Last updated 2026-07-25
TL;DR
LogistiCare renamed itself Modivcare in 2019, though many drivers and state contracts still use the old name. It's a transportation broker, not Medicaid itself. To haul Medicaid trips you generally need state Medicaid provider enrollment first, then separate broker credentialing (vehicle inspection, driver background checks, insurance minimums) with whichever broker holds your state's contract.
What is LogistiCare, and is it still called that?
LogistiCare was one of the largest non-emergency medical transportation (NEMT) brokers in the country, managing rides for Medicaid managed care plans and state Medicaid agencies across dozens of states. In 2019, the company rebranded to Modivcare, and today that's the legal name you'll see on contracts, provider portals, and 1099s [1]. The name change didn't change what the company does. Modivcare (formerly LogistiCare) still holds broker contracts with state Medicaid agencies and managed care organizations, and it still subcontracts the actual driving to independent transportation providers, which is likely you if you own a wheelchair van and you're reading this. Old habits die hard in this industry: drivers, dispatchers, and even some state documents still say "LogistiCare" years after the rebrand, so don't panic if you see both names used interchangeably in your state's paperwork. Modivcare isn't the only broker in the space. Depending on your state, you might instead deal with MTM (Medical Transportation Management), Access2Care, SafeRide Health, or a state-run broker model. Some states split regions between two or three brokers. The only way to know which broker covers your county is to confirm with your state Medicaid agency directly, because broker contracts get rebid every few years and the company running your region today might not be the one running it in 2027.
What is NEMT, and how is it different from an ambulance?
Non-emergency medical transportation (NEMT) is transportation for Medicaid enrollees who need to get to a covered medical appointment (dialysis, chemotherapy, physical therapy, a primary care visit) but don't need emergency ambulance-level care. Federal Medicaid rules require states to "ensure necessary transportation for beneficiaries to and from providers," and this obligation has existed since 42 CFR 431.53 was written into the regulations decades ago [2]. NEMT covers a range of vehicle types: wheelchair vans, ambulatory sedans, stretcher vans, and in rural areas sometimes even public transit vouchers or mileage reimbursement for a friend or family member who drives the beneficiary. What NEMT does not cover is anything requiring emergency medical care during transport. If a patient needs monitoring, oxygen titration, or ALS/BLS-level intervention en route, that's an ambulance call, billed under a completely different Medicaid benefit and usually a completely different set of state licensing rules (EMS licensure through your state health department, not a NEMT broker credential). The practical distinction for a new owner-operator: if you're buying a wheelchair van and don't hold an EMS or ambulance license, you're in the NEMT lane, not the ambulance lane. That's a good thing. NEMT credentialing is generally faster and cheaper to obtain than ambulance licensure, though it still requires real paperwork, real insurance, and a real vehicle inspection.
Does Medicaid cover ambulance rides?
Yes. Medicaid covers ambulance transportation when it's medically necessary, meaning the beneficiary's condition requires the kind of care and monitoring only an ambulance crew can provide during transport. This is a distinct benefit from NEMT and is typically billed separately, often directly to the state Medicaid agency or MCO rather than routed through an NEMT broker [3]. Coverage rules and reimbursement rates for ambulance transport vary by state, and most states require ambulance providers to hold separate state EMS licensure in addition to any Medicaid provider enrollment. If you're only planning to run a wheelchair van (no lights, no siren, no paramedic crew), ambulance rules mostly don't apply to you, but it's worth knowing the line exists so you don't accidentally market your NEMT service as "ambulance transport" and create a licensing problem for yourself.
Does Medicare cover medical transportation?
