Last updated 2026-07-25
TL;DR
MTM (Medical Transportation Management) is a transportation broker that manages non-emergency medical transportation (NEMT) benefits for state Medicaid agencies and some Medicare Advantage plans. Owner-operators don't enroll with Medicaid directly for MTM-managed trips; they credential as a transportation provider through MTM's network in whichever state or region MTM holds the contract.
What is MTM in the context of non-emergency medical transportation?
MTM, short for Medical Transportation Management, Inc., is one of the largest NEMT brokers in the country. States that manage Medicaid transportation through a broker model hire a company like MTM (or Modivcare, Access2Care, or SafeRide) to handle trip scheduling, driver credentialing, and payment on the state's behalf, instead of paying every transportation provider directly. If you're a wheelchair-van owner-operator, MTM is usually not your customer in the sense of a client who books a ride and pays you cash. MTM is the middleman between the state Medicaid agency and you. The state pays MTM a monthly amount (often a capitated rate) to manage all NEMT trips in a region, and MTM in turn contracts with local transportation providers, schedules the rides, and pays providers per completed trip, usually on a set fee schedule. MTM operates NEMT contracts in a number of states and also manages some non-Medicaid transportation benefits for Medicare Advantage plans and other health plans. The exact states and regions MTM covers change over time as state contracts are rebid, so confirm current coverage with your state Medicaid transportation unit and with MTM directly before you assume MTM is the broker in your area [1]. This matters for owner-operators because your entire enrollment path depends on who holds the brokerage contract where you operate. Get that wrong and you'll spend weeks credentialing with the wrong company.
What is non-emergency medical transportation (NEMT)?
Non-emergency medical transportation is transportation to and from covered medical services for people who have no other way to get there and don't need an ambulance. It covers rides to dialysis, physical therapy, chemotherapy, primary care visits, mental health appointments, and pharmacy pickups for eligible Medicaid enrollees. Federal Medicaid regulation requires state Medicaid programs to make sure eligible people can get to and from covered services. The regulation at 42 CFR 431.53 states that a state plan must "specify that the Medicaid agency will ensure necessary transportation for beneficiaries to and from providers" [2]. States have wide flexibility in how they meet that requirement: some run NEMT in-house, some pay transportation providers directly on a fee-for-service basis, and many now use a broker model where a company like MTM or Modivcare manages the whole benefit under contract. NEMT is distinct from emergency ambulance transport. NEMT vehicles are wheelchair vans, ambulettes, and sometimes sedans or ride-hail vehicles for ambulatory riders. There's no siren, no EMT crew, and no emergency dispatch. For background on how the broader NEMT system fits together across states, see nemt and non emergency medical transportation.
Does Medicaid cover ambulance rides, and how is that different from NEMT?
Yes, Medicaid covers ambulance transportation when it's medically necessary, but that's a separate benefit from NEMT and it isn't run through brokers like MTM in most states. Ambulance transport is for emergencies or situations where the patient needs medical monitoring or a stretcher-level transport with clinical staff aboard. Medicaid.gov describes NEMT as covering trips where beneficiaries "have no other means of transportation" to get to Medicaid-covered services, while ambulance benefits fall under separate emergency and non-emergency ambulance transportation rules typically billed directly to the state Medicaid agency or a Medicaid managed care plan, not through the NEMT broker [1]. If you're buying a wheelchair van, you are not entering the ambulance business. Wheelchair-van NEMT does not require EMT certification, a stretcher, or emergency lights. Don't let anyone (including a broker recruiter) tell you that you need ambulance-level credentials to do wheelchair-van work. You need a properly equipped wheelchair-accessible vehicle, a driver with the right license class for your state, and the broker's own credentialing checklist.
Does Medicare cover medical transportation?
Medicare's coverage of non-emergency medical transportation is much narrower than Medicaid's. Original Medicare (Part B) covers ambulance services when other transportation could endanger your health, and it generally does not cover routine non-emergency rides to doctor visits or dialysis for ambulatory or wheelchair-mobile beneficiaries [3]. Some Medicare Advantage (Part C) plans offer a supplemental non-emergency transportation benefit as an extra, and many of those plans contract with the same brokers used in Medicaid, including MTM, to manage that benefit. Coverage, trip limits, and prior authorization rules vary plan by plan, so a rider's eligibility for an MTM-arranged trip under Medicare Advantage depends entirely on their specific plan's benefit design, not on a blanket Medicare rule [4]. For owner-operators, this means a single MTM contract in your state might include both Medicaid fee-for-service trips and Medicare Advantage supplemental trips, each with its own eligibility rules, even though you're credentialed with MTM only once.
How does MTM credentialing work for a wheelchair-van owner-operator?
