1. Pick one month: a recent one to check how you are doing, or a future one you are planning.
2. Enter the days you run trips that month.
3. Enter the paid Medicaid, broker, and health plan trips on an average working day. Count each one-way ride as one trip.
4. Enter the base rate per trip and the rate per mile from your fee schedule, broker rate sheet, or plan contract. For a flat rate per trip, enter it as the base rate and set the rate per mile to $0.
5. Enter the average loaded miles per Medicaid trip.
6. Enter your private pay trips a day and your average private pay price.
7. Enter your facility trips a day and your average facility price.
8. Read the revenue a month at the top. The rest of the results show where it comes from.

The results change as you type. Reset to example puts the example numbers back, and Show the formula lists every step of the math. Give a payer you do not have 0 trips.

If you run more than one level of service at different rates, enter the average pay per trip for your mix. The section on levels of service below shows how.

What each number means

Box	What to enter	Where to find it
Working days a month	Days you run trips	Your schedule, counting any weekend service
Medicaid trips a day	Paid one-way trips from Medicaid, brokers, and health plans on an average working day	Last month’s paid trips ÷ its working days
Medicaid base rate per trip	The flat amount each trip pays before mileage	Your state fee schedule, broker rate sheet, or plan contract
Medicaid rate per mile	What each loaded mile pays	The same schedule, rate sheet, or contract
Miles per Medicaid trip	Average loaded miles the payer pays for	Loaded miles billed ÷ trips billed
Private pay trips a day	Trips riders or their families pay for	Your invoices or card receipts ÷ working days
Private pay price per trip	The average private pay trip, mileage included	Private pay revenue ÷ private pay trips
Facility trips a day	Trips a clinic, dialysis center, hospital, or care home pays for	Your facility invoices ÷ working days
Facility price per trip	The average facility trip, mileage included	Facility revenue ÷ facility trips

Trips a day

Count the way payers count: one trip is one ride from a pickup to a drop-off, so a round trip is two. MTM Health’s standard provider agreement, in the January 1, 2023 version posted by Pennsylvania’s Department of Human Services, defines a trip or trip leg as one-way transportation from pickup to drop-off. Arizona’s fee-for-service manual, revised July 31, 2026, has providers bill the number of trips and the number of loaded miles as the units of service.

Enter paid trips, not booked ones. A rider who does not show up pays nothing, so last month’s paid trips ÷ its working days is the most honest number. For one van, enter that van’s trips. For the whole company, enter every van’s trips together. If you are planning a new van, the trips per day calculator shows how many trips fit in a shift.

Medicaid base rate and rate per mile

These come from whoever pays the trip:

• State fee-for-service. Your state Medicaid agency publishes a fee schedule. The table further down uses three of them.
• A broker. The rates are in your contract. MTM’s standard agreement puts them in Schedule A, the Transportation Provider Compensation rate sheet.
• A Medicaid health plan. The plan’s provider agreement sets the rate. Ohio rule 5160-15-28, effective August 1, 2026, says this for the state’s managed care plans.

Some state schedules list the most they will pay, not a set price. Ohio’s fee-for-service program pays the lesser of your submitted charge and the Medicaid maximum. South Dakota’s schedule, effective July 1, 2026, tells providers to bill their usual and customary charge and lists the maximum allowable amount. If you bill less than the maximum, enter what you bill.

CMS says states have broad latitude and flexibility in setting Medicaid payment rates (SMD 23-006, September 28, 2023), so rates differ from state to state. The guide to NEMT reimbursement rates shows where to find yours.

Miles per Medicaid trip

Enter the loaded miles the payer pays for: the miles with the rider on board. CMS says miles with no Medicaid member in the vehicle generally cannot be paid, though a state may build their cost into its rates (SMD 23-006). Arizona’s manual bars any claim for unloaded mileage and defines loaded mileage as the statute miles traveled with the member on board. The drive out to a pickup is deadhead and belongs in your costs, not here.

Some schedules pay for fewer miles than the rider rides. South Dakota’s July 1, 2026 schedule pays community transportation mileage (S0215) only on trips outside the city of 21 miles or more one way. It pays secured van and stretcher van mileage only from the point the trip leaves city limits. It also has you round every mileage claim to the nearest whole mile, with no decimals. Read your schedule’s notes before you enter a number.