Medicare's coverage of NEMT is much narrower than Medicaid's. Original Medicare generally does not cover routine non-emergency transportation to medical appointments. Medicare Part B does cover emergency ambulance transportation when medically necessary, and in limited cases it covers non-emergency ambulance transportation if a doctor certifies it's medically necessary (for example, a bed-confined patient needing dialysis transport) [2]. Some Medicare Advantage (Part C) plans have started adding NEMT as a supplemental benefit, and this has grown significantly in recent years as plans compete on extra benefits. If you want Medicare Advantage trip volume, you'll need to contract with the specific MA plan or its transportation vendor, which is a completely separate credentialing track from Medicaid NEMT broker enrollment. Don't assume a broker relationship with Modivcare or MTM for Medicaid trips automatically gets you Medicare Advantage trips too; often it doesn't, and you'll need a separate agreement.
How do you start a medical transportation business?
Starting a medical transportation business for Medicaid NEMT work generally follows this sequence: form your business entity, get your vehicle and insurance in place, enroll as a Medicaid transportation provider with your state, then get credentialed with whichever broker(s) manage rides in your service area. Here's the rough order most new owner-operators follow, though your state may sequence it differently: 1. Form an LLC or corporation and get an EIN from the IRS. 2. Buy or lease a wheelchair-accessible van that meets ADA and state vehicle standards. 3. Get commercial auto insurance with limits that meet your state Medicaid and broker minimums (often $1 million combined single limit, but this varies). 4. Enroll with your state Medicaid agency as an NEMT provider, which usually means an application, an NPI number, and sometimes a state-specific permit or certificate of authority. 5. Apply for credentialing with the broker(s) operating in your region (Modivcare, MTM, Access2Care, SafeRide, or a state-run system). 6. Complete driver background checks, drug testing, and any required training (defensive driving, passenger assistance, wheelchair securement). 7. Pass a vehicle inspection, sometimes annual, sometimes tied to broker onboarding. The order of steps 4 and 5 can flip depending on your state. Some states require Medicaid enrollment before a broker will even look at your application; others let the broker run parallel intake and hold your credentialing pending state approval. Always confirm with your broker and state Medicaid agency which comes first where you operate.
How to start an NEMT business with just one van
Plenty of owner-operators start with a single wheelchair van, and it's a completely viable way to enter the business, though it comes with real constraints worth planning around. With one vehicle, you're limited to running one trip (or one linked set of trips) at a time, which caps how many broker "trip offers" you can realistically accept in a day. Brokers dispatch trips through an app or portal, and if you're the only driver and the only van, you'll need to be selective about which trips you accept and realistic about how far apart pickups can be geographically. Some owner-operators start solo to prove out the credentialing process and their local trip flow, then add a second van and a hired driver once they understand demand in their area. One-van operations still have to meet the same insurance, inspection, and driver background check standards as larger fleets. Brokers generally don't have a lower bar for small operators; you'll fill out the same credentialing packet whether you own one van or twenty. Budget for that reality. The paperwork burden is the same either way, so a lot of new owners batch their state enrollment and broker credentialing applications together and treat it as one project rather than two.
What does a broker like LogistiCare/Modivcare actually check during credentialing?