MTM credentialing generally means submitting an application through MTM's transportation provider network portal for the specific state or region where you'll operate, along with your business licensing, vehicle documentation, driver records, and insurance certificates. Requirements are set separately by each state contract, so exact document lists differ by state. Common items brokers ask for across most state NEMT networks include: a valid state business registration or NEMT permit if your state requires one, vehicle registration and safety inspection records, proof of commercial or livery insurance meeting the state's minimum limits, driver background checks (often including a state-specific criminal history and exclusion list check), driver's license verification for the correct class, and proof of wheelchair-lift or ramp maintenance records. Some states also require drivers to complete passenger assistance training or defensive driving certification before they can be approved [5]. MTM, like other brokers, typically checks drivers and owners against the federal List of Excluded Individuals/Entities (LEIE) maintained by the HHS Office of Inspector General, since anyone excluded from federal health programs cannot bill Medicaid, directly or through a broker [4]. If you or an employee has ever had a Medicaid exclusion, disclose it up front; it will surface in the check regardless. Because requirements are set at the state and contract level and change over time, confirm the current document checklist with MTM's provider recruitment team and with your state Medicaid transportation unit before you assume any list (including this one) is complete.
What is the actual process to start working trips through MTM?
The rough sequence looks like this in most states, though order and naming vary by contract: 1. Confirm MTM (not Modivcare or another broker) holds the NEMT contract in your county or region. This changes when states rebid contracts, so check current status with your state Medicaid agency's transportation unit. 2. Set up your business entity, get your NEMT-specific state permit or certificate of authority if your state requires one, and get commercial auto insurance quoted for livery/NEMT use. 3. Submit a transportation provider application through MTM's provider portal or recruitment contact for your state. 4. Pass vehicle inspection and driver background/exclusion checks. 5. Sign the provider agreement, which sets your per-trip or per-mile reimbursement rates, cancellation policies, and performance standards (on-time percentage, complaint thresholds). 6. Get trained on MTM's dispatch and trip-management system, since most brokers now assign and confirm trips through a mobile app or web portal rather than phone calls. 7. Start receiving trip offers, which you accept or decline based on your capacity. MTM's provider agreements typically include performance metrics like on-time pickup rates and complaint ratios, and providers who fall below the standard can be put on a corrective action plan or removed from the network. Read the agreement's termination and performance clauses closely before you sign; these vary by state contract and MTM does not publish a single national template.
How do you start a medical transportation business from scratch?
Starting a medical transportation business generally means five things happening roughly in this order: forming a legal business entity, getting the right vehicle, obtaining Medicaid/broker credentials, securing insurance, and hiring or training compliant drivers. None of these steps is optional, and skipping the state permit step is the single most common reason new owner-operators get stuck for months. First, register your business entity (LLC is common) with your Secretary of State, and get an EIN from the IRS. Second, check whether your state requires a separate NEMT operating permit or certificate of need; a growing number of states do, on top of standard business licensing. Third, buy or convert a wheelchair-accessible vehicle that meets ADA-adjacent mobility equipment standards and your state's vehicle inspection rules. Fourth, apply for Medicaid provider enrollment with your state Medicaid agency (if your state pays NEMT fee-for-service) and separately apply for broker credentialing with whichever companies (MTM, Modivcare, Access2Care, SafeRide) manage NEMT in your area. Fifth, get commercial auto insurance sized for NEMT/livery use, not a personal auto policy, since personal policies typically exclude for-hire transportation. Medicaid provider enrollment itself, separate from broker credentialing, usually runs through a state's Medicaid Management Information System (MMIS) provider portal and can take anywhere from a few weeks to a few months depending on the state's backlog and your document completeness. CMS requires state Medicaid agencies to screen providers according to a risk level (limited, moderate, or high) under 42 CFR 455.450, which determines whether you need fingerprint-based background checks and site visits before enrollment is approved . For a state-by-state breakdown of enrollment steps, see medical transportation and non emergency medical transportation services.
How do you start an NEMT business with just one van?
You can absolutely start with a single wheelchair van; most owner-operators do. The steps are the same as starting any NEMT business, just scaled down: one vehicle, one or two drivers (possibly just you), and a tighter budget for insurance and permits. The practical constraints of a one-van operation are worth naming honestly. You'll have zero redundancy if that van breaks down or fails inspection, so budget for a maintenance reserve and know your backup plan (a rental or a partner operator) before you need it. You'll also be capacity-limited on trip volume, which affects how brokers view you; some broker contracts favor providers who can reliably cover a minimum number of trips per week in a service area, so ask MTM's recruitment contact directly whether there's a practical minimum before you commit. One van also means your insurance and permit costs are fixed regardless of how many trips you run, so those early credentialing and insurance costs matter more per trip than they would for a larger fleet. Get quotes for commercial NEMT insurance before you buy the vehicle, not after, since premiums vary a lot by state and by whether the vehicle carries a wheelchair lift.
