NEMT Trip Profit Calculator (2027): Should You Take This Trip?

What the trip profit calculator does

A broker offer tells you what a trip pays. It does not tell you what the trip costs you to run, and that is the part that decides whether to accept. This calculator puts the two side by side for one trip, so you can answer an offer on a portal, a marketplace, or a dispatch call while it is still open.

It works for any one-way trip: a ride to dialysis, the ride home, a hospital discharge. Each leg is its own trip, so run a round trip as two. See trip leg.

The calculator counts only the costs that come with this trip:

• Fuel and wear for every mile. That means the loaded miles with the rider on board and the deadhead miles with no one on board: out to the pickup and on to your next stop.
• Driver time. Every minute the trip ties up your driver, from leaving the last stop to being free for the next one.

Insurance, the van payment, and office costs stay out, because one more trip does not change them. So the answer is the trip’s profit before fixed costs: what it adds toward those bills and your own pay. The break-even calculator covers the fixed side.

How to use the calculator

1. Open the offer and find the pay: a base rate plus a rate for each loaded mile, or one total.
2. Enter the base rate and the pay per loaded mile. For an offer with one total, put the total in the base rate and enter 0 per mile.
3. Enter the loaded miles from the offer.
4. Enter the empty miles: from where the van will be to the pickup, plus from the drop-off to the next stop or back to your lot.
5. Enter every minute the trip takes your driver: the drive out, loading and securing, the ride, unloading, and any wait.
6. Enter your driver cost per hour, fuel price, miles per gallon, and wear per mile. These stay the same from trip to trip, so you set them once.
7. Read the profit on this trip and the profit per hour of driver time.

The results change as you type. Reset to example puts the example numbers back, and Show the formula lists every step of the math. When a trip costs more to run than it pays, the calculator says so.

What each number means

Box	What to enter	Where to find it
Base rate for the trip	The flat part of the pay, before mileage	The offer, or the rate sheet in your broker agreement
Pay per loaded mile	What each mile with the rider pays	The same rate sheet, or the state fee schedule
Loaded miles	Pickup to drop-off miles	The mileage on the offer
Empty miles	Miles with no rider: out to the pickup and on to the next stop	A map from where the van will be, to the pickup, and from the drop-off onward
Driver time	Every minute the trip ties up the driver	Trip times for similar rides on your trip logs or GPS history
Driver cost per hour	Hourly pay plus payroll taxes and benefits	Payroll records
Fuel price per gallon	What you pay for a gallon	Fuel card statement or receipts
Miles per gallon	The van’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 bills ÷ a year of miles

Reading the pay on an offer

Brokers show pay in a few ways, and each goes into the boxes a little differently.

• One total. American Logistics says each trip it offers states the pickup city, the mileage, the vehicle type (wheelchair, ambulatory, or gurney), and the payment for completing the trip, and that taking it is up to you. Enter that payment as the base rate and 0 per mile.
• Miles and a claim amount. MTM Health’s Rhode Island portal shows the estimated miles and the claim dollar amount for each trip on its Trips tab (handbook last updated July 1, 2026). Use the claim amount the same way, or split it with your rate sheet.
• A base rate plus a mile rate. Many rate sheets and state fee schedules pay a base rate for the trip and a rate for each loaded mile. Enter both as they are.

Some base rates already include the first few miles. MTM Health’s Rhode Island rate sheet is Schedule A, effective July 1, 2023, and MTM still links it as its current rates in September 2026. For a wheelchair trip in business hours with the pickup up to 40 miles from where your vans are kept (Tier 1), it pays $28.50 for the first 5 loaded miles and $2.50 for each mile after that. Nebraska’s fee-for-service wheelchair base rate, $46.12 on its July 1, 2026 schedule, also covers the first five loaded miles, with $1.85 for each mile after. For a trip longer than the included miles:

Base rate to enter = the base rate minus included miles × pay per loaded mile

For the Rhode Island rate that is $28.50 minus 5 × $2.50 = $16.00, with $2.50 a mile. A 10-mile trip then shows $16.00 + 10 × $2.50 = $41.00, the same as $28.50 + 5 × $2.50. For a trip inside the included miles, enter the full base rate and 0 per mile.

When you will drive more loaded miles than the offer pays for, as on a detour or a shared ride, enter the offer’s miles as loaded miles and add the extra to empty miles. Those miles cost fuel and wear but earn nothing. Arizona’s fee-for-service manual (revised July 31, 2026), for example, bills each rider on a shared ride for the most direct route between that rider’s own pickup and drop-off. See NEMT multiloading.

If the trip pays for waiting, add that pay to the base rate. Arizona’s fee-for-service program pays T2007 at $4.59 for each 30 minutes from October 1, 2026, but only when the driver waits at the appointment because a return to base is not practical. Its manual also rules out wait pay when the wait is under 30 minutes, the appointment is 10 miles away or less, the trip is one way, two vans or drivers run the round trip, or the odometer moves during the wait. See NEMT wait time billing.

Driver time

Count every minute the trip keeps your driver from other work. Federal wage rules count travel from job site to job site during the workday as hours worked (29 CFR 785.38), so the drive out to the pickup is paid time.

