Last updated 2026-07-25
TL;DR
NEMT companies drive Medicaid and Medicare Advantage members to routine medical appointments in wheelchair vans or ambulatory sedans. Find one through your state Medicaid transportation broker (Modivcare, MTM, Access2Care, or a state-run line), not a general web search. If you're trying to start one instead of hire one, expect state Medicaid provider enrollment plus separate broker credentialing, usually 60 to 120 days combined, before you can bill.
What is non emergency medical transportation (NEMT)?
Non emergency medical transportation, usually shortened to NEMT, is scheduled transportation to and from medical care for people who don't need an ambulance but can't drive themselves or take a bus. Think dialysis three times a week, chemotherapy, physical therapy, or a routine OB checkup for someone without a car. The vehicle is a wheelchair-accessible van, a stretcher van, or an ambulatory sedan, not an ambulance with lights and sirens. Federal Medicaid rules require states to make sure eligible people can actually get to covered care. The regulation at 42 CFR 431.53 says states must "ensure necessary transportation for beneficiaries to and from providers" [1]. States don't have to do it themselves; almost all of them contract with a transportation broker who manages scheduling, trip verification, and driver credentialing on the state's behalf. That's the piece people miss when they search "non emergency medical transportation companies near me." You're not looking for a taxi company. You're looking for a Medicaid-enrolled NEMT provider that's also credentialed with whichever broker runs transportation in your county, because a member's ride has to be booked through that broker's system to get paid. For background on how the whole system fits together, see our medical transportation overview and the nemt hub page.
How do I find NEMT companies near me if I need a ride?
If you're a Medicaid member (or a caregiver) trying to book a ride, start with your state's Medicaid transportation line, not Google. Every state Medicaid agency either runs NEMT directly or contracts it to a broker like Modivcare, MTM, or a regional vendor, and that broker's call center or app is the actual booking front door. Call your state Medicaid member services number or check your state Medicaid agency's transportation page for the broker name and phone number for your county; brokers vary by region within the same state. Medicare Advantage members should check their plan's supplemental benefits, since some plans include a set number of NEMT trips per year even though Original Medicare does not cover this routinely (more on that below). If you're private-pay or need transport a broker can't schedule in time, search for "NEMT" plus your city, and confirm any company you call is currently insured, has ADA-compliant lift equipment if you need a wheelchair van, and is actually licensed to operate in your state. A company that shows up in search results isn't automatically broker-credentialed. And a driver who isn't in the broker's system can't bill Medicaid for that trip even if they show up and drive you.
Does Medicaid cover ambulance rides?
Yes. Medicaid covers ambulance transportation when it's medically necessary, meaning any other form of transportation would endanger the person's health, per federal guidance on Medicaid transportation benefits [2]. This is separate from NEMT. Ambulance transport is emergency or medically necessary transport, usually billed by a licensed ambulance service under its own Medicaid provider type, and it requires a higher level of clinical staffing (EMTs or paramedics) than a wheelchair van does. NEMT, by contrast, covers people who are stable enough to ride in a van or sedan but still can't get to their appointment on their own. A dialysis patient in a wheelchair with no clinical needs during transport is an NEMT trip. Someone having a medical emergency mid-transport is an ambulance call. States define the medical necessity line differently, so if you're building a company that wants to do both, you'll be enrolling as two distinct provider types with two different sets of rules. See our emergency medical transport page for how ambulance-level transport enrollment differs from NEMT.
Does Medicare cover medical transportation?
Original Medicare (Part A and Part B) covers ambulance transportation only when it's medically necessary and other transportation would be unsafe, per CMS guidance on ambulance services [3]. It generally does not cover routine non-emergency rides to a doctor's office or dialysis center the way Medicaid does. Medicare Advantage (Part C) plans are different. Many MA plans offer NEMT as a supplemental benefit, meaning a limited number of one-way or round trips per year to plan-network providers. Coverage, trip limits, and the booking process vary by plan and by insurer, so a Medicare Advantage member needs to check their plan's Evidence of Coverage document or call member services directly rather than assume any transportation is covered. This distinction matters a lot for owner-operators deciding who to contract with. Medicaid NEMT is broker-run and volume-heavy. Medicare Advantage NEMT is plan-specific and usually smaller volume, contracted through the same brokers (Modivcare and MTM both run Medicaid and MA transportation networks in various states), so credentialing conversations with a broker should specify which population you're trying to serve.
How do I start a non-emergency medical transportation business?