MTM vs. other NEMT brokers: what's actually different for an owner-operator?
| MTM (Medical Transportation Management) | State Medicaid NEMT contracts, some Medicare Advantage transportation benefits | MTM provider portal for the specific state contract | |
|---|---|---|---|
| Modivcare | State Medicaid NEMT contracts in multiple states | Modivcare provider network application | |
| Access2Care | Regional NEMT and some ambulance-adjacent contracts | Access2Care provider recruitment | |
| SafeRide Health | NEMT and rideshare-style transportation benefit management | SafeRide provider onboarding | Coverage by broker changes as states rebid multi-year contracts, sometimes swapping the incumbent broker entirely. A state that used Modivcare last year might use MTM this year, or split the state into regions with different brokers in each. Always verify current broker assignment directly with your state Medicaid transportation unit before you build your business plan around one company's name. Because of that turnover, it's worth building relationships and paperwork readiness for more than one broker if your state has more than one operating in different counties, or if a rebid is coming up. See broker-guides resources for credentialing checklists by broker. |
From an owner-operator's seat, the brokers look more alike than different: they all run a provider credentialing process, assign trips through a dispatch app, and pay on a fee schedule set by the state contract. The real differences are which states or counties each broker covers, and the specific documentation and technology each broker requires. | Broker | What they manage | Where owner-operators apply |
What does it cost to get a wheelchair van and get credentialed?
Costs break into vehicle cost, insurance, and permit/credentialing fees, and they vary widely by state and by whether you buy new or used. A new wheelchair-accessible minivan conversion typically runs well into the $50,000 to $80,000+ range depending on the conversion type (side-entry vs. rear-entry) and manufacturer, while used conversions can run considerably less depending on age and mileage; exact pricing depends on your market and the vehicle you choose, so get quotes from mobility dealers rather than relying on a single number. Commercial NEMT insurance premiums vary heavily by state, driving record, and vehicle type, and some states require higher minimum liability limits for NEMT/livery vehicles than for standard personal auto policies. State-level NEMT permit or certificate fees, where required, are typically a few hundred dollars, but a handful of states charge more for a certificate of need or operating authority review process. Broker credentialing itself (the MTM or Modivcare application) is typically free to apply, but background check fees, DOT physical costs for drivers, and vehicle inspection fees are often out-of-pocket costs on top of the application. Given how much these numbers vary by state, treat any flat dollar figure you see online (including this one) as a starting range, and confirm current fee schedules with your state Medicaid agency and your target broker before budgeting.
What trips will MTM assign you, and how does payment work?
MTM assigns trips through its dispatch system based on the rider's pickup location, appointment time, and the vehicle type needed (ambulatory sedan, wheelchair van, or stretcher van). As a wheelchair-van provider, you'll generally only see trips flagged for wheelchair-accessible vehicles, though some brokers also route ambulatory trips to wheelchair-van providers when ambulatory capacity is short. Payment is set by the provider agreement you sign, usually a per-trip or per-mile rate (sometimes both, as a base rate plus mileage) that's specific to the state contract, not a national MTM rate. Payment cycles are typically weekly or biweekly through direct deposit, contingent on trip documentation (pickup/drop-off confirmation, sometimes rider signature or a mobile app check-in). Missed trips, no-shows, and late cancellations are handled according to the contract's policy, and these policies vary by state; some allow a partial payment for a documented no-show, others don't. Read this section of your provider agreement closely, since it directly affects cash flow on a route where riders sometimes cancel same-day for medical reasons outside anyone's control. For drivers coming from the trucking or livery side, nemt transportation covers how trip assignment and driver logistics typically differ from other for-hire driving work.
Where should you go next to actually get credentialed?
Start with your state Medicaid agency's transportation unit page, which will tell you whether your state runs NEMT fee-for-service, through managed care plans, or through a broker like MTM, and will list current broker contacts. Medicaid.gov's non-emergency medical transportation overview is a reasonable starting point for how the federal requirement works before you get into state specifics [1]. From there, contact the broker (or brokers) operating in your specific county directly for their current provider application and document checklist, since these details change and a broker's own recruitment team is the only reliably current source. If you want a structured starting point that pulls state Medicaid enrollment steps and broker credentialing checklists into one place so you're not chasing a dozen separate government and broker web pages, RideCredential's $199 one-time State + Broker NEMT Launch Kit is built for exactly this stage of getting a first wheelchair van credentialed. It doesn't replace confirming details with your state agency and broker directly, but it saves the hunting.
