T2049 Medicaid reimbursement rate by state (2026)

• Order. States are listed from the highest published rate to the lowest. A like-for-like rank only counts states that use the same unit: 9 of the 10 states publish T2049 per mile, enough to rank them against each other.
• Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 3 of the 10 states list more than one rate for T2049, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
• Unit. Of the 10 states, 9 publish T2049 per mile and 1 per per whole mile.
• Per hour. T2049 is not billed in time units in these states, so no hourly figure is shown.
• Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
• % of Medicare. No Medicare physician fee schedule amount is on file for T2049, so there is no percentage.
• Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.

Published rates for T2049 run from $0.66 in New Mexico to $2.61 in South Dakota. The two publish it in different units (per whole mile versus mile), so part of that gap is the unit rather than the price. Half the states pay more than the median of $2.19 and half pay less. The usual reasons for a spread like this in transportation rates:

• Ambulance payment is usually a base rate per transport plus mileage, and states weight the two differently.
• Emergency and non-emergency trips, advanced and basic life support, and urban and rural trips can each carry their own rates.
• Many states run non-emergency medical transportation through a broker, so the state fee schedule covers only part of the benefit.

Timing matters too. 5 states set the current rate for T2049 in 2026 or later, while 4 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

What a plan pays for T2049 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 10 states.

In 3 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 3 states, the service is paid outside the plans or through a state-directed payment. The rule for the remaining 4 states is not classified yet.

• Paid by the state, outside the plans (3 states). Bill the state's Medicaid program, not the plan, at the published rate. There is no plan contract to negotiate for this service.
• Plans negotiate; the published rate applies out of network (2 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
• Suggested schedule for plans (1 state). Use the schedule as a public benchmark in negotiations; the actual rate is whatever you and the plan agree.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example South Dakota managed care.

T2049 is a HCPCS Level II state Medicaid agency code in the transportation line, billed mostly by ambulance services and non-emergency transportation providers. T codes were created for state Medicaid agencies, for services such as personal care, private duty nursing, case management and waiver services. Each state defines how the code is used and paid, so units vary from 15 minutes to a month.

Origin and destination modifiers on the claim identify where the trip started and ended. The base rate is billed once per trip and mileage per loaded mile under its own code.

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.