Last updated 2026-07-25
TL;DR
To start a NEMT business in Georgia, you form a legal entity, get commercial auto and wheelchair-van insurance, enroll as a Georgia Medicaid transportation provider through the Georgia Medicaid Management Information System, and credential with the state's NEMT broker (Modivcare manages Georgia's brokered NEMT under DCH). One van and one driver is enough to start; approval timelines run weeks to a few months.
How do you start a medical transportation business in Georgia, step by step?
You need six things in roughly this order: a legal business entity, the right vehicle and insurance, a driver who meets state and broker background-check standards, Georgia Medicaid provider enrollment, broker credentialing (Modivcare in Georgia), and a way to track trips and billing once you're moving patients. Skipping the order costs you money. Buying a van before you've confirmed insurance pricing, or applying to the broker before your Medicaid enrollment is final, are the two most common ways owner-operators waste a few weeks. Georgia's NEMT program is brokered, meaning the Department of Community Health (DCH) contracts with a transportation broker to manage trip assignment, provider networks, and day-to-day scheduling for Medicaid members who need a ride to a covered medical appointment. Modivcare has held Georgia's statewide NEMT broker contract in recent years, but broker contracts get rebid, so confirm the current broker with the Georgia DCH transportation unit before you apply for anything. Realistically, plan for two parallel tracks running at the same time: Georgia Medicaid provider enrollment (state-level) and broker credentialing (contract-level with whichever company holds the trip-assignment contract). They are not the same process and one doesn't substitute for the other. You'll fill out paperwork twice, submit similar documents twice, and wait on two different clocks. For a wider look at how this process works outside Georgia, see our state-by-state NEMT guide and our breakdown of medical transportation provider types generally.
What is NEMT, and how is it different from an ambulance ride?
NEMT stands for non-emergency medical transportation. It's a Medicaid benefit that covers rides to and from covered medical appointments (dialysis, chemotherapy, physical therapy, primary care) for members who have no other way to get there and don't need emergency medical care during the ride. Federal Medicaid rules require states to make sure eligible individuals can get transportation to and from providers, described in regulation as 'necessary transportation' assurance, at 42 CFR 431.53 [1]. An ambulance is emergency medical transport with clinical staff and equipment on board, billed under a completely different set of Medicaid and Medicare rules. A wheelchair van, ambulatory sedan, or stretcher van under NEMT carries no clinical staff and provides no medical care in transit. If a rider needs monitoring, oxygen support beyond a portable tank the rider brings, or any hands-on medical intervention, that's outside NEMT scope and belongs with an ambulance provider instead. For background on how ambulance transport is regulated and reimbursed separately, see emergency medical transport. For a plain definition of the NEMT benefit itself, see non emergency medical transportation and non emergency medical transportation services.
Does Medicaid cover ambulance rides?
Yes. Medicaid covers medically necessary ambulance transport when a beneficiary's condition requires it, and states set their own coverage and payment rules within federal minimums. Medicaid.gov's benefits page confirms non-emergency medical transportation and emergency ambulance transport are both benefits states must address in their programs [2]. Ambulance coverage and NEMT coverage are administered separately in most states, including Georgia, and ambulance providers generally enroll and bill through a different pathway than NEMT transportation providers. If you're starting a wheelchair-van NEMT business, you are not enrolling as an ambulance provider and you should not represent your service as ambulance transport to riders or to the broker. Confirm your service category (ambulatory, wheelchair, stretcher-van) with Georgia DCH and with the broker before you submit any application, since the category determines which forms, vehicle inspection requirements, and rate schedule apply to you.
Does Medicare cover medical transportation?
Medicare covers ambulance transport when it's medically necessary and covers some non-emergency ambulance transport for beneficiaries who need it repeatedly (like dialysis patients), under Medicare Part B rules described by CMS [3]. Standard Medicare does not generally cover routine NEMT rides like wheelchair vans to a doctor's office the way Medicaid does for its members. Some Medicare Advantage plans add NEMT as a supplemental benefit, and CMS has allowed Medicare Advantage plans to offer non-medical transportation as a supplemental benefit since a 2018 policy change expanding what counts as 'primarily health related' [4]. If you want Medicare Advantage NEMT business, you'd contract directly with the individual MA plan or a broker network the plan uses, not through Georgia Medicaid's enrollment process. That's a separate application and separate contract, and most new owner-operators in Georgia should get Medicaid enrollment and broker credentialing solid first before chasing MA plan contracts.