| Business entity | Active LLC/corp registration, EIN, business license | |
|---|---|---|
| Vehicle | Age limits, ADA wheelchair lift/ramp compliance, current state inspection, odometer/mileage caps in some states | |
| Insurance | Commercial auto liability minimums (often $1M CSL, confirm exact figure with broker), sometimes general liability | |
| Driver background | Criminal background check, motor vehicle record (MVR) pull, sex offender registry check | |
| Driver training | Defensive driving certificate, passenger assistance/wheelchair securement training, sometimes CPR/First Aid | |
| Drug testing | Pre-employment and often random drug screening program | |
| Medicaid enrollment | Active state Medicaid provider number, NPI | None of these checks are unique to Modivcare. MTM, Access2Care, and SafeRide run substantially similar programs because they're all built to satisfy the same underlying state Medicaid managed care contract requirements. That's actually good news if you plan to work with more than one broker: once you've built the insurance, training, and vehicle compliance file for one broker, most of it transfers directly to the next application with only minor tweaks. |
Broker credentialing exists to verify that your vehicle, your drivers, and your insurance meet the broker's contract requirements with the state or health plan. While exact checklists differ by broker and by state contract, the categories are fairly consistent across Modivcare, MTM, Access2Care, and SafeRide. Typical items a broker will verify: | Category | What's checked |
How to start a non-emergency medical transportation business step by step
If you're starting from zero, the practical build-out looks like this, roughly in order: First, nail down your state's specific Medicaid NEMT enrollment requirements. Every state Medicaid transportation unit publishes its own provider manual or NEMT provider handbook, and these differ meaningfully in required forms, vehicle age limits, and insurance minimums. Skipping this step and going straight to broker paperwork is the single most common time-waster new owner-operators report; you end up redoing forms because you didn't know the state wanted something specific first. Second, get your entity and tax paperwork square. An LLC (or corp, depending on your state and tax situation) with a clean EIN makes broker and state applications go faster, because most credentialing forms ask for your business's legal name, tax ID, and formation date up front. Third, buy insurance before you buy the van, or at least get quotes lined up simultaneously. NEMT-specific commercial auto policies aren't the same as personal auto or standard commercial policies; insurers need to know you're hauling wheelchair passengers under a Medicaid contract, and not every carrier writes this coverage. See our insurance guide for what to ask carriers. Fourth, submit your state Medicaid provider enrollment application. Processing time varies widely by state (some move in a few weeks, others take a couple of months), so build in a buffer before you count on trip revenue. Fifth, apply for broker credentialing once state enrollment is active or, in some states, in parallel. Brokers won't dispatch trips to you until both pieces (state enrollment and broker credential) are complete.
What documents does Medicaid NEMT enrollment usually require?
State Medicaid NEMT provider enrollment applications typically ask for a similar core set of documents, though the exact list and required forms live on your specific state Medicaid transportation unit's website and can change without much notice. Most states will want: proof of business formation (Articles of Organization or Incorporation), an EIN letter from the IRS, a National Provider Identifier (NPI) obtained through the National Plan and Provider Enumeration System, proof of vehicle insurance meeting state minimums, vehicle registration and inspection records, driver background check results, and a completed state-specific provider enrollment application form. Some states also require a surety bond, a certificate of need, or a separate state transportation permit issued by the state Department of Transportation or Department of Health, layered on top of the Medicaid enrollment itself. This is exactly the kind of detail that varies state to state and changes when legislatures amend transportation statutes, so treat any specific bond or permit dollar figure as something to confirm with your state Medicaid agency before you budget for it.
Which broker will I actually work with, Modivcare, MTM, Access2Care, or SafeRide?
Which broker manages Medicaid NEMT trips in your area depends entirely on which company holds the current state or regional contract, and these contracts get rebid on cycles that typically run three to five years. Modivcare (formerly LogistiCare) has historically held some of the largest state contracts in the country. MTM (Medical Transportation Management) holds contracts in a number of other states and often specializes in state fee-for-service Medicaid programs. Access2Care and SafeRide Health hold smaller but meaningful regional and MCO-level contracts. In some states, more than one broker operates simultaneously, split by county, by managed care plan, or by service type (ambulatory versus wheelchair versus stretcher). Because these contracts change, the only reliable way to know your broker is to check your state Medicaid agency's transportation page directly, or ask the managed care organizations operating in your state which vendor they use for transportation benefits. Don't build your entire business plan around one broker's name; build it around "whichever broker holds the contract in my county this year," because that answer can change out from under you even if nothing else about your business does.
What ongoing compliance does a broker require after I'm credentialed?
