NEMT billing codes (HCPCS)

One code stands for one service, so a trip is often billed with 2 of them: a code for the ride and a code for the miles. The descriptions below follow the wording used in the Michigan Medicaid code listing, along with the North Dakota NEMT manual.

You bill a taxi ride under A0100, and you count it in units. A unit is one countable piece of the service, such as one mile or one trip, and you enter the number of units on the claim. In Colorado, each taxi unit covers one one-way stretch of the ride, so a round trip counts as 2 units.

A wheelchair van ride goes on the claim as A0130, and Colorado bills it per one-way trip. The miles are separate, so Colorado adds S0209, a code reserved only for wheelchair van mileage.

Minnesota's state fee schedule sets a $19.80 base rate for A0130. In Colorado, if an extra-large wheelchair van trip includes 2 attendants, you bill A0130 with the U9 modifier starting November 1, 2025.

S0215 is charged by the mile, per the North Dakota billing rules, so a 12 mile ride comes to 12 units. In Colorado, each mile counts as one unit for rides from July 1, 2025. S0215 also replaced an older code, A0425, for mileage on trips by riders who can walk and on mobility van trips.

Minnesota pays mileage starting from the first mile the client is riding in the vehicle, along the most direct route.

T2003 is a flat charge for each trip or encounter, so you use it when your state or broker pays one set amount per ride instead of paying by the mile. In Minnesota, for instance, T2003 with the UA modifier pays $75.00 per trip when the transport is protected, and an attendant has to ride along.

A modifier is a short code added to the main code to give the payer extra detail. The pair used most often shows where the trip began and finished: CMS's system relies on two letters, with each letter naming a location, and Minnesota treats the first letter as the start of the trip and the second as its end. A trip from home to the hospital, for example, would be marked RH.

When a member takes more than one trip in a day, Colorado also applies 76 and 77: 76 when the same provider handled every ride, and 77 when more than one provider was involved. Colorado also pairs TK with A0120 when a mobility van carries an extra passenger.