Non-emergency medical transportation rates in Florida

Last updated 2026-07-25

What is non-emergency medical transportation (NEMT), exactly?

Non-emergency medical transportation is scheduled transport to and from covered medical care for people who don't need an ambulance but can't get there on their own, whether that's a dialysis run three times a week or a one-time specialist visit. It covers ambulatory sedan trips, wheelchair van trips, and in some cases stretcher van trips, but it explicitly excludes emergencies. Federal Medicaid rules require states to make sure eligible people can get to and from providers. The regulation at 42 CFR 431.53 says state Medicaid plans must "specify that the Medicaid agency will ensure necessary transportation for recipients to and from providers" ^[1]. States meet that obligation in different ways: fee-for-service NEMT run directly by the state, or (far more common now) a managed care model where the state contracts with health plans, and those plans contract with a broker like a regional NEMT management company. Florida uses the managed care route. Under the Statewide Medicaid Managed Care (SMMC) program, Florida's Agency for Health Care Administration (AHCA) requires managed care plans to arrange transportation for enrollees as part of covered services ^[2]. That means if you're a wheelchair-van operator in Florida, you're not billing AHCA directly in most cases. You're billing (or getting paid through) whichever broker or plan holds the transportation contract in your region.

How are NEMT rates set in Florida? Is there one statewide rate?

No. Florida does not publish a single statewide NEMT fee schedule the way it does for, say, physician services under the Medicaid fee schedule. Transportation rates are negotiated between AHCA-contracted managed care plans and their NEMT brokers, and then between those brokers and the transportation providers (you) who actually run the trips. That structure means rates can differ by region, by plan, and even by contract renewal cycle. A wheelchair van trip paid under one plan's broker in Miami-Dade may be reimbursed differently than the same mileage and lift-assist trip paid under a different plan's broker in the Panhandle. AHCA's SMMC managed care plans operate by region, and each plan can select its own transportation vendor arrangement ^[2]. In practice, most Florida NEMT payments follow a base rate (sometimes called a "per-trip" or "loaded mile" rate) plus a per-mile rate once you're past a certain distance, with an added multiplier or flat add-on for wheelchair accessibility, and sometimes a separate line item for wait time or additional passengers. But the actual dollar figures are not something you should treat as fixed. They change when contracts renew, and brokers don't always publicize them. The only reliable way to get real numbers is to ask the broker directly once you're credentialed, or during the enrollment conversation, since many brokers will share a fee schedule as part of onboarding.

Does Medicaid cover ambulance rides?

Yes, Medicaid covers ambulance transportation, but it's billed and regulated differently from NEMT. Ambulance transport (ground or air) is for emergency situations or medically necessary non-emergency transport that requires ambulance-level care, and it's typically billed through the standard Medicaid fee-for-service or managed care medical claims process, not through the NEMT broker network. CMS makes the emergency versus non-emergency distinction clear in its guidance on medical transportation, noting that Medicaid covers transportation "including ambulance, or other appropriate means" when it's necessary to secure medical examinations and treatment for beneficiaries ^[3]. In Florida, ambulance services (ALS and BLS) are billed under separate provider types and require state ambulance licensure and, often, a certificate of need depending on the county, which is a different regulatory track from wheelchair van or ambulatory NEMT enrollment. If you're buying a wheelchair van, you are not entering the ambulance business, and you don't need EMT-level licensure for your drivers in most NEMT roles. Confirm the specific driver credential and vehicle inspection requirements with the Florida Medicaid transportation unit and your broker, since requirements (CPR/first aid, defensive driving, background screening under Florida's Level 2 screening standard) get enforced at the broker and county level.

Does Medicare cover medical transportation?

Medicare's NEMT coverage is much narrower than Medicaid's. Traditional Medicare (Part B) generally covers ambulance transportation when other transportation could endanger your health, and covers it under specific medical necessity conditions, not routine non-emergency rides to a doctor's office. CMS states that Medicare Part B covers ambulance services "only if other transportation could endanger your health" ^[4]. Some Medicare Advantage plans have started adding limited non-emergency transportation as a supplemental benefit. A certain number of one-way trips per year to plan-approved medical appointments. This varies enormously by plan and by year, and it's the insurer's choice, not a federal Medicare requirement. If you want to serve Medicare Advantage members, you'd be contracting with that specific plan or its transportation vendor, separate from your Florida Medicaid broker credentialing. Bottom line for a new wheelchair-van operator: your bread-and-butter payer relationship in Florida NEMT is Medicaid managed care through a broker, not Medicare. Don't structure your business plan around Medicare NEMT revenue; it's a much smaller and less predictable slice.

