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A study of Delaware Medicaid NEMT found that the reason for treatment was significantly associated with cancelations. In multivariate analyses, trips for a wide variety of treatment reasons were more likely to be canceled compared with dialysis encounters except for obtained alternative transportation cancelations. Doctor’s encounter trip had 2.1 and 2.5 times the odds for all reasons cancelations and client cancelations, respectively. Substance use trips had 5.2 and 7.9 times the odds, respectively; however, the estimates are less precise (95% confidence interval = 2.5–10.8 and 3.1–20.5, respectively). No substance use trips were canceled for health reasons. In multivariate analyses, more frail individuals as indicated by need for wheelchair and stretcher had 1.8 and 2.9 times the odds of canceling for health reasons compared with ambulatory level of service, respectively. Needing a wheelchair was associated with increased odds of canceling for any reason and for client reasons by 29% and 40%, respectively, compared with ambulatory level of service.