Frequently asked questions
What is non-emergency medical transportation?
Non-emergency medical transportation (NEMT) is transportation to and from covered medical appointments for people who have no other way to get there and don't need ambulance-level emergency care. It typically covers dialysis, therapy, and routine medical visits for Medicaid enrollees, and federal rule at 42 CFR 431.53 requires state Medicaid programs to ensure this transportation is available.
What is MTM in NEMT?
MTM (Medical Transportation Management, Inc.) is a company that many state Medicaid agencies contract with to manage their non-emergency medical transportation benefit. MTM credentials transportation providers, schedules trips, and pays providers on the state's behalf under a broker contract.
Does Medicaid cover ambulance rides?
Yes. Medicaid covers ambulance transportation when it's medically necessary, as a benefit separate from NEMT. Ambulance transport typically involves emergency response or a need for clinical monitoring during transit, and it's usually billed directly to the state Medicaid agency or managed care plan rather than routed through an NEMT broker like MTM.
Does Medicare cover medical transportation?
Original Medicare Part B covers ambulance transport when other transportation would endanger the patient's health, but it generally doesn't cover routine non-emergency rides. Some Medicare Advantage plans offer a supplemental non-emergency transportation benefit as an extra, and many contract with the same brokers, including MTM, that manage Medicaid NEMT.
How do I start a medical transportation business?
Form a business entity, check whether your state requires a separate NEMT operating permit, buy or convert a wheelchair-accessible vehicle, apply for Medicaid provider enrollment and broker credentialing (MTM, Modivcare, etc.), and get commercial NEMT insurance. Order matters: get your state permit and insurance lined up before you commit to broker credentialing paperwork.
How do I start an NEMT business with one van?
The steps are identical to starting any NEMT business, just scaled to one vehicle: business registration, state NEMT permit if required, vehicle purchase or conversion, driver licensing and background checks, commercial insurance, and broker credentialing. Budget a maintenance reserve since a one-van operation has no backup vehicle if it breaks down.
How do I start a non-emergency medical transportation business?
Register your business, secure a wheelchair-accessible or ambulatory vehicle meeting your state's NEMT standards, get commercial auto insurance for livery/NEMT use, enroll with your state Medicaid agency if it pays fee-for-service, and apply for credentialing with whichever broker (MTM, Modivcare, Access2Care, SafeRide) manages NEMT in your county.
Is MTM the same as Medicaid?
No. MTM is a private company that contracts with state Medicaid agencies to manage the NEMT benefit. The state Medicaid agency sets the rules and pays MTM; MTM in turn credentials and pays transportation providers. Your Medicaid provider enrollment (if your state requires it) is a separate process from MTM broker credentialing.
How much does it cost to get credentialed with MTM?
Applying to MTM's provider network is typically free, but you'll pay for driver background checks, DOT physicals, vehicle inspections, and commercial NEMT insurance out of pocket, and possibly a state NEMT permit fee. Total credentialing costs vary a lot by state; confirm current fee schedules with your state Medicaid agency and MTM directly.
Does every state use MTM for NEMT?
No. States choose their own NEMT model: some pay providers fee-for-service directly, some route it through Medicaid managed care plans, and some contract with a broker like MTM, Modivcare, Access2Care, or SafeRide. Broker contracts are rebid periodically and can change hands, so confirm current broker assignment with your state Medicaid transportation unit.
What vehicle do I need for MTM wheelchair-van trips?
You need a vehicle with a working wheelchair lift or ramp that meets your state's vehicle inspection and safety standards for NEMT service. MTM and your state will typically require documentation of lift maintenance, current registration, and passing inspection before approving the vehicle for trip assignment.
Can I work with MTM and another broker at the same time?
Often yes, if your state has more than one broker operating in different counties, or if you serve a region where broker contracts changed recently. Each broker requires its own separate credentialing application; there's no shared credential between MTM, Modivcare, Access2Care, and SafeRide.
Sources
- Medicaid.gov, Non-Emergency Medical Transportation: States use different models including brokers to manage the NEMT benefit
- 42 CFR 431.53, eCFR: State Medicaid plans must ensure necessary transportation for beneficiaries to and from providers
- Medicare.gov, Ambulance Services coverage: Medicare Part B covers ambulance services when other transportation could endanger health, and does not generally cover routine non-emergency rides
- 42 CFR 455.450, eCFR: State Medicaid agencies must screen enrolling providers according to a categorical risk level
- HHS Office of Inspector General, List of Excluded Individuals/Entities (LEIE): Individuals and entities excluded from federal health programs cannot bill Medicaid directly or through a broker