Nationwide NEMT broker list: Modivcare, MTM, and more (2026)

Last updated 2026-07-25

What is non-emergency medical transportation (NEMT)?

NEMT is transportation to and from medical appointments for people who don't need an ambulance but can't get there on their own, whether that's because of a wheelchair, a walker, dialysis three times a week, or just no car and no bus route. It covers everything from a folding-wheelchair sedan trip to a stretcher van and, in rural areas, sometimes mileage reimbursement for a friend or family member who drives. Federal Medicaid rules require states to make sure eligible people can get to and from covered services. The actual regulation, 42 CFR 431.53, says states must "assure necessary transportation for recipients to and from providers" ^[1]. States meet that obligation mostly by hiring transportation brokers, which is where Modivcare, MTM, Access2Care, and SafeRide come in. They don't replace the state Medicaid agency; they manage the day-to-day dispatching, driver credentialing, and trip billing on the state's behalf. For a broader look at how the whole NEMT industry fits together, see medical transportation and nemt transportation.

Does Medicaid cover ambulance rides?

Yes, but that's a different program than NEMT. Ambulance transport (emergency and some non-emergency ambulance trips ordered by a doctor) is billed as a distinct Medicaid benefit, usually through the state's regular medical claims system, not through the NEMT broker network. The federal regulation at 42 CFR 440.170 defines transportation and ambulance services as benefits a state plan may cover, separate from the broader assurance-of-transportation duty under 431.53 ^[2]. The practical difference for you as an owner-operator: if you're running wheelchair vans or ambulatory sedans, you're doing NEMT, not ambulance work, and you credential through the broker, not through the ambulance billing side of Medicaid. If you eventually add a BLS ambulance to your fleet, that's a separate state EMS licensing process on top of your NEMT credentialing, and the two don't overlap much administratively.

Does Medicare cover medical transportation?

Medicare's coverage of NEMT is much thinner than Medicaid's. Original Medicare generally does not cover routine rides to routine appointments. It covers ambulance transportation when medically necessary (an emergency, or a non-emergency ambulance trip your doctor certifies is required because other transport would endanger your health), under the Medicare Part B ambulance benefit rules codified at 42 CFR 410.40 ^[3]. Some Medicare Advantage plans offer limited non-emergency transportation as a supplemental benefit, but that's plan-specific, not a standard Medicare entitlement. If a caller says "Medicare will pay for my van," ask which plan; if it's Original Medicare, the answer is almost always no for routine NEMT. This matters for your business model because it means your Medicaid broker contracts, not Medicare, are the real revenue mechanism for wheelchair-van NEMT work.

Who are the major national NEMT brokers?

Four names dominate Medicaid NEMT brokering nationally, though their footprint shifts as states rebid contracts (typically every 3 to 5 years). Modivcare (formerly LogistiCare) is the largest NEMT manager in the country by state contract count, operating in dozens of states and reporting tens of millions of completed trips a year in its public filings ^[4]. MTM (Medical Transportation Management) holds contracts across a large number of states and is a major competitor to Modivcare, particularly strong in the Midwest and parts of the South. Access2Care manages NEMT and some crisis transport contracts in a smaller but meaningful number of states, often overlapping with managed care organization contracts. SafeRide Health has grown fastest in recent years by contracting directly with managed care plans (rather than state Medicaid agencies) in multiple states, layering itself into NEMT networks alongside or instead of the traditional statewide brokers. Smaller regional brokers and some states running NEMT in-house (no broker at all, direct fee-for-service enrollment) round out the picture. A handful of states, and some individual managed care organizations within a state, run their own transportation networks or use a different regional vendor than the big four. There is no single authoritative "nationwide broker list" published by any federal agency, because Medicaid transportation is administered state by state, not federally. The most reliable source for who holds your state's contract right now is your state Medicaid transportation unit's own website, not a third-party list (including this one) that could be a contract cycle out of date.

How do state Medicaid NEMT contracts actually work?