Starting an NEMT business means stacking four separate approvals before you can legally drive a single billable trip: business formation, vehicle and driver compliance, state Medicaid enrollment, and broker credentialing. Skipping the order costs people the most time; a lot of new owner-operators buy the van first and then discover enrollment takes months. Here's the realistic sequence: 1. Form your business entity (LLC is standard) and get an EIN from the IRS. 2. Get general liability and commercial auto insurance with limits that meet your state's requirements; wheelchair-van operators typically need higher limits than sedan-only operators. 3. Buy or lease a compliant vehicle. Wheelchair vans need a certified lift or ramp installation, not a DIY conversion, and many states require an annual vehicle inspection specific to accessible vehicles. 4. Get drivers cleared: background check, driving record pull, drug screen, and often a defensive-driving or passenger-assistance course depending on the state. 5. Apply for state Medicaid transportation provider enrollment. This is separate from any broker application, and states process it on their own timeline, commonly 30 to 90 days depending on the state Medicaid agency's backlog. 6. Apply for broker credentialing with each broker operating NEMT in your service area (Modivcare, MTM, Access2Care, or others depending on state). Brokers require their own insurance certificates, vehicle inspections, and driver files even after state enrollment is done. 7. Once both are approved, you get a provider ID and log into the broker's dispatch or scheduling portal to start receiving trip assignments. States and brokers change requirements often, so confirm current document lists and timelines with your specific state Medicaid agency and broker before you spend money on vehicles or insurance. For a walkthrough of the licensing and paperwork layer, see non emergency medical transportation and nemt transportation.
How do you start a medical transportation business with just one van?
You can start with one van. Plenty of owner-operators do exactly that, and neither state Medicaid agencies nor the major brokers require a minimum fleet size to enroll (though some brokers cap how many trips a one-vehicle provider can realistically take, since you can't be in two places at once). The practical constraints with one van are about coverage, not eligibility. If your van is in the shop, you have zero capacity, and brokers track no-show and late-cancel rates closely; falling below their on-time or completion thresholds can get you suspended from the trip queue even if your paperwork is perfect. Many one-van operators solve this by being selective about the trip radius and appointment types they accept rather than trying to cover everything a broker offers. Insurance and vehicle compliance costs don't scale down much for one van versus three. You still need commercial auto coverage, lift certification, and driver background checks for that single vehicle, so the fixed cost of getting compliant is similar whether you're running one van or five. That's the part new owner-operators underestimate: the paperwork burden per vehicle is roughly flat, so a one-van operation has a higher cost-per-vehicle than a small fleet, even though total spend is lower.
What does state Medicaid NEMT provider enrollment actually involve?
State Medicaid enrollment is where you register your business as an approved provider type with the state Medicaid agency, separate from any broker's own vetting process. Every state runs this differently because Medicaid is state-administered within federal rules, so "NEMT provider enrollment" in Texas looks different on paper than in Ohio or California. Common elements across states include a completed provider enrollment application, proof of business registration, vehicle registration and inspection records, driver rosters with background check results, proof of insurance meeting state minimums, and sometimes a site visit or fingerprint-based background check for the business owner. Some states also require a surety bond. Processing time is the biggest variable and states don't publish a single reliable number; ranges reported by owner-operators and state provider manuals commonly run from about 30 days to well over 90 days depending on application volume and completeness. Confirm current requirements, forms, and timelines directly with your state Medicaid agency's transportation or provider enrollment unit before assuming any number applies to you [4].
How is broker credentialing different from state Medicaid enrollment?
State enrollment gets you a Medicaid provider ID. Broker credentialing gets you access to that broker's trip-dispatch system, and you generally need both before a single trip you drive gets paid. Modivcare, MTM, Access2Care, and SafeRide (and various regional brokers) each run their own credentialing process on top of whatever the state already required. That typically means submitting a separate application, current insurance certificates naming the broker as certificate holder, vehicle photos or inspection reports, driver files again (even if the state already checked them), and agreeing to the broker's service standards for on-time pickup, no-show handling, and trip documentation. The two processes run on different clocks and different portals, so don't assume finishing one starts the other automatically. A common mistake is treating broker credentialing as a formality after state enrollment; in practice, brokers can and do reject or delay applicants for reasons the state never asked about, like vehicle age limits or specific dash-cam and GPS tracking requirements. Confirm each broker's current document checklist directly, since brokers update their credentialing packets without much public notice. Our broker guides content and a $199 one-time State + Broker NEMT Launch Kit walk through the document checklist side of this if you want a single reference instead of hunting through separate broker portals.
What vehicle and insurance requirements do NEMT companies need?