Who actually pays wheelchair-van operators in Florida, and how does the money flow?

Here's the chain, from state down to your bank account. AHCA runs Statewide Medicaid Managed Care and requires participating health plans to cover transportation for enrollees ^[2]. Each health plan either runs its own transportation network or, more commonly, contracts with a dedicated NEMT broker (companies like Modivcare, MTM, Access2Care, or others depending on the region and current contract cycle) to manage scheduling, dispatch, and provider payment. As a wheelchair-van owner-operator, you enroll as a subcontracted transportation provider with that broker. The broker assigns you trips through its dispatch system (often an app or a phone-based system), you complete the trip, you submit the trip for payment through the broker's portal, and the broker pays you according to its negotiated provider rate schedule. You are not billing AHCA and you're not billing the health plan directly in almost all cases. This matters for rate expectations: two operators driving the same wheelchair van in the same county can be paid differently if they're contracted with different brokers serving different health plans. Before you sign anything, ask the broker for its current fee schedule in writing and confirm whether it changes seasonally, by contract renewal, or by region.

What determines the wheelchair-van rate versus the ambulatory rate?

Wheelchair-van rates are almost always higher than ambulatory sedan or minivan rates, because the vehicle costs more to buy, maintain, and insure, and because loading a wheelchair passenger with a lift or ramp takes real time (the industry sometimes calls this "wait and load" time, and some brokers pay a separate per-trip fee to compensate for it). Rate structures you'll typically see broken out, subject to what your specific broker actually offers: - A base or "flag drop" rate for picking up the trip

• A per-mile loaded rate once you exceed a base mileage threshold
• A wheelchair or lift-assist add-on, sometimes a flat dollar amount, sometimes a percentage bump over the ambulatory rate
• Wait-time compensation, often billed in increments after a grace period
• No-show or deadhead mileage reimbursement, which some brokers pay and many don't Don't assume any of these exist until you see them in writing from your broker. Ask specifically: is there a wheelchair differential, is deadhead mileage paid, and is there a minimum trip guarantee. Get the answer in the provider manual or contract, not verbally.

How do I start a medical transportation business in Florida?

Starting a NEMT business is really three parallel tracks running at once: business formation, vehicle and insurance compliance, and Medicaid/broker credentialing. Skipping any one of them stalls the whole launch. Business formation: register your entity with the Florida Division of Corporations (Sunbiz), get an EIN from the IRS, and set up business banking and bookkeeping before you touch a client. Vehicle and insurance: buy or convert a wheelchair-accessible van that meets ADA-style accessibility standards, and get commercial auto insurance with limits that meet your state's and broker's minimums (this is often higher than personal auto minimums; confirm the exact figure with your insurer and broker, since NEMT commercial policies commonly require limits well above Florida's standard financial responsibility minimums under Florida Statutes Section 324.021). Credentialing: enroll with Florida Medicaid as applicable and then apply for provider status with each broker operating in your target county, since broker credentialing (background checks, vehicle inspection, driver files, HIPAA training) is usually separate from and happens after state-level enrollment. Realistically, plan for weeks, not days, between application and your first paid trip. Broker credentialing queues, vehicle inspections, and driver background checks all take real processing time. Confirm current timelines with the specific broker and county program you're targeting, since they change.

How do you start a NEMT business with just one van?

One van is a completely normal way to start, and plenty of operators run profitably as a true owner-operator before adding a second vehicle. The core requirements don't shrink just because you have one vehicle, but the paperwork burden per vehicle is fixed regardless of fleet size, so starting small is often the right move financially. With one van, you'll still need: business registration, an EIN, commercial auto insurance meeting broker minimums, a vehicle that passes broker/state inspection standards for wheelchair accessibility (secure tie-downs, working lift or ramp, proper door clearance), a driver (you, or an employee) who passes Florida's Level 2 background screening where required, and broker credentialing with at least one NEMT broker in your service county. The advantage of starting with one van is that you can absorb credentialing delays and learning-curve mistakes without the overhead of paying multiple drivers while you wait. The disadvantage is limited trip capacity, since brokers assign trips based partly on your reported vehicle capacity and availability, so a single van means fewer simultaneous trip assignments. Many owner-operators use their first six to twelve months to learn the broker's dispatch system, scheduling patterns, and payment cycle before deciding whether to add a second van.

How do I start a Medicaid NEMT business specifically (versus general medical transport)?