Private pay and facility prices

You set these. Price each trip from what it costs you with the trip price calculator, and see how much to charge for NEMT for base, mileage, and wait rates. Enter the average across the month: private pay revenue ÷ private pay trips, and the same for facilities. The guide to NEMT facility contracts covers how to win and price facility work.

Keep these prices for private work. Under 42 CFR 447.15, a Medicaid provider accepts the program’s payment, plus any cost sharing the state plan requires, as payment in full. MTM’s standard agreement also bars billing members, except for a copayment or fee that MTM or its client authorizes.

A worked example

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

Step	Math	Result
Medicaid pay per trip	$25.00 base + 10 miles × $2.00	$45.00
Medicaid trips a month	6 trips × 22 days	132
Medicaid revenue a month	132 trips × $45.00	$5,940
Private pay revenue a month	2 trips × 22 days = 44 trips × $60.00	$2,640
Facility revenue a month	2 trips × 22 days = 44 trips × $50.00	$2,200
Revenue a month	$5,940 + $2,640 + $2,200	$10,780
Revenue a year	$10,780 × 12	$129,360
Average pay per trip	$10,780 ÷ 220 trips	$49.00

The payer split comes straight from those lines. Medicaid brings in $5,940 ÷ $10,780 = 55.1% of the month, private pay 24.5%, and facilities 20.4%. Each working day is worth $490: 6 × $45 + 2 × $60 + 2 × $50.

Revenue a year is the month × 12, so it assumes every month looks like this one. Months with holidays or fewer working days bring in less.

What published Medicaid rates do to the example

Here are the example’s 6 Medicaid trips a day at 10 loaded miles each, run through real fee-for-service schedules. The private pay and facility trips stay at the example numbers, so the last column adds $4,840 of them to each row. The monthly dollars are what the calculator shows.

Schedule and codes	Pay per trip	Medicaid a month	All payers a month
Arizona wheelchair van, Phoenix or Tucson metro (A0130 plus S0209)	$11.15 + 10 × $1.54 = $26.55	$3,505	$8,345
Arizona wheelchair van, rural (TN modifier)	$12.21 + 10 × $1.66 = $28.81	$3,803	$8,643
Ohio wheelchair van maximum (A0130 plus S0209)	$31.00 + 10 × $1.30 = $44.00	$5,808	$10,648
South Dakota mini-bus or other transportation system, in the city (A0120)	$5.20, with no mileage paid in the city	$686.40	$5,526
The calculator’s example	$25.00 + 10 × $2.00 = $45.00	$5,940	$10,780

The Arizona rates take effect October 1, 2026. AHCCCS counts every trip that starts outside the Phoenix and Tucson metro areas as rural, billed with the TN modifier. The Ohio amounts are maximums in the appendix to rule 5160-15-28, effective August 1, 2026, and have not changed since January 1, 2024. The South Dakota amount is the one-way in-city rate on its July 1, 2026 schedule.

The same 10 trips a day bring in anywhere from $5,526 to $10,780 a month, and only the Medicaid rate changed. That makes the rate the most important number you enter. Brokers and health plans set their own rates, so use the rate you are actually paid. The Arizona state guide covers how that program works.

How to enter a mix of levels of service

The calculator takes one base rate and one rate per mile. If you run trips at more than one rate, such as ambulatory rides and wheelchair van rides, work out the average pay per trip for your mix. Then enter it as the base rate and set the rate per mile to $0.

1. For each level of service, work out one trip’s pay: base rate + average loaded miles × rate per mile.
2. Multiply it by the trips a day at that level.
3. Add those up and divide by all Medicaid trips a day.

Here it is with Arizona’s metro rates effective October 1, 2026, for 4 rides a day in a mini-bus or other vehicle and 2 in a wheelchair van, each with 10 loaded miles.

Level of service	Trips a day	Pay per trip	Pay a day
Mini-bus or other vehicle (A0120 plus S0215)	4	$6.64 + 10 × $1.28 = $19.44	$77.76
Wheelchair van (A0130 plus S0209)	2	$11.15 + 10 × $1.54 = $26.55	$53.10
All Medicaid trips	6	$130.86 ÷ 6 = $21.81	$130.86

Enter $21.81 as the Medicaid base rate and $0 as the rate per mile. With 22 working days, the calculator shows $2,879 of Medicaid revenue a month: $130.86 a day × 22 days is $2,878.92. With the rate per mile at $0, the miles box no longer changes the answer, so redo the table when your miles change.