Getting credentialed with a broker isn't a one-time event. Most brokers require annual (or more frequent) revalidation of insurance certificates, vehicle inspections, driver background checks, and sometimes drug testing panels. Expect your broker to request updated Certificates of Insurance every policy renewal period, and expect them to flag you immediately if your coverage lapses even for a day. Vehicle inspections typically need to be re-done annually, and some states or brokers require more frequent checks for older vehicles. Driver files also need periodic refreshes: MVR pulls every year or two are common, and any new hire needs the full background check and training package before they touch a wheelchair passenger. Missed revalidation is one of the most common reasons owner-operators get suspended from a broker's active provider list, not fraud or bad driving records. Set calendar reminders for every expiration date the moment you get credentialed, because brokers generally don't send generous advance warnings, and a lapsed credential means zero dispatched trips until you're reinstated.
Where does building this paperwork trail actually get complicated?
The technical requirements aren't usually the hard part. Insurance minimums are published numbers, background checks are standardized processes, and vehicle inspection checklists are just checklists. The hard part is sequencing: knowing which application to submit first, which forms are state-specific versus broker-specific, and which documents get reused across multiple applications versus which need to be customized per broker. A lot of new owner-operators lose weeks re-doing paperwork because they submitted broker credentialing before state Medicaid enrollment was final, or because they didn't realize their state requires a separate transportation permit on top of standard Medicaid provider enrollment. If you want a structured starting point that maps state Medicaid enrollment steps against broker credentialing requirements side by side, the $199 State + Broker NEMT Launch Kit is built around exactly that sequencing problem, though it's not a substitute for reading your specific state's provider manual or confirming current requirements directly with your state Medicaid transportation unit and target broker. Whatever path you take, keep one master folder (physical or digital) with every document you'll need to produce more than once: your Articles of Organization, EIN letter, NPI confirmation, insurance certificates, and driver files. You'll be asked for most of these documents by every broker you ever apply to, and by your state every time your enrollment comes up for renewal.
Frequently asked questions
Is LogistiCare the same company as Modivcare?
Yes. LogistiCare rebranded to Modivcare in 2019 after a corporate restructuring, but it's the same underlying NEMT broker company managing Medicaid transportation contracts across many states [1]. Drivers, dispatchers, and even some state documents still use the old "LogistiCare" name years later, so seeing both names doesn't mean you're dealing with two different companies.
What is NEMT?
NEMT stands for non-emergency medical transportation, meaning transport for Medicaid enrollees to covered medical appointments who don't need ambulance-level emergency care. Federal Medicaid rules require states to ensure this transportation is available under 42 CFR 431.53 [2]. It includes wheelchair vans, ambulatory sedans, and stretcher vans, but not emergency ambulance response.
Does Medicaid cover ambulance rides?
Yes, Medicaid covers medically necessary ambulance transportation, but this is a separate benefit from NEMT with its own billing and licensing rules [3]. If your condition requires monitoring or emergency-level care during transport, it's billed as ambulance service, not NEMT, and providers usually need separate state EMS licensure to offer it.
Does Medicare cover medical transportation?
Original Medicare generally doesn't cover routine non-emergency transportation to medical appointments. Medicare Part B covers emergency ambulance transport when medically necessary and limited non-emergency ambulance transport with a doctor's certification [4]. Some Medicare Advantage plans now offer NEMT as a supplemental benefit, but that requires a separate contract from Medicaid broker credentialing.
How do I start a medical transportation business?
Form a business entity, get commercial auto insurance meeting state minimums, buy an ADA-compliant wheelchair van, enroll as a Medicaid NEMT provider with your state, then get credentialed with the broker(s) operating in your area (Modivcare, MTM, Access2Care, or SafeRide). Driver background checks, drug testing, and vehicle inspections happen alongside these steps.
How do you start a NEMT business with just one van?
You can start with a single wheelchair van, and many owner-operators do exactly that. You'll still need to meet the same insurance, background check, and vehicle inspection standards as larger fleets; brokers don't lower requirements for small operators. Expect to be selective about which dispatched trips you accept since you can only run one at a time.
What is non-emergency medical transportation?
