Select transport sacramento nemt: what it means for owner-ops

Last updated 2026-07-23

what does "select transport sacramento nemt" actually mean

If you landed here searching that exact phrase, you're probably one of two people: someone in the Sacramento area looking for a ride to a dialysis appointment or dentist, or someone thinking about starting a wheelchair-van business and trying to figure out who the players are. "Select Transport" reads like the name of a local transportation company, and Sacramento has several small NEMT operators that use names like that (Select, Choice, Premier, First Class, that whole family of names owner-operators pick because the good ones are taken). Here's the thing worth knowing upfront: there isn't one single national company called "Select Transport" that dominates NEMT. NEMT in California, like in most states, runs through a patchwork of small local operators (often one to five vans) who get their trip assignments from a Medicaid managed care broker. In Sacramento County, Medi-Cal managed care plans (Health Net, Kaiser, Molina, Aetna Better Health, depending on the plan) contract with transportation brokers to route non-emergency rides. So a company called Select Transport, if it exists in your search results, is very likely one of these small credentialed vendors, not a giant chain. If you're the rider: contact your Medi-Cal managed care plan's member services line and ask about your NEMT benefit before booking anything privately. If you're the aspiring operator: this article is your map for what it actually takes to become one of these credentialed vendors, in Sacramento or any county.

what is nemt

NEMT stands for non-emergency medical transportation. It's transportation to and from medical appointments, dialysis, physical therapy, and pharmacy pickups for people who don't need an ambulance but can't drive themselves or use regular transit because of a disability, age, or medical condition. Federal Medicaid rules require states to make sure Medicaid enrollees can get to and from covered medical services, and NEMT is how that mandate gets fulfilled ^[1]. The federal regulation is at 42 CFR 431.53, which says states must "ensure necessary transportation for beneficiaries to and from providers" and may do this through direct payment, contracts with transportation vendors, or broker arrangements ^[1]. That single sentence in the Code of Federal Regulations is the entire legal reason this multi-billion-dollar industry of wheelchair vans and ambulettes exists. NEMT vehicles are usually one of three types: ambulatory sedans (regular cars for people who can walk and get in/out on their own), wheelchair vans (for riders who use a wheelchair and need a lift or ramp), and stretcher vans (for bed-bound riders who don't need full ambulance-level medical care). Most new owner-operators start with a wheelchair van because that's where Medicaid demand tends to be steadiest, and because ambulatory-only competition (think rideshare-style apps) has gotten crowded. For a broader look at how the whole system fits together, see non emergency medical transportation.

does medicaid cover ambulance rides

Yes, Medicaid covers ambulance rides, but only when the trip meets the program's definition of medical necessity for emergency or urgent transport, which is a different benefit than NEMT. Ambulance transport (the kind with paramedics and emergency equipment) is billed as an emergency medical service, usually through a 911 dispatch or a hospital-to-hospital transfer, and it's reimbursed under different codes than the routine trips NEMT vans provide. Medicaid.gov describes NEMT specifically as a distinct benefit from ambulance transportation, aimed at getting Medicaid beneficiaries "to and from providers" for covered care that isn't an emergency ^[2]. So if someone asks "does Medicaid cover ambulance," the honest answer is: generally yes, for medically necessary emergency or urgent transport, under separate coverage rules than the ones that govern wheelchair-van and ambulatory NEMT trips. If you're trying to become an ambulance provider specifically (as opposed to an NEMT van operator), you're looking at a much heavier licensing lift involving EMT/paramedic staffing, state EMS agency certification, and different insurance minimums. That's a separate business than what this article covers; see emergency medical transport for how that path differs from NEMT.

does medicare cover medical transportation

Medicare's coverage of non-emergency medical transportation is much narrower than Medicaid's. Original Medicare (Part B) covers ambulance services when other transportation could endanger your health, and it covers non-emergency ambulance transport only in limited situations, like scheduled trips for a patient with a condition requiring monitoring during transit, and even then it typically requires a physician's written order (a Certificate of Medical Necessity) ^[3]. Medicare generally does not cover routine non-emergency van or wheelchair-van trips to a regular doctor's appointment the way Medicaid does. Some Medicare Advantage (Part C) plans offer NEMT as a supplemental benefit, but that varies plan by plan and isn't guaranteed. If you're building a business plan around Medicare-funded NEMT trips as your bread and butter, don't. The steady, recurring NEMT volume in this industry comes from Medicaid managed care contracts, not from traditional Medicare. Confirm current coverage details directly at medicare.gov before making any assumptions ^[3].

how to start a medical transportation business

Starting a medical transportation business (meaning NEMT, not an ambulance company) generally follows the same sequence no matter which state you're in, though the paperwork and timelines differ. 1. Pick your vehicle type and buy or lease it. A used wheelchair-accessible van with a working lift or ramp is the most common starting vehicle. Budget for the van itself plus a wheelchair tie-down/securement system that meets your state's standards. 2. Form a business entity (LLC is common) and get an EIN from the IRS. 3. Get commercial auto insurance rated for NEMT/livery use, not a personal auto policy. Brokers and state Medicaid programs will require specific liability minimums, commonly in the $1 million range per occurrence, though the exact figure depends on your state and broker; confirm with your broker and state Medicaid agency. 4. Enroll as a Medicaid transportation provider with your state Medicaid agency, or apply directly with the managed care broker operating in your county (Modivcare, MTM, Access2Care, SafeRide, or a state-specific broker), or often both, since some states require state enrollment before a broker will even look at your application. 5. Get driver background checks, drug testing, and any required driver certifications (defibrillator training, passenger assistance training, wheelchair securement training) done and documented. 6. Pass a vehicle inspection, which usually checks the lift, tie-downs, first aid kit, fire extinguisher, and general roadworthiness against your state's NEMT vehicle standards. The hardest part for most new owner-operators isn't any single step, it's the sequencing. Some states require Medicaid provider enrollment before broker credentialing; others let you credential with the broker first. Get this order wrong and you can lose weeks. For a state-by-state look at how enrollment works, see medical transportation.

how to start a nemt business (and how it differs from a medical transportation business in general)

"NEMT business" and "medical transportation business" get used interchangeably, but NEMT specifically excludes emergency ambulance work. Starting an NEMT business means you're building a company that transports Medicaid (and sometimes private-pay or Medicare Advantage) members to non-emergency appointments, using a van, sedan, or stretcher vehicle, not