NEMT rates in California fall into two very different worlds. Medi-Cal, the state’s Medicaid program, pays fixed maximum reimbursements that range from about $17.65 for a mini-bus trip to $107.16 for a non-emergency ambulance transport, plus a per-mile charge during transport. Private-pay rates charged directly to patients or facilities run several times higher, with wheelchair trips commonly billed at $70 to $200 and basic life support ambulance runs at $350 to $800 or more.
Medi-Cal Base Rates by Vehicle Type
The Department of Health Care Services publishes a fee schedule in the Medi-Cal provider manual. Providers are paid their usual charge or the listed maximum, whichever is lower. The UJ modifier applies in specific circumstances and yields a higher rate.
- Wheelchair van (A0130): $20.30 base, $26.43 with UJ modifier.
- Mini-bus and mountain area transport (A0120): $17.65 base, $23.78 with UJ modifier. Capped at 8 units per month absent additional documentation.
- Stretcher van (T2005): $26.29 base, $32.42 with UJ modifier.
- BLS non-emergency ambulance (A0428): $107.16 base, $117.04 with UJ modifier.
- ALS non-emergency ambulance, Level 1 (A0426): $107.16 base, $117.04 with UJ modifier.
These figures come from the ground transportation billing codes and reimbursement schedule last revised in March 2024.1Medi-Cal. Medical Transportation – Ground: Billing Codes and Reimbursement Rates
Emergency ground transports pay more. The base fee-for-service rate is $118.20 per transport for BLS emergency (A0429), ALS emergency Level 1 (A0427), ALS Level 2 (A0433), and specialty care transport (A0434).1Medi-Cal. Medical Transportation – Ground: Billing Codes and Reimbursement Rates
Mileage Reimbursement
On top of each base rate, Medi-Cal pays per-mile during the actual transport of the patient. Rates differ by vehicle type:
- Ambulance ground mileage (A0425): $3.55 per statute mile, limited to providers certified by the California Highway Patrol.
- Wheelchair and litter van mileage (A0380): $1.50 per mile.
- Non-medical transportation mileage (A0390): $1.30 per mile.
Mileage is only paid while a patient is being transported. Dry runs, where a vehicle arrives but no transport occurs, are not reimbursable. Providers must document total miles from pickup to destination, and the return mileage for round trips.2Medi-Cal. Medical Transportation – Ground: General Information Complete origin and destination addresses must appear on the claim.1Medi-Cal. Medical Transportation – Ground: Billing Codes and Reimbursement Rates
Waiting Time and Attendants
Non-emergency vehicle waiting time is billed under T2007 in half-hour increments. The clock starts after the first 15 minutes of waiting to load the patient, and no more than 90 minutes (three units) can be billed. Neonatal ambulance transports are the exception, allowing up to 8 hours of waiting time to stabilize the infant.2Medi-Cal. Medical Transportation – Ground: General Information
A patient attendant or escort (T2001) is reimbursed at $5.52. An extra ambulance attendant (A0424) is paid up to $16.44 per hour for ground transport.1Medi-Cal. Medical Transportation – Ground: Billing Codes and Reimbursement Rates
Air Ambulance Rates
Medi-Cal also reimburses air medical transport. Fixed-wing airplane transport pays a $1,275 base rate with $14.25 per statute mile. Rotary-wing helicopter transport pays $1,800 base with $22.10 per statute mile. Air waiting time (T2007 with the TU modifier) pays $50 per half-hour increment, up to the same 90-minute cap that applies to ground.3Medi-Cal. Medical Transportation – Air: Billing Codes and Reimbursement Rates
Prior Authorization Affects Whether You Get Paid
Most non-emergency transports billed to Medi-Cal need a Treatment Authorization Request (TAR) before the trip. The TAR confirms medical necessity and the appropriate service level. Limited exceptions exist — non-emergency transfers from an acute care hospital to a nursing facility billed with the HN and QN modifier combination may not require a TAR under updates to the billing manual.1Medi-Cal. Medical Transportation – Ground: Billing Codes and Reimbursement Rates Emergency transports generally do not require prior authorization. DHCS publishes a separate list of which procedure codes require a TAR.4Medi-Cal. Medical Transportation Publications
Private-Pay Rates in California
Rates charged to self-pay patients or to facilities contracting directly with transport companies are far higher than Medi-Cal reimbursement. Pricing varies by company, region, and trip details, but two California operators show the general range.
A Southern California ambulance company lists wheelchair transport at $70 to $200 or more per trip, with a typical 10-mile scheduled ride from a skilled nursing facility to dialysis running $110 to $130. Stretcher transport ranges from $170 to over $400, and BLS ambulance trips from $350 to $800 or more. Critical care transports can reach $3,000, and long-distance BLS transfers such as Los Angeles to San Diego run $1,500 to $1,800.5West Coast Ambulance. Pricing Guide
A Sacramento-based NEMT provider charges $45.99 as a base rate for ambulatory (walk-on) transport covering the first five miles, with additional mileage at $2.00 to $3.99 per mile depending on distance. Wheelchair transport starts at $79.99 for the first five miles, and gurney van service at $269.90. Wait time is $50 for the first hour and $25 per hour after that.6Rapid Response Medical Transportation. Medical Transportation Pricing
The contrast is sharp. A wheelchair van trip that a private-pay patient might be charged $110 or more for yields $20.30 at the Medi-Cal base rate plus $1.50 per mile, coming out well under $40 for a 10-mile ride.
Changes That May Raise Medi-Cal Rates
Two developments could shift the numbers above.
First, the Ground Emergency Medical Transport Quality Assurance Fee program adds a supplemental payment on top of the base emergency rate. Under State Plan Amendment 24-0025, approved by the Centers for Medicare and Medicaid Services, eligible private GEMT providers receive a flat add-on of $220.80 per transport for services provided between July 1, 2024, and June 30, 2025. That brings combined reimbursement for codes A0427, A0429, A0433, and A0434 to $339.00 per transport, and for neonatal emergency transport (A0225) to $400.72.7California Department of Health Care Services. SPA 24-0025 Approval Public ambulance providers in the separate Public Provider GEMT Intergovernmental Transfer program are not eligible for the add-on. DHCS estimated the program would raise aggregate Medi-Cal spending on ground emergency transports by roughly $12 million in total funds for state fiscal year 2024–25.8California Department of Health Care Services. SPA 24-0025 Public Notice
Second, Assembly Bill 1328 (2025–2026 session) would set Medi-Cal fee-for-service reimbursement for non-emergency ambulance services at 80 percent of the federal Medicare ambulance fee schedule, adjusted by the Geographic Practice Cost Index. It would also require DHCS to set up a managed care directed payment program with rates at least equal to the new fee-for-service amount. The bill would allow GPS tracking and digital mapping software to verify mileage, and would let authorized non-physician practitioners certify medical necessity for non-emergency ambulance trips. As of mid-2025, AB 1328 was held under submission in the Senate Committee on Appropriations and had not received a floor vote.9Digital Democracy. AB 1328 Medi-Cal Reimbursements: Nonemergency Ambulance and Other Transportation