If your target payer is Medicaid, the credentialing path runs through both the state and the broker, and you need both pieces before you can get paid on Medicaid trips. First, check whether Florida requires direct Medicaid enrollment for transportation providers in addition to broker credentialing; this varies by state and can change, so confirm directly with AHCA's Medicaid provider enrollment resources ^[2] rather than relying on secondhand information. Second, identify which managed care plans operate in your target county and which broker each plan uses for transportation, since Florida's SMMC regions each have their own contracted plans ^[2]. Third, apply for provider status with that broker (or brokers, if more than one operates trips in your county), submitting your business registration, insurance certificates, vehicle documentation, and driver files. A practical shortcut a lot of new operators use is building out a standard document packet once (business license, EIN letter, insurance certificate, vehicle registration and inspection records, driver background check results) so you're not recreating it from scratch for each broker application. Some new operators use paid document-and-checklist services to organize this the first time; the Launch Kit Builder is one option for that, but the actual state and broker forms and requirements always come from the state Medicaid agency and the broker directly, not from any third-party product.

What does the wheelchair-van rate structure actually look like, in plain numbers?

Base/flag rate	Picking up the trip, first few miles	Exact dollar amount and included mileage
Per-mile rate	Loaded miles beyond the base	Rate per mile and whether deadhead miles count
Wheelchair differential	Extra cost of accessible vehicle and loading	Flat add-on or percentage over ambulatory rate
Wait time	Time waiting at pickup or appointment	Grace period length and per-minute or per-15-min rate
No-show/cancellation	Trip cancelled after dispatch	Whether any payment applies at all	Every cell in that table is broker-specific and changes over time. Treat this as a checklist of questions to ask, not as Florida's actual rate card, because there isn't one universal card to quote.

Because Florida doesn't publish one fixed statewide rate, the honest answer is: it depends on your broker and region, and you need the current fee schedule in writing before you commit. But here's the general shape most Florida NEMT wheelchair-van contracts follow, so you know what to ask for. | Rate component | What it typically covers | What to confirm with your broker |

How is Florida's rate approach different from states with a published fee schedule?

Some states publish a fixed statewide NEMT fee schedule as part of their Medicaid state plan or a public rate bulletin, so a provider can look up the exact per-mile and base rate for wheelchair van service. Florida generally does not do this for managed care NEMT, because the rate-setting authority sits with the managed care plan and its broker, not with AHCA directly, under the SMMC model ^[2]. This is a real practical difference for new operators moving from a fee-schedule state to Florida, or vice versa. In a published-schedule state, you can estimate your per-trip revenue before you ever talk to a broker. In Florida, you generally cannot get a reliable number until you're in the broker credentialing conversation and they share their provider fee schedule. Don't build a business plan around a specific dollar-per-mile number you found on a forum or an old blog post. Rates change when contracts renew (Florida's SMMC contracts go through periodic re-procurement), and the number that was accurate two years ago in one county may not apply today, or in a neighboring county with a different plan and broker.

What other Medicaid NEMT rules should Florida operators know?

Federal Medicaid rules require that NEMT be provided "in the most appropriate and cost-effective way possible" per CMS guidance on transportation services ^[3], which is part of why brokers push routing and shared-ride logistics so hard; grouping riders lowers their per-trip cost even when your reimbursement per rider stays the same. CMS also finalized updates to Medicaid NEMT regulations in 2023 addressing things like driver qualifications and safety standards for non-emergency transportation, found in the Federal Register update to 42 CFR Part 431 ^[5]. If you're credentialing now, ask your broker whether any of those federal changes have altered their driver qualification or documentation requirements recently, since implementation timing varies by state. Finally, remember that HIPAA compliance isn't optional for NEMT drivers, even though you're not a clinical provider. You're transporting people to and from medical appointments and often have access to appointment details, diagnoses implied by destination, and personal health information in scheduling systems. Most brokers require HIPAA training as part of onboarding; confirm the specific training module and refresh schedule with your broker. For broader context on how NEMT fits into the Medicaid system generally, see our guides on medical transportation and what NEMT is and how it works.

Frequently asked questions

What is non-emergency medical transportation (NEMT)?

NEMT is scheduled transportation to and from covered medical appointments for people who don't need an ambulance but can't safely get there themselves, due to mobility limits, lack of a working vehicle, or a disability. It includes ambulatory sedan trips, wheelchair van trips, and stretcher van trips, and Medicaid programs are federally required to arrange it for eligible beneficiaries under 42 CFR 431.53.

Does Medicaid cover ambulance rides?

Yes. Medicaid covers ambulance transportation when it's medically necessary, billed separately from routine NEMT through standard medical claims rather than the NEMT broker network. CMS guidance describes Medicaid transportation coverage as including "ambulance, or other appropriate means" necessary to get beneficiaries to covered care. Non-emergency ambulance trips (for example, for a bed-bound patient) may also be covered but require separate medical necessity documentation.

