v3.25.4
Revenue Recognition
 9 Months Ended
Sep. 30, 2025
Revenue from Contract with Customer [Abstract]  
Revenue Recognition Revenue Recognition
Under ASC 606, the Company recognizes revenue as it transfers promised services to its customers and generates all of its revenue from contracts with customers. The amount of revenue recognized reflects the consideration to which the Company expects to be entitled in exchange for these services. The Company satisfies substantially all of its performance obligations over time and recognizes revenue over time instead of at points in time.

Revenue Contract Structure

NEMT Capitated Contracts (per-member-per-month)

Under capitated contracts, payors pay a fixed amount per eligible member per month. Capitation rates are generally based on expected costs and volume of services. The Company assumes the responsibility of meeting the covered healthcare related transportation requirements based on per-member per-month fees for the number of eligible members in the payor’s program. Revenue is recognized based on the population served during the period. Certain capitated contracts have provisions for reconciliations, risk corridors or profit rebates. For contracts with reconciliation provisions, capitation payment is received as a prepayment during the month service is provided. These prepayments are reconciled based on actual cost and/or trip volume and may result in refunds to the payor, or additional payments due from the payor. Contracts with risk corridor or profit rebate provisions allow for profit within a certain corridor and once the Company reaches profit level thresholds or maximums, it discontinues recognizing revenue and instead records a liability within the accrued contract payable account. This liability may be reduced through future increases in trip volume or periodic settlements with the payor. While a profit rebate provision could only result in a liability from this profit threshold, a risk corridor provision could potentially result in a receivable if the Company does not reach certain profit minimums, which would be recorded in the reconciliation contract receivables account.
NEMT Fee-for-service Contracts

FFS revenue represents revenue earned under non-capitated contracts in which the Company bills and collects a specified amount for each service that it provides. FFS revenue is recognized in the period in which the services are rendered and is reduced by the estimated impact of contractual allowances.

PCS Fee-for-service Contracts

PCS FFS revenue is reported at the estimated net realizable amount from clients, patients and third-party payors for services rendered based on actual personal care hours provided. Payment for services received from third-party payors includes, but is not limited to, insurance companies, governmental agencies and other home health care providers who subcontract work to the Company. Certain contracts are subject to retroactive audit and possible adjustment by those payors based on the nature of the contract or costs incurred. The Company makes estimates of adjustments and considers these in the recognition of revenue in the period in which the related services are rendered. The difference between estimated settlement and actual settlement is reported in net service revenues as adjustments become known or as years are no longer subject to such audits, reviews, or investigations.

Monitoring per-member-per-month Contracts

Monitoring per-member-per-month ("PMPM") revenue consists of revenue from monitoring services provided to the customer. Under Monitoring contracts, payors pay per-enrolled-member-per-month based on enrolled membership. Consideration is generally fixed for each type of monitoring service and revenue is recognized ratably over the contract term based on the monthly fee paid by customers.

Disaggregation of Revenue by Contract Type
The following table summarizes disaggregated revenue from contracts with customers by contract type for the three and nine months ended September 30, 2025 and 2024 (in thousands):

Three months ended September 30,Nine months ended September 30,
2025202420252024
NEMT capitated contracts$343,865 $389,110 $989,136 $1,199,506 
NEMT FFS contracts147,807 103,143 424,878 262,730 
Total NEMT service revenue, net$491,672 $492,253 $1,414,014 $1,462,236 
PCS FFS contracts168,737 188,518 517,412 558,696 
Monitoring PMPM contracts
17,046 19,448 52,653 58,575 
Other service revenue2,252 1,818 5,835 5,280 
Total service revenue, net$679,707 $702,037 $1,989,914 $2,084,787 

Payor Information
Service revenue, net, is primarily derived from state Medicaid, managed Medicaid, and managed Medicare contracts, with a smaller portion from private payors and other sources. Of the NEMT segment’s revenue, 10.1% and 10.7% were derived from one payor for the three months ended September 30, 2025 and 2024, respectively, and 10.8% and 11.2% were derived from one payor for the nine months ended September 30, 2025 and 2024, respectively. Of the PCS segment's revenue, 14.6% and 12.4% were derived from one payor for the three months ended September 30, 2025 and 2024, respectively, and 14.3% and 12.2% were derived from one payor for the nine months ended September 30, 2025 and 2024. Of the Monitoring segment's revenue, 13.7% and 18.6% were derived from one payor for the three months ended September 30, 2025 and 2024, respectively, and 14.2% and 18.7% were derived from one payor for the nine months ended September 30, 2025 and 2024, respectively.