Minimum vehicle insurance	State minimum + broker overlay, often $1M combined single limit for wheelchair vans
Driver background check depth	State requirement (fingerprint vs. name-based)
Vehicle inspection frequency	Broker policy, often annual or semi-annual
Credentialing portal	Broker-specific online system
Rate per trip/mile	Negotiated per state contract, not public
Recredentialing cycle	Usually annual

Each state Medicaid agency decides how to deliver the transportation benefit required under 42 CFR 431.53 ^[1]. Most states pick one of three models: a single statewide broker contract, regional broker contracts (different vendor in different parts of the state), or transportation folded into managed care organization contracts (where each MCO picks its own broker, which is how SafeRide has grown). Contracts get rebid on a cycle, commonly every 3 to 5 years, and the incumbent doesn't always win. That's the single biggest reason a printed or scraped "nationwide list" goes stale fast: a broker holding a state's contract in 2023 might lose it in a 2026 rebid. When you're checking who to credential with, go to the state Medicaid transportation unit's page directly and confirm the current broker and any regional carve-outs before you fill out a single form. Here's a general comparison of what differs broker to broker, based on typical published requirements (confirm specifics with your broker and state Medicaid agency, since thresholds vary by state and change over time): | Factor | Typically varies by |

How to start a medical transportation business

Starting a medical transportation business means building the legal, insurance, and vehicle pieces before you ever touch a broker application, because brokers won't credential a business that isn't already legitimate on paper. The rough order most owner-operators follow: form a business entity (LLC is common), get a federal EIN, secure commercial auto insurance sized for passenger transport (not a personal auto policy), title and equip a wheelchair-accessible vehicle that meets ADA and state accessibility standards, get any required state-level NEMT operating permit or Certificate of Need (some states require this before Medicaid enrollment, some don't), and then enroll as a Medicaid transportation provider with your state Medicaid agency. Only after that state enrollment is approved do you typically apply to be a credentialed network provider with the broker (Modivcare, MTM, Access2Care, SafeRide, or whichever holds your state's contract). Skipping ahead and applying to a broker before your state Medicaid provider number exists is one of the most common time-wasters new operators run into; most brokers require an active state Medicaid enrollment as a precondition.

How to start a NEMT business step by step

Breaking the process into concrete steps helps, because "start a NEMT business" actually means clearing several separate approvals that don't always run in parallel. 1. Entity and tax setup. Form your LLC or corporation in your state, get your EIN from the IRS. 2. Vehicle acquisition. Buy or lease a wheelchair-accessible van that meets your state's NEMT vehicle standards (tie-down systems, ramp or lift specs, signage rules if any). 3. Insurance. Get commercial auto liability sized for passenger-for-hire transport; many states and brokers require higher limits than standard commercial policies, so ask your agent specifically about NEMT or paratransit coverage. 4. State-level transportation permit, if your state requires one (some states regulate NEMT companies separately from Medicaid, through a Department of Transportation or Public Utilities Commission). 5. Medicaid provider enrollment. Apply through your state Medicaid agency (or its designated enrollment portal) as a transportation provider. This is separate from broker credentialing and comes first in almost every state. 6. Broker credentialing. Apply to the broker(s) holding your state's NEMT contract, submitting vehicle inspection records, driver background checks, and insurance certificates. 7. Driver requirements. Background checks, drug testing where required, defensive driving or passenger-assistance training depending on your state and broker. For more detail on the enrollment side specifically, see non emergency medical transportation and non emergency medical transportation services.

How to start a non-emergency medical transportation business with one van

One van is enough to start; plenty of owner-operators run their first year or two with a single wheelchair-accessible vehicle before adding a second. The credentialing requirements don't change based on fleet size. Whether you own one van or twenty, you still need the same state Medicaid enrollment, the same broker credentialing packet, and the same insurance minimums. What does change with a one-van operation is scheduling risk: if that vehicle is in the shop, you have zero backup capacity, and brokers do track no-show and late-cancellation rates closely as part of ongoing performance reviews. Some brokers can suspend or terminate a contract for repeated service failures, so a maintenance plan (and maybe a relationship with another small operator for overflow trips) matters more when you're a fleet of one. Budget-wise, the vehicle itself (used wheelchair van conversions commonly run in the $25,000 to $55,000 range depending on age, mileage, and conversion type) is usually the biggest single expense, with insurance, permitting, and credentialing paperwork costing far less by comparison but taking real time to assemble correctly the first time.