Waiting counts too. A worker who waits on duty for the next task is working (29 CFR 785.15). Waiting is off the clock only when the driver is completely relieved of duty, told in advance they may leave and when to be back, and the break is long enough to use for their own purposes (29 CFR 785.16). A driver who waits at the clinic for the ride home is usually on the clock, so those minutes belong in the box.

For driver cost per hour, start with the wage and add your share of payroll taxes: 6.2% Social Security and 1.45% Medicare, 7.65% in all (IRS Topic 751, updated September 24, 2026). A $17 hourly wage costs you $18.30 before unemployment tax, workers’ compensation, and benefits. If you drive yourself, enter what you would pay a driver. The driver cost calculator builds the full hourly number.

Wheelchair and stretcher rides take longer to load and secure than ambulatory rides. Use real minutes for each level of service, not one number for all.

Fuel and wear

Use what you pay at the pump. For comparison, EIA’s survey for the week of September 28, 2026 put regular gasoline at $4.465 a gallon across the U.S., $1.347 more than a year before, and on-highway diesel at $6.382. By region, regular ranged from $3.924 on the Gulf Coast to $5.724 on the West Coast that week. The example uses $4.50. At 15 miles per gallon, the example trip’s 18 miles burn 1.2 gallons, so every $1 a gallon changes its cost by $1.20.

For wear, enter only the costs that rise with miles: tires, oil, brakes, and repairs. Do not use the IRS standard mileage rate here. The business rate is 72.5 cents a mile from 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 already includes fuel, and 35 cents of the 2026 rate is treated as depreciation (Notice 2026-10), which you pay whether or not you take the trip.

A worked example

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

Step	Math	Result
What the trip pays	$25 base rate + 10 loaded miles × $2	$45.00
Miles driven	10 loaded + 8 empty	18 miles
Fuel	18 ÷ 15 miles per gallon × $4.50	$5.40
Wear on the vehicle	18 × $0.20	$3.60
Driver time cost	60 minutes ÷ 60 × $20 an hour	$20.00
Cost to run the trip	$5.40 + $3.60 + $20.00	$29.00
Profit on this trip	$45.00 minus $29.00	$16.00
Profit per hour of driver time	$16.00 ÷ 1 hour	$16.00

The driver’s hour is $20 of the $29, more than twice the fuel and wear together. On most trips, the minutes decide the cost more than the miles do.

How to decide in seconds

Once your own costs are in, two numbers answer most offers before you open the calculator:

Cost per minute of driver time = driver cost per hour ÷ 60

Cost per mile driven = fuel price per gallon ÷ miles per gallon + wear per mile

In the example, that is $20 ÷ 60 = about 33 cents a minute and $4.50 ÷ 15 + $0.20 = 50 cents a mile. The example trip takes 60 minutes and 18 miles: $20.00 + $9.00 = $29.00. An offer that pays less than that loses money on the trip itself.

Two more checks follow from the same numbers:

• The lowest base rate that breaks even is the cost to run the trip minus loaded miles × pay per loaded mile. In the example, $29 minus 10 × $2 = $9. At $2 a mile, a base rate under $9 loses money on this trip.
• What a farther pickup costs. At 30 miles an hour, each extra empty mile takes 2 minutes, so it costs 50 cents plus 2 × 33 cents, about $1.17 in the example. A pickup 10 miles farther away needs about $11.67 more pay to leave the same profit.

Write your two numbers on a card by the dispatch phone, and redo them when fuel, wages, or the van change.

Which offer pays better per hour

Profit on a trip tells you whether it pays. Profit per hour tells you which of two offers pays better for the same van and driver. Here are five example offers, all at the example’s $25 base rate and $2 a loaded mile, with the example’s costs:

Offer	Miles and driver time	Pays	Profit	Profit per hour
A. The example trip	10 loaded, 8 empty, 60 minutes	$45.00	$16.00	$16.00
B. Long ride	40 loaded, 10 empty, 150 minutes	$105.00	$30.00	$12.00
C. Short ride, far pickup	3 loaded, 20 empty, 45 minutes	$31.00	$4.50	$6.00
D. Short ride, pickup nearby	3 loaded, 2 empty, 25 minutes	$31.00	$20.17	$48.41
E. Ride home after a 60-minute wait	10 loaded, 0 empty, 90 minutes	$45.00	$10.00	$6.67

Every one of them makes money. They are far from equal.

Set a floor to compare them against. Fixed costs per hour = a month of fixed costs ÷ the hours your van runs trips in a month. Say the van payment, insurance, and office come to an example $2,640 a month, and the van runs 8 hours a day for 22 days, 176 hours. The floor is $15.00 an hour. Offers A and D clear it. B, C, and E do not.

How to use the floor:

• When the day is full, take the offers above your floor first. The long ride leaves the most dollars, but in the 150 minutes it takes, the van could run six trips like D back to back.
• When the van would sit anyway, a trip under the floor still helps, as long as it leaves a profit. If the driver is paid for the shift either way, set driver cost per hour to 0 to see what the trip adds.
• When a return means a long wait, compare the $6.67 an hour of offer E with sending the van to run other trips and coming back. The wait time cost calculator weighs that choice.