Revenue Adjustments

During the three months ended September 30, 2025 and 2024, the Company recognized a reduction of $5.6 million and a reduction of $4.1 million in service revenue, respectively, from contractual adjustments relating to performance obligations satisfied in previous periods to which the payor agreed. During the nine months ended September 30, 2025 and
2024, the Company recognized a reduction of $0.1 million and an increase of $7.1 million in service revenue, respectively, from contractual adjustments related to performance obligations satisfied in previous periods to which the payor agreed.

Related Balance Sheet Accounts
The following table provides information about accounts receivable, net (in thousands):
September 30, 2025December 31, 2024
Accounts receivable$279,483 $223,756 
Allowance for credit losses
(383)(1,439)
Accounts receivable, net$279,100 $222,317 
The following table provides information about other revenue related accounts included on the accompanying unaudited condensed consolidated balance sheets (in thousands):
September 30, 2025December 31, 2024
Accrued contract payables(1)
$27,601 $22,639 
Contract receivables(2)
$122,454 $117,795 
Deferred revenue, current$381 $300 
(1)     Accrued contract payables primarily represent overpayments and liability reserves on certain risk corridor, profit rebate and reconciliation contracts. See the contract payables and receivables activity below.

(2)     Contract receivables primarily represent underpayments and receivables on certain risk corridor, profit rebate, and reconciliation contracts. See the contract payables and receivables activity below.
The following table provides the summary activity of total contract payables and receivables as reported within the unaudited condensed consolidated balance sheets (in thousands):

December 31, 2024Additional Amounts RecordedAmounts Paid or SettledMarch 31, 2025
Reconciliation contract payables$3,419 $2,247 $(77)$5,589 
Profit rebate/corridor contract payables12,595 5,838 (4,611)13,822 
Overpayments and other cash items6,625 2,918 (2,100)7,443 
Total contract payables$22,639 $11,003 $(6,788)$26,854 
Reconciliation contract receivables$33,749 $16,911 $(9,512)$41,148 
Corridor contract receivables84,046 25,769 (15,615)94,200 
Total contract receivables(1)
$117,795 $42,680 $(25,127)$135,348 

March 31, 2025Additional Amounts RecordedAmounts Paid or SettledJune 30, 2025
Reconciliation contract payables$5,589 $812 $(49)$6,352 
Profit rebate/corridor contract payables13,822 (1,593)(4,285)7,944 
Overpayments and other cash items7,443 2,737 (2,947)7,233 
Total contract payables$26,854 $1,956 $(7,281)$21,529 
Reconciliation contract receivables$41,148 $3,959 $(6,430)$38,677 
Corridor contract receivables94,200 31,100 (48,356)76,944 
Total contract receivables(1)
$135,348 $35,059 $(54,786)$115,621 
June 30, 2025Additional Amounts RecordedAmounts Paid or SettledSeptember 30, 2025
Reconciliation contract payables$6,352 $1,865 $(51)$8,166 
Profit rebate/corridor contract payables7,944 2,577 — 10,521 
Overpayments and other cash items7,233 2,722 (1,041)8,914 
Total contract payables$21,529 $7,164 $(1,092)$27,601 
Reconciliation contract receivables$38,677 $15,075 $(12,308)$41,444 
Corridor contract receivables76,944 20,265 (16,199)81,010 
Total contract receivables(1)
$115,621 $35,340 $(28,507)$122,454 

(1)    Total contract receivables is comprised of the current and long-term contract receivables balances, which are broken out separately on the unaudited condensed consolidated balance sheets. Long-term contract receivables primarily represent future receivable balances on certain risk corridor, profit rebate and reconciliation contracts that are expected to be received in greater than 12 months.