How do you register your NEMT business entity in Georgia?
Form an LLC or corporation through the Georgia Secretary of State's Corporations Division. Most owner-operators use an LLC; the online filing fee is $100 as of the Secretary of State's published fee schedule [5]. You'll also need an EIN from the IRS (free, done online) and, depending on your county and city, a local business license. Don't skip the entity step even if you plan to run this as a true one-person operation. Broker credentialing applications and Georgia Medicaid provider enrollment both ask for a business tax ID and entity documentation, more than your Social Security number, and running as a sole proprietor complicates your commercial insurance options later. While you're setting up the entity, get your NPI (National Provider Identifier) through the federal NPPES system if the broker or state enrollment requires one for your provider type. Confirm with your state Medicaid agency whether NEMT transportation providers in Georgia need an NPI or a state-assigned provider ID instead; this varies by provider category and has changed in some states over the past several years.
What vehicle and insurance do you need to start with one wheelchair van?
| LLC formation (GA Secretary of State) | $100 filing fee [5] | Plus any registered agent fee if you use one | |
|---|---|---|---|
| Wheelchair-accessible van (used, converted) | Wide range, varies by age/mileage | Confirm ADA lift/tie-down condition before buying | |
| Commercial auto + wheelchair-van insurance | Wide range by carrier and limits | Get broker's minimum limits in writing first | |
| Driver background check / MVR pull | Set by state or broker vendor | Confirm current fee with broker | Don't guess at insurance minimums or assume your personal umbrella policy will cover a commercial NEMT run. It won't, and a lapsed or non-compliant policy is one of the fastest ways to get pulled from a broker's active roster after you've already invested in the van. |
One van is enough to start. You do not need a fleet to enroll as a Georgia Medicaid NEMT provider or to get credentialed with the broker. What you need is a vehicle that meets ADA accessibility standards for wheelchair loading (ramp or lift, secured tie-downs, functioning restraints) and passes whatever vehicle inspection the broker requires before it can be added to your active roster. Insurance is where new owner-operators most often underbudget. You need commercial auto liability, not a personal auto policy, and most brokers set minimum liability limits well above what a personal policy carries. Confirm current minimum limits with your broker in writing before you bind a policy, because a policy that doesn't meet the broker's stated minimum gets your application rejected or your provider file flagged during audit. Many operators also carry general liability and non-owned/hired auto coverage if they ever use a second vehicle. |Startup cost item|Typical range|Notes|
How do you enroll as a Georgia Medicaid NEMT provider?
Georgia Medicaid providers enroll through the state's Medicaid Management Information System, administered for DCH by its fiscal agent. You'll submit a provider enrollment application, your entity and tax documents, proof of insurance, vehicle information, and driver background check results. Georgia DCH's transportation and NEMT program information is published on the Georgia Medicaid site and updated when policy or the broker contract changes. Georgia Medicaid enrollment generally requires disclosure of ownership and control information consistent with federal Medicaid provider screening rules at 42 CFR Part 455, Subpart B, which require states to collect ownership, criminal history, and licensure disclosures from providers as a condition of enrollment [6]. Expect a background screening step tied to a federal risk category; transportation providers are commonly screened at a 'moderate' categorical risk level under CMS's provider screening framework, though states apply their own categorical risk assignments and Georgia's current assignment should be confirmed directly with DCH. Build in real time for this. State provider enrollment plus fingerprint-based background checks (if required for your risk category) can take anywhere from a few weeks to a few months depending on current processing volume. Applying with incomplete insurance documentation or an entity that isn't yet registered with the Secretary of State are the two most common causes of delay owner-operators report.