Requirements vary by state and by broker, but a few things show up almost everywhere. Wheelchair vans need a certified accessibility lift or ramp, not an aftermarket install without documentation, and many states require an annual inspection specific to the lift mechanism in addition to standard vehicle safety inspection. Commercial auto insurance limits for passenger-transport vehicles are typically higher than a personal auto policy, and brokers commonly require the broker be listed as an additional insured or certificate holder. General liability coverage is usually required on top of auto coverage. Some states also require a specific surety bond amount for NEMT providers. Drivers typically need a clean driving record check, a criminal background check (often at the state and federal level), and drug and alcohol screening. Depending on the state, drivers may also need passenger assistance or defensive driving certification, particularly for wheelchair securement training, since improperly secured wheelchairs are a real injury risk during transport. None of these figures are universal. Confirm exact insurance minimums, bond amounts, and inspection frequency with your state Medicaid agency and the specific broker you're credentialing with, since both change these requirements periodically.
How much does it cost to start an NEMT business?
There's no single honest number here because vehicle cost, insurance premiums, and state fees vary too much by location and by whether you buy new or used, so treat any flat national figure you see elsewhere skeptically. What's true everywhere is that the vehicle is usually the largest single cost, followed by commercial insurance premiums, which run higher for wheelchair-accessible vehicles than for ambulatory sedans because of the added liability of lift equipment and wheelchair securement. Ongoing costs that new owners frequently underweight include annual vehicle inspections, insurance renewal (often at a higher rate the first renewal after your first claims history builds), driver background check renewals, and broker-required equipment like GPS tracking or dash cams that some brokers mandate as a condition of staying credentialed. Beyond the vehicle and insurance, budget time and paperwork cost, more than cash. Assembling a clean state enrollment and broker credentialing packet the first time, rather than getting rejected and resubmitting, is worth real money in lost weeks of trip eligibility. This is the exact gap a flat-fee document package is built to close, which is the one time we'll mention it directly: RideCredential's $199 Launch Kit Builder assembles the state enrollment and broker credentialing paperwork in one pass instead of you rebuilding it per portal.
What's the difference between NEMT, ambulette, and medical transport services?
"NEMT," "ambulette," and "medical transport" mean different things depending on the state, and mixing them up on an application can slow your enrollment down. NEMT is the umbrella federal and Medicaid term for non-emergency rides to medical appointments, covering everything from sedans to wheelchair vans to stretcher vans. "Ambulette" is a term some states (New York notably) use as the specific regulated vehicle and license category for wheelchair-accessible NEMT vehicles, with its own licensing rules distinct from a general livery or taxi permit. If your state uses this term, you'll see it on the actual license application, more than as marketing language. "Medical transport" is a looser industry phrase that sometimes includes ambulance-level (emergency) transport and sometimes doesn't, so when you're researching a state's rules, look for the exact regulatory term that state's Medicaid agency uses rather than assuming all three phrases point to the same license. Our non emergency medical transportation services page breaks down how these terms map across a few different state systems.
Who are the major NEMT brokers and how do they differ?
Most states contract Medicaid NEMT management to one or a handful of transportation brokers rather than running it in-house, and the same broker often manages the benefit across several states. Modivcare (formerly LogistiCare) and MTM (Medical Transportation Management) are the two largest national brokers, with Access2Care and SafeRide operating in specific states and regions. Some states, like a portion of counties in certain state Medicaid programs, run transportation management directly through the state or through regional transit authorities instead of a national broker. The practical difference for an owner-operator is which portal you use, which documents each broker demands, and how each broker pays (per-trip mileage rate structures differ, and some brokers pay on a delayed cycle that new operators need to plan cash flow around). None of this is standardized nationally. A credentialing packet that works with MTM in one state won't necessarily transfer to Modivcare in a neighboring state, even for the same owner-operator. The only reliable way to know which broker covers your service area, and what that broker currently requires, is to check your state Medicaid agency's transportation broker page directly, since broker contracts get rebid and can change which company holds a state's contract every few years.
Comparison: NEMT vs. ambulance vs. Medicare Advantage transport benefit
| Feature | NEMT (Medicaid) | Ambulance | Medicare Advantage transport benefit | |
|---|---|---|---|---|
| Who it's for | Stable patients needing a ride to care | Medically necessary emergency or urgent transport | MA plan members, limited to plan network | |
| Vehicle type | Sedan, wheelchair van, stretcher van | Ambulance with EMT/paramedic staff | Sedan or wheelchair van, broker-dispatched | |
| Who approves the provider | State Medicaid agency + broker | State EMS licensing + Medicaid provider enrollment | MA plan + its contracted broker | |
| Booking method | Broker call center or app | 911 or facility-arranged | Plan member services line | |
| Federal coverage basis | 42 CFR 431.53 [1] | Medically necessary, per CMS guidance [3] | Supplemental benefit, plan-specific, not guaranteed | This table is a starting frame, not a substitute for your state's actual rules; trip limits, covered mileage, and prior authorization requirements differ by state and by MA plan. |
Frequently asked questions
What is non emergency medical transportation?