A stretcher van trip moves the average fast. On the same Arizona metro schedule it pays $49.09 plus $1.54 a mile (T2005 plus T2049), or $64.49 at 10 loaded miles. That is more than three times the mini-bus trip.

Add paid extras to the base rate

Some payers pay for more than the ride itself: an attendant, waiting time, or an extra rider. The calculator has no box for these, so add their average per trip to the base rate.

• An attendant. Ohio’s fee-for-service maximum for a wheelchair van attendant is a flat $15.00 (T2001), unchanged since January 1, 2024. If one Ohio trip in six bills an attendant at that maximum, add $15.00 ÷ 6 = $2.50 to the $31.00 base rate, for $33.50.
• Waiting time. Arizona pays $4.59 per 30 minutes (T2007) from October 1, 2026, and only when the distance makes it not feasible for the driver to return to base. It pays nothing for a wait under 30 minutes, a one-way trip, a medical visit 10 miles away or less, a round trip that uses two vehicles or drivers, or a wait when the odometer moves between drop-off and pickup.
• An extra rider. South Dakota pays half the one-way rate for each additional rider on the same trip, such as $2.60 instead of $5.20 in the city (TK modifier, July 1, 2026).

Only add extras your payer actually pays.

What moves revenue most

Each row changes one box and keeps the rest at the example values.

Change from the example	Revenue a month	Difference
None	$10,780	None
One more Medicaid trip a day	$11,770	$990 more
One more private pay trip a day	$12,100	$1,320 more
15 loaded miles per Medicaid trip instead of 10	$12,100	$1,320 more
A rate per mile of $1.50 instead of $2.00	$10,120	$660 less
20 working days instead of 22	$9,800	$980 less

Trips and rates move the number most. Every $1 of Medicaid base rate is worth $132 a month here, one dollar on each of the 132 Medicaid trips. Check a new contract rate this way before you accept it. MTM’s standard agreement lets MTM change compensation rates with written notice, and a change you do not reject in writing within 30 days counts as accepted.

From revenue to money in the bank

The calculator treats every trip you enter as paid. Real months lose some of that, so enter paid trips and keep these in mind:

• No-shows pay nothing. Federal Medicaid funds are not available for a trip to a member who does not appear, and states and providers may not charge the member for a no-show (SMD 23-006). See what counts as a no-show and how to reduce no-shows.
• Denied claims pay nothing. MTM’s standard agreement makes no payment for trips run by uncredentialed drivers or attendants or in uncredentialed vehicles. The guide to NEMT claim denials covers the common causes.
• Late claims pay nothing. Federal rule 42 CFR 447.45(d)(1) requires each state Medicaid agency to have providers submit all claims within 12 months of the date of service. Payers can set a shorter timely filing limit: MTM’s standard agreement refuses claims sent more than 90 days after the ride, or after a different limit its client sets.
• Payment takes time. MTM’s standard agreement pays uncontested invoices within 30 days of electronic submission. The cash reserve calculator takes the Medicaid, facility, and private pay revenue from this calculator and shows how much cash to hold while you wait.
• Trip volume is not guaranteed. MTM’s standard agreement guarantees no minimum number of trips.

How to use the answer

• See what is left after costs. Carry the revenue into the profit per vehicle calculator, and use the break-even calculator to see how many trips cover your fixed costs.
• Plan your cash. Enter the three revenue lines in the cash reserve calculator, with the days each payer takes to pay.
• Check how much rides on one payer. If one broker or plan brings in most of the Medicaid line, put each payer’s monthly revenue in the payer mix calculator. The guide to NEMT payer mix covers how to spread the risk.
• Test a contract. Change the base rate, rate per mile, or miles to the new contract’s numbers and compare the two months.
• Find revenue per van. Divide revenue a month by the vans that ran. For the full picture of what owners earn after costs, see how much a NEMT business makes.

Mistakes that throw off revenue

• Counting booked trips. Enter the trips that were paid.
• Entering every mile driven. Medicaid pays loaded miles only, and some schedules pay for fewer still.
• Counting a round trip as one trip. Each leg is a trip with its own base rate.
• Using the state schedule for broker trips. A broker or plan pays its contract rate.
• Using a maximum you do not bill. Where the state pays the lesser of your charge and its maximum, a lower charge is what you get paid.
• Adding extras your payer does not pay. Wait time and attendants count only where the schedule or contract pays for them.
• Forgetting short months. Revenue a year assumes 12 months like this one.