Non-emergency medical transportation (NEMT) is a Medicaid benefit that gets enrollees to and from covered medical appointments when they don't need ambulance-level care during transport. States must ensure this transportation is available under federal Medicaid rules found at 42 CFR 431.53 [2], and most states contract this out to brokers like Modivcare or MTM.
Which broker will manage my trips, Modivcare, MTM, Access2Care, or SafeRide?
It depends entirely on which company holds your state's or region's current Medicaid transportation contract, and these contracts get rebid every few years. Confirm directly with your state Medicaid agency's transportation unit or the managed care plans in your area, since the answer can change even if your business doesn't.
How long does state Medicaid NEMT enrollment take?
Processing time varies widely by state, ranging from a few weeks to a couple of months in some cases. There's no single national timeline because each state Medicaid agency runs its own enrollment process. Confirm expected processing time directly with your state Medicaid transportation unit before you count on any specific start date for trips.
Do I need Medicaid enrollment and broker credentialing separately?
In most states, yes. State Medicaid provider enrollment and broker credentialing (with Modivcare, MTM, or another broker) are two distinct processes with separate applications, even though they cover overlapping requirements like insurance and background checks. Some states require enrollment first; others allow parallel processing. Confirm the required order with your state and broker.
What insurance do I need for an NEMT wheelchair van business?
You'll need a commercial auto policy specifically underwritten for NEMT/wheelchair passenger transport, with liability limits meeting your state Medicaid and broker minimums, often around $1 million combined single limit though this varies. Not every insurer writes NEMT coverage, so get quotes early and confirm exact minimums with your broker and state before buying a policy.
Can I work with more than one NEMT broker at the same time?
Yes, many owner-operators are credentialed with multiple brokers to maximize trip access, since brokers often require substantially similar documentation (insurance, background checks, vehicle inspection). Once you've built one broker's credentialing file, most of it transfers to a second broker's application with only minor state-specific or broker-specific adjustments.
What happens if my broker credential lapses?
A lapsed credential, usually from expired insurance, an overdue vehicle inspection, or an unrenewed background check, typically means the broker stops dispatching trips to you immediately. Reinstatement can take time, and brokers generally don't send generous advance warnings. Set your own calendar reminders for every expiration date the day you get credentialed.
Sources
- Electronic Code of Federal Regulations, 42 CFR 431.53: States must ensure necessary transportation for Medicaid beneficiaries to and from providers
- Medicaid.gov, Non-Emergency Medical Transportation: Medicaid covers medically necessary ambulance transportation as a benefit distinct from NEMT
- Medicare.gov, Ambulance Services Coverage: Medicare Part B covers emergency ambulance transport and limited non-emergency ambulance transport with physician certification
- Electronic Code of Federal Regulations, 42 CFR 440.170: Federal definition of transportation as a covered Medicaid service
- Medicaid.gov (CMCS Informational Bulletin): CMS has issued guidance to states on non-emergency medical transportation (NEMT) brokerage program requirements and oversight.
- Social Security Administration (Social Security Act Section 1902): State Medicaid plans must ensure necessary transportation for beneficiaries to and from providers, the statutory basis for NEMT coverage.
- Federal Motor Carrier Safety Administration: NEMT businesses operating vehicles that transport passengers across state lines or meet certain size thresholds may need a USDOT number as part of starting the business.
- U.S. Small Business Administration: Steps for registering a new business entity, a foundational requirement when starting an NEMT company.
- Medicaid.gov: Medicaid provider enrollment and management information systems used by states to credential and verify NEMT and other providers.
- U.S. Department of Health & Human Services: NEMT providers handling patient information as part of broker credentialing must comply with HIPAA covered entity/business associate requirements.
- eCFR (Title 49, Part 390 - FMCSA): Federal motor carrier safety regulations governing driver qualification and vehicle maintenance requirements relevant to NEMT compliance.