Non emergency medical transportation (NEMT) is scheduled transportation for people who need help getting to medical appointments but don't need an ambulance. It covers wheelchair van rides to dialysis, sedan rides to a doctor's office, and stretcher van transport for people who can't sit upright, typically arranged through a state Medicaid transportation broker.
How to start a medical transportation business?
Form your business entity, get commercial insurance, buy a compliant vehicle, clear your drivers through background checks, apply for state Medicaid provider enrollment, then get credentialed with each transportation broker (Modivcare, MTM, Access2Care, or others) operating in your service area. State enrollment and broker credentialing are separate processes with separate timelines.
Does Medicaid cover ambulance rides?
Yes, Medicaid covers ambulance transportation when it is medically necessary, meaning other transportation would endanger the patient's health. This is billed separately from NEMT under a different Medicaid provider type, since ambulance transport requires EMT or paramedic staffing that NEMT vehicles don't have.
Does Medicare cover medical transportation?
Original Medicare covers ambulance transport only when medically necessary and other transportation would be unsafe; it generally doesn't cover routine non-emergency rides. Some Medicare Advantage plans include a limited NEMT benefit as a supplemental benefit, but coverage and trip limits vary by plan, so check the plan's Evidence of Coverage document.
How do I start a NEMT business with just one van?
You can start with one van; neither states nor major brokers require a minimum fleet size. The tradeoffs are capacity (if your one van is down, you have zero coverage) and broker performance thresholds around on-time and completion rates, since those apply per provider regardless of fleet size.
How do you start a medical transportation business from scratch with no experience?
Start by researching your specific state Medicaid agency's transportation provider enrollment requirements and the brokers operating in your area, since both dictate what licenses, insurance, and vehicle standards you need before you spend money. Many new owners buy a van before confirming these requirements, which is backwards and costly.
What's the difference between a NEMT broker and a NEMT provider?
A broker (like Modivcare or MTM) manages scheduling and dispatch for a state's Medicaid transportation benefit and decides which transportation companies get trips. A provider is the actual company (often an owner-operator) driving the vehicle and getting paid per trip, and must be credentialed with the broker separately from state Medicaid enrollment.
How long does NEMT provider enrollment take?
There's no universal number. Owner-operators and state provider manuals commonly report ranges from about 30 days to over 90 days for state Medicaid enrollment alone, with broker credentialing adding more time on top. Confirm current processing timelines directly with your state Medicaid agency's transportation unit.
Do I need separate credentialing for each broker in my state?
Usually yes. If more than one broker operates in your state (or different brokers cover different counties), you typically need to apply and get credentialed separately with each one, even though you only enroll once with the state Medicaid agency. Confirm this structure with your specific state, since some states use a single statewide broker.
What insurance does an NEMT company need?
At minimum, commercial auto insurance covering passenger transport and general liability insurance, often with the broker listed as an additional insured or certificate holder. Wheelchair-van operators typically carry higher limits than sedan-only operators due to lift and securement liability. Exact minimums vary by state and by broker, so confirm current requirements before buying a policy.
What vehicle do I need to start an NEMT business?
An ambulatory sedan can serve non-wheelchair trips, but many broker contracts and higher trip volumes involve wheelchair-accessible vans with a certified lift or ramp. Stretcher vans serve patients who can't sit upright. Vehicle age limits, inspection frequency, and lift certification rules vary by state, so confirm specifics before purchasing.
Does NEMT count as medical transport for Medicare Advantage members?
It can, if the member's specific MA plan includes an NEMT supplemental benefit. This isn't automatic or universal across MA plans; the member needs to check their plan's Evidence of Coverage or call member services to confirm trip limits and the booking process for their specific plan.
How do I find NEMT companies near me as a rider needing a ride?
Call your state Medicaid member services line or check your state Medicaid agency's transportation page to find the broker (Modivcare, MTM, Access2Care, or another vendor) serving your county, then book through that broker's call center or app. A general web search may surface companies that aren't currently broker-credentialed in your area.
Sources
- eCFR, 42 CFR 431.53: States must ensure necessary transportation for Medicaid beneficiaries to and from providers
- Medicaid.gov, Non-Emergency Medical Transportation: Medicaid NEMT and ambulance transportation coverage overview
- Medicare.gov, Ambulance Services coverage: Original Medicare covers ambulance transport only when medically necessary and other transport would be unsafe
- Medicaid.gov, Provider Enrollment: State Medicaid provider enrollment is administered separately by each state agency
- Ohio Administrative Code 5160-15-01, Non-emergency transportation: Ohio Medicaid regulation defines non-emergency transportation providers and requirements under the state's administrative code
- 42 CFR 440.170: Federal definition of transportation as a Medicaid benefit, including NEMT as an assurance rather than a standalone Medicaid state plan service in every state