Does Medicare cover medical transportation?

Medicare Part B covers ambulance transportation only when other transportation would endanger the patient's health, per CMS coverage rules. Routine non-emergency rides to a doctor's office generally aren't covered by traditional Medicare. Some Medicare Advantage plans offer limited non-emergency transportation as a supplemental benefit, but this is plan-specific, not a standard Medicare benefit, and varies year to year.

How do I start a medical transportation business in Florida?

Register your business entity, get an EIN, buy a compliant wheelchair-accessible vehicle, secure commercial auto insurance meeting broker minimums, and then pursue both Florida Medicaid provider enrollment (where applicable) and broker credentialing with the NEMT broker(s) operating in your target county. Confirm exact current requirements with AHCA and each broker, since forms and timelines change.

How do you start a NEMT business with one van?

You need the same core pieces as a larger fleet: business registration, an EIN, commercial insurance meeting broker minimums, a properly equipped wheelchair-accessible vehicle, a background-screened driver, and broker credentialing in your service county. One van limits how many simultaneous trips you can take, but it's a legitimate and common way to start before scaling to more vehicles.

What is Florida's NEMT rate per mile?

There's no single published statewide rate. Florida's Medicaid NEMT is managed through Statewide Medicaid Managed Care plans, and each plan's broker sets its own provider fee schedule, which typically includes a base rate plus a per-mile rate, with a wheelchair differential. Get the current fee schedule directly from the broker you're credentialing with; it varies by region and contract cycle.

Do wheelchair van operators get paid more than sedan operators in Florida Medicaid NEMT?

Generally yes. Wheelchair-accessible trips typically carry a rate add-on or higher base rate than ambulatory sedan trips, reflecting the higher vehicle cost and the additional loading and securing time required. The exact differential (flat dollar amount versus percentage) is set by each broker's provider agreement, so confirm the specific structure before you sign.

Who do I bill for NEMT trips in Florida, the state or the broker?

Almost always the broker, not the state directly. Florida's AHCA requires Medicaid managed care plans to arrange transportation, and those plans typically subcontract to an NEMT broker who handles dispatch and provider payment. You submit completed trips through the broker's system and get paid according to their negotiated rate schedule.

How long does NEMT broker credentialing take in Florida?

Timelines vary by broker and by how complete your application packet is when submitted. Expect the process to involve business document review, insurance verification, vehicle inspection, and driver background screening, each of which can take real processing time. Ask the specific broker for their current average turnaround before finalizing your launch timeline.

What insurance do I need to run a wheelchair van in Florida Medicaid NEMT?

You'll need commercial auto insurance with liability limits that meet both Florida's financial responsibility requirements and, typically, higher minimums set by the broker's provider contract. Confirm exact required limits with your specific broker and your insurance agent, since NEMT commercial policy minimums are commonly set well above standard personal auto minimums.

Does Florida Medicaid require a special license for NEMT drivers?

Requirements are enforced mostly at the broker and county level rather than through one statewide NEMT driver license. Common requirements include a valid driver's license, passing Florida's Level 2 background screening, CPR/first aid certification, and broker-specific defensive driving or HIPAA training. Confirm the exact current list with the broker you're credentialing with.

Can I bill Medicare and Medicaid NEMT with the same wheelchair van business in Florida?

You can, but they're separate credentialing paths. Medicaid NEMT runs through managed care plan brokers; Medicare non-emergency coverage is limited and, where it exists, usually comes through a Medicare Advantage plan's own supplemental transportation vendor. You'd need to credential separately with each payer's network to bill both.

Why doesn't Florida publish a fixed NEMT rate schedule like some other states?

Because Florida delivers Medicaid NEMT through its Statewide Medicaid Managed Care model, rate-setting authority sits with each managed care plan and its contracted broker rather than with the state agency directly. That decentralizes rates by region and plan, which is why new operators can't look up one universal number and have to get it from the broker.

Sources

1. eCFR, 42 CFR 431.53: Federal Medicaid regulation requiring states to ensure necessary transportation to and from providers
2. Florida Agency for Health Care Administration, Statewide Medicaid Managed Care Program: Florida delivers Medicaid transportation benefits through managed care plans under SMMC
3. Medicaid.gov, Nonemergency Medical Transportation: Medicaid transportation is intended to be delivered in the most appropriate and cost-effective way and covers ambulance or other appropriate means
4. Medicare.gov, Ambulance Services coverage: Medicare Part B covers ambulance transportation only if other transportation could endanger the beneficiary's health
5. Federal Register, Medicaid Program; Nonemergency Medical Transportation: CMS finalized 2023 updates to Medicaid NEMT regulations affecting driver qualifications and program standards