How do you start a medical transportation business without a big fleet or investors?

Most successful owner-operators bootstrap: they buy or finance one used wheelchair van, self-fund the insurance and permitting costs, and grow the fleet only after the first vehicle is generating consistent broker trip assignments. There's no Medicaid or broker rule requiring a minimum fleet size, and no state we're aware of requires proof of outside investment to enroll. What you can't skip regardless of fleet size is the paperwork: business licensing, insurance certificates, vehicle inspection documentation, driver background checks, and the state Medicaid provider application itself. A lot of new operators underestimate how much time assembling that packet correctly takes, and resubmissions for missing documents are a common cause of delay. Building the full packet once, correctly, before you submit anything, saves weeks compared to submitting piecemeal and fixing rejections one at a time. That's the gap a purpose-built packet fills: assembling your state Medicaid enrollment forms and broker credentialing documents in one place before you submit, rather than discovering missing items one rejection letter at a time. If you want a starting point instead of building the checklist from scratch, RideCredential's $199 one-time State + Broker NEMT Launch Kit is built around exactly that packet.

What documents do brokers actually require for credentialing?

Every broker's exact checklist differs and changes, so treat this as a general shape to confirm against your specific broker's current application, not a final list. Commonly requested items include: proof of business entity and EIN, active state Medicaid provider enrollment confirmation, commercial auto insurance certificate naming required limits, vehicle registration and current inspection or safety certification, wheelchair lift/ramp and tie-down compliance documentation, driver's license and background check results for every driver, drug and alcohol testing program compliance (where required), and a signed broker provider agreement. Most brokers now run credentialing through an online portal rather than paper submission, and most require annual recredentialing, meaning you'll resubmit updated insurance certificates and vehicle inspections on a yearly cycle even after initial approval. Missing a recredentialing deadline is one of the more common (and avoidable) reasons active providers get suspended from a broker's network, so calendar it the day you're approved.

How long does NEMT provider enrollment and broker credentialing take?

Timelines vary widely by state and by broker, and neither CMS nor the individual brokers publish a standardized national processing time, so the honest answer is: confirm current timelines with your specific state Medicaid agency and broker, because they change. That said, based on the general shape of state provider enrollment processes described across state Medicaid agency websites, applicants commonly report state Medicaid provider enrollment taking anywhere from a few weeks to a couple of months depending on the state's application volume and whether your packet is complete on first submission, with broker credentialing adding additional weeks on top once your state enrollment is active. The single biggest lever you control is submission completeness. Incomplete applications go back in the queue, not to the front once fixed, so a packet with every document correct the first time is consistently faster than a fast initial submission with follow-up corrections.

How do I find which broker covers my state right now?

Go to your state Medicaid agency's transportation or NEMT page directly; most states publish the current broker's name and contact information there, along with provider enrollment instructions specific to transportation providers. Medicaid.gov's mandatory benefits page confirms transportation is a required benefit category states must arrange for eligible enrollees, which is the underlying reason every state has some broker or in-house system to check ^[5]. If your state runs NEMT through managed care organizations rather than a single statewide broker, you may need to check with each MCO operating in your area, since (as with SafeRide's model) different plans can use different transportation vendors even within the same state. Don't rely on any single web list, including broker or advocacy sites, without confirming against the state Medicaid transportation unit's own current page, since contract cycles turn over every few years and a list built during one contract period can be wrong within a year or two.

Frequently asked questions

What is NEMT?

NEMT stands for non-emergency medical transportation. It's Medicaid-covered transport, using wheelchair vans, ambulatory sedans, or stretcher vehicles, for people who need to get to medical appointments but don't require an ambulance. States must arrange this transportation under 42 CFR 431.53, and most do it through contracted brokers like Modivcare, MTM, Access2Care, or SafeRide Health.

Does Medicaid cover ambulance rides?

Yes. Ambulance transport is a mandatory Medicaid benefit distinct from NEMT, billed through regular Medicaid claims rather than the broker network, under coverage rules at 42 CFR 440.170. Coverage requires medical necessity documentation. NEMT (wheelchair vans, sedans) is a separate benefit category with its own broker-based enrollment process for providers.

Does Medicare cover medical transportation?

