This synthesis documents current and innovative practices of U.S. transit agencies in the development and implementation of passenger no-show and late cancellation policies for paratransit programs operated under the regulatory requirements of the Americans with Disabilities Act of 1990 (ADA). It describes how some policies are administered, the community response, and their effectiveness in small, medium, and large transit agencies surveyed. It examines policies both as a way to improve system productivity, efficiency, and capacity, and as a means to better serve riders with disabilities who may experience difficulties with the advance reservation aspect of most ADA complementary paratransit operations. This topic is of interest to transit agencies that are responsible for providing ADA complementary paratransit that is efficient, cost-effective, and responsive to customer needs. It is also of interest to the disability community and other stakeholders who are concerned about having access to transportation services that are efficient, cost-effective, and appropriate for customer needs.