What real rates leave on the same trip

The same example trip, 10 loaded miles, 8 empty miles, and 60 minutes at a cost of $29.00, pays very differently by payer. Here it is on one broker rate sheet and three state fee-for-service schedules for a wheelchair van. Profit per hour is the same as profit here, because the trip takes one hour.

Rate	Enter as base rate	Pay per loaded mile	The trip pays	Profit on the example trip
MTM Health, Rhode Island, Tier 1, business hours (effective July 1, 2023)	$28.50 minus 5 × $2.50 = $16.00	$2.50	$41.00	$12.00
Arizona, Phoenix or Tucson metro, A0130 and S0209 (from October 1, 2026)	$11.15	$1.54	$26.55	Loses $2.45
Arizona, the rest of the state, with the TN modifier (from October 1, 2026)	$12.21	$1.66	$28.81	Loses $0.19
Ohio, A0130 and S0209 (rates last changed January 1, 2024)	$31.00	$1.30	$44.00	$15.00
Nebraska, A0130 and S0209 (July 1, 2026 schedule)	$46.12 minus 5 × $1.85 = $36.87	$1.85	$55.37	$26.37

• Arizona counts a trip as urban when it starts in the Phoenix or Tucson metro area. Every other trip bills with the TN modifier, which AHCCCS says allows for dirt roads, long drives to reach the member, and a lack of providers.
• Ohio pays the lesser of your charge or the maximum in the appendix to rule 5160-15-28, whose current version took effect August 1, 2026. Trips for a managed care plan pay what your agreement with that plan says.
• Nebraska folds the first five loaded miles, all unloaded miles, and usual waiting time into the base rate. Its July 1, 2026 schedule notes that rates did not rise because no increase was funded.
• Rhode Island pays more for a far pickup. When the pickup is over 40.1 miles from where your vans are kept, MTM’s Tier 2 pays a wheelchair trip $29.81 for the first 5 miles and $3.81 a mile after: $48.86 for the 10-mile trip, $7.86 more than Tier 1.

That premium is worth running through the calculator. Say the far pickup brings the example trip to 45 empty miles and adds an hour of driving. Enter a base rate of $29.81 minus 5 × $3.81 = $10.76, $3.81 a mile, 10 loaded miles, 45 empty miles, and 120 minutes. The trip costs $67.50 to run and loses $18.64. The higher rate pays for a small part of the drive out.

Broker and health plan trips pay whatever your contract says, and a state schedule is still a fair yardstick when a broker names a rate. See NEMT reimbursement rates for other states and A0130 and S0209 for the codes.

Before you turn down an offer

A losing trip is not always one to decline, and how you decline matters as much as whether.

• Answer inside the window. MediTrans in Louisiana asks providers to decline within 30 minutes when they cannot complete a trip, with no penalty for a timely decline (provider hub, September 2026).
• Watch your acceptance rate. To stay in its network, SafeRide Health requires a 100% ride response rate and a 95% ride acceptance rate (September 2026). At 95%, you can turn down about one offer in twenty.
• Do not decline by trip type alone. Louisiana requires its broker to make sure providers do not reject local trips in favor of long-distance ones, and a pattern can bring trip reductions or other sanctions (Chapter 10, Section 10.2, issued July 14, 2025). CareOregon’s manual (version 1.3, February 2024) calls cherry-picking, a pattern of accepting only the trip types that pay the most, an unacceptable reason to hand trips back. A short trip that loses a little can keep the good ones coming.
• Do not plan to make it up from the rider. Under 42 CFR 447.15, a Medicaid provider accepts the program’s payment, plus any cost sharing the state plan sets, as payment in full. CMS says neither states nor providers may charge a member for a no-show (SMD 23-006, September 28, 2023).
• If you already accepted, hand the trip back early and by the broker’s rules. The guide to NEMT broker trip offers lists turnback deadlines by broker and what late ones cost.

How to use the answer

• Set your floor once. Divide a month of fixed costs by the hours your vans run trips, and keep that number next to the phone with your cost per minute and cost per mile. The profit per vehicle calculator shows what a month of trips leaves after fixed costs.
• Price a standing order before you take it. A rider who goes to dialysis three days a week is 6 legs a week and 312 a year. A leg that loses $2.45, like the Arizona metro line above, costs $764.40 a year. A leg that leaves $12.00 adds $3,744. See NEMT standing orders.
• Fix the offers at the source. If losing offers keep coming from far away, shrink the service area in your broker profile. The deadhead cost calculator shows what a day of empty driving costs, and service area explains how brokers use yours.
• Bring numbers to a rate talk. Run your most common trip shapes through a broker’s rate sheet and show which ones lose money. See how to negotiate NEMT broker rates.
• Check the month, not only the trip. One good trip does not make a good month. The guide to NEMT cost per trip spreads fixed costs over every trip a van runs and shows which kinds lose money.
• Price private rides from the same costs. Riders and facilities outside Medicaid can pay a price that covers the empty miles and the wait. The trip price calculator adds overhead and a margin to the same inputs.