Original Medicare covers ambulance transportation when medically necessary under the Part B ambulance benefit rules at 42 CFR 410.40, but generally does not cover routine non-emergency rides to appointments. Some Medicare Advantage plans offer limited NEMT as a supplemental benefit, but that varies by plan and isn't a standard Medicare entitlement.

How to start a NEMT business from scratch?

Form a business entity, get commercial auto insurance sized for passenger transport, acquire a wheelchair-accessible vehicle meeting your state's standards, obtain any required state transportation permit, enroll as a Medicaid transportation provider with your state agency, then apply for broker credentialing with whichever company (Modivcare, MTM, Access2Care, SafeRide) holds your state's current contract.

How to start a medical transportation business with one van?

One van is enough to launch. Requirements (insurance, state enrollment, broker credentialing) don't scale down for smaller fleets, but a single-vehicle operation carries more scheduling risk since there's no backup if that van needs repairs. Budget for a used wheelchair conversion, commercial insurance, and the time to assemble a complete credentialing packet.

Is there one official nationwide list of NEMT brokers?

No. Medicaid transportation is administered state by state, and no federal agency publishes a single current national broker list. Modivcare, MTM, Access2Care, and SafeRide Health are the largest players, but which one holds a given state's contract changes as states rebid, typically every 3 to 5 years. Always confirm with your state Medicaid transportation unit.

What's the difference between Medicaid provider enrollment and broker credentialing?

State Medicaid provider enrollment gives you a Medicaid provider number and legal authorization to bill Medicaid. Broker credentialing is a separate process with the private company (Modivcare, MTM, etc.) managing trip dispatch for that state, requiring vehicle inspections, insurance certificates, and driver checks. Most brokers require active state enrollment before they'll credential you.

How much does it cost to start an NEMT business?

Costs vary widely by state and fleet size. A used wheelchair-accessible van conversion commonly runs $25,000 to $55,000. Add commercial auto insurance, any state permit fees, and the time cost of assembling enrollment and credentialing paperwork. No federal agency publishes a standardized total startup cost figure, since requirements differ by state.

Do I need a Certificate of Need to start NEMT in my state?

Some states require a Certificate of Need or similar state transportation permit before you can enroll as a Medicaid NEMT provider; others don't regulate NEMT separately from Medicaid enrollment at all. This varies significantly by state, so confirm directly with your state's Medicaid transportation unit or Department of Transportation before applying.

How often do broker contracts change in a state?

Most state NEMT broker contracts are rebid on a 3 to 5 year cycle, and the incumbent broker doesn't always keep the contract. This is why nationwide broker lists go out of date quickly. Confirm your state's current broker directly on the state Medicaid agency's transportation page rather than relying on older published lists.

Can I work with more than one broker if my state uses managed care organizations?

Yes, and in states where NEMT runs through managed care organizations rather than a single statewide broker, you may need to credential with multiple vendors, since different MCOs operating in the same state can contract with different transportation brokers. Check with each MCO in your service area to confirm which broker manages their network.

What happens if I miss a broker recredentialing deadline?

Missing recredentialing (typically an annual requirement to resubmit updated insurance certificates, vehicle inspections, and driver documentation) can result in suspension from the broker's active provider network, meaning no new trip assignments until you're recredentialed. Calendar your renewal date as soon as you're initially approved to avoid a gap in trip assignments.

Sources

1. eCFR, 42 CFR 431.53: States must assure necessary transportation for Medicaid recipients to and from providers
2. eCFR, 42 CFR 440.170: Transportation and ambulance services are defined as distinct Medicaid benefit categories a state plan may cover
3. eCFR, 42 CFR 410.40: Medicare Part B covers ambulance transportation when medically necessary, with specific criteria for non-emergency ambulance trips
4. Modivcare Inc., 2023 Annual Report (Form 10-K): Modivcare operates NEMT contracts across a large number of U.S. states and reports tens of millions of completed trips annually
5. eCFR, 42 CFR 431.51: Federal Medicaid regulations require states to specify how they ensure freedom of choice and access to transportation for enrollees, the same subpart underlying the transportation assurance duty
6. Medicaid.gov, Mandatory & Optional Medicaid Benefits: Transportation is a mandatory benefit category states must cover for eligible Medicaid enrollees