How do you get credentialed with Georgia's NEMT broker?
After your Medicaid provider enrollment is active (or in some cases, in parallel, depending on the broker's current process), you apply directly to the broker to join its transportation network. In Georgia this has been Modivcare in recent contract cycles, but broker contracts are rebid on a schedule set by DCH, so confirm the current broker name and application portal directly with the Georgia DCH transportation unit before applying. Broker credentialing typically asks for: your Georgia Medicaid provider number, vehicle inspection records, current insurance certificates naming the broker as certificate holder or additional insured (confirm this requirement, it varies), driver files including MVR and background check results, and a signed broker services agreement. Some brokers also require a facility or vehicle inspection visit before activating your account. This is a contract relationship, not a government license, so the broker sets its own credentialing standards inside whatever DCH's contract requires as a floor. That means requirements can and do change between contract cycles. Don't assume what worked for another owner-operator last year still applies; call the broker's provider relations line and get current requirements in writing. For a comparison of how different national brokers structure credentialing (useful if you ever operate near a state line or take on private-pay work), see our NEMT transportation broker comparison.
How much does it cost to start a NEMT business in one-van form?
Costs vary a lot by vehicle condition, county, and insurance carrier, so treat any flat number you see online with suspicion. What's real and confirmable: the Georgia LLC filing fee is $100 through the Secretary of State's online system [5]. Everything else (vehicle purchase or conversion, commercial insurance premiums, background check fees, any local business license) depends on your specific situation and needs to be quoted directly by the vendor or agency involved. We don't publish income estimates or trip-volume forecasts for NEMT operators, and you should be skeptical of anyone who does. Broker trip assignment volume depends on regional Medicaid enrollment, competing providers already in the network, and broker demand that shifts month to month. No one, including us, can promise you a certain number of trips or a certain income from one van. What you can control is not overspending on the vehicle before your insurance and credentialing numbers are confirmed. Get insurance quotes and broker insurance-minimum requirements in writing first. Then shop the van.
What does the paperwork actually involve, and can I do it myself?
Yes, plenty of owner-operators do the whole thing themselves. It's paperwork, not a bar exam. The friction is usually not difficulty, it's the sheer number of separate documents (entity filing, EIN, insurance certificates, driver background results, vehicle inspection forms, provider enrollment application, broker credentialing packet) that all have to line up and stay current at the same time. Where people get stuck is version control: an insurance certificate that expired between when you submitted your state application and when the broker asked for it, or a driver background check that's aged out of the broker's acceptable window. If you'd rather have a checklist that keeps the state and broker requirements organized side by side instead of hunting through two separate portals, our $199 State + Broker NEMT Launch Kit walks through both tracks together so nothing falls out of sync while you wait on approvals. Whatever route you take, keep copies of everything you submit, with dates. If an application stalls, the first thing any state or broker rep will ask is when you submitted what.
What should I check before I sign anything or spend money?
Confirm five things directly with Georgia DCH and the current broker before you commit money to a vehicle or insurance policy: which company currently holds Georgia's NEMT broker contract, the minimum commercial insurance limits the broker requires, the vehicle inspection standard for wheelchair-accessible vans, the current background check requirements for drivers, and whether NEMT providers in Georgia need an NPI or a state-specific provider ID. None of this is legal advice, and broker requirements do change between contract cycles. If something in this guide is out of date by the time you read it, that's normal for a brokered state Medicaid program, not a sign you're doing something wrong. Call DCH's transportation unit and the broker's provider relations line and get the current answer directly, in writing if you can.
Frequently asked questions
How do I start a NEMT business in Georgia with just one van?
Form an LLC, get commercial auto and wheelchair-van insurance meeting the broker's minimum limits, have your driver pass a background check, enroll as a Georgia Medicaid provider through DCH's Medicaid Management Information System, then apply for broker credentialing (Modivcare in recent contract cycles). One van and one driver is enough to start; you don't need a fleet.
What is NEMT?
NEMT (non-emergency medical transportation) is a Medicaid benefit covering rides to and from covered medical appointments for members who have no other transportation and don't need emergency care during the ride. It's required under federal Medicaid transportation assurance rules at 42 CFR 431.53 and is separate from ambulance transport.
Does Medicaid cover ambulance rides?
Yes, Medicaid covers medically necessary ambulance transport, with states setting specific coverage and payment rules within federal minimums. This is administered separately from the NEMT benefit (wheelchair vans, ambulatory sedans) in most states, including Georgia, and ambulance providers enroll through a different pathway than NEMT transportation providers.
Does Medicare cover medical transportation?
Original Medicare Part B covers medically necessary ambulance transport, including some recurring non-emergency ambulance trips like dialysis. It generally does not cover routine wheelchair-van or sedan NEMT rides. Some Medicare Advantage plans add NEMT as a supplemental benefit under CMS policy allowing non-medical transportation since 2018.
How do you start a medical transportation business?
Set up a legal business entity, secure the right vehicle and commercial insurance, get your driver background-checked, enroll as a state Medicaid transportation provider, and credential with your state's NEMT broker if the state uses one. The exact steps and forms vary by state, so confirm specifics with your state Medicaid agency.
What is non-emergency medical transportation?
Non-emergency medical transportation (NEMT) covers rides to Medicaid-covered appointments for members who can't get there on their own and don't need medical care en route. It includes ambulatory sedan rides, wheelchair-van rides, and non-emergency stretcher-van rides, and it's distinct from ambulance transport.
How much does it cost to start a NEMT business in Georgia?
The Georgia LLC filing fee is $100 through the Secretary of State's online system. Vehicle, insurance, and background check costs vary widely by carrier, county, and vehicle condition, so get direct quotes rather than relying on a flat estimate. We don't publish income estimates since broker trip volume varies too much to promise.
Who is the NEMT broker in Georgia?
Georgia's Medicaid NEMT program is brokered by DCH, and Modivcare has held the statewide contract in recent cycles. Broker contracts get rebid periodically, so confirm the current broker name and application process directly with the Georgia DCH transportation unit before applying.
Do I need a fleet of vans to get approved in Georgia?
No. Georgia Medicaid provider enrollment and broker credentialing don't require a minimum fleet size. A single ADA-compliant wheelchair van with a driver who passes background checks and a policy meeting the broker's insurance minimums is enough to apply.
What insurance do I need for a wheelchair van NEMT business?
You need commercial auto liability insurance, not a personal auto policy, at limits meeting or exceeding your broker's stated minimums. Many operators also carry general liability coverage. Get the broker's current minimum limits in writing before buying a policy, since requirements vary by broker and can change.
How long does Georgia Medicaid NEMT provider enrollment take?
Timelines vary with processing volume and whether a background screening or fingerprinting step applies to your provider risk category, but owner-operators commonly report a few weeks to a few months from application to active status. Incomplete insurance documentation and unfinished entity registration are common causes of delay.
Can I do Georgia NEMT enrollment and broker credentialing myself?
Yes, it's paperwork rather than something that legally requires a professional. The challenge is usually keeping documents (insurance certificates, background checks, vehicle inspections) synced across two separate applications, the state's and the broker's, so nothing expires or falls out of date while you wait.
Sources
- eCFR, 42 CFR 431.53: Federal Medicaid rule requiring states to assure necessary transportation for beneficiaries to and from providers
- Medicaid.gov, Medicaid Benefits: Non-emergency medical transportation and ambulance transport are both Medicaid benefit categories states address
- CMS, Medicare Coverage of Ambulance Services (Publication 11021): Medicare Part B covers medically necessary ambulance transport including recurring non-emergency trips like dialysis
- Georgia Secretary of State, Corporations Division fee schedule: Georgia LLC online formation filing fee is $100
- eCFR, 42 CFR Part 455, Subpart B: Federal Medicaid provider screening rules require disclosure of ownership, control, and criminal history information at enrollment
- CMS, Medicaid Provider Enrollment Compendium (MPEC) risk-based screening guidance: CMS provider screening framework assigns provider types to categorical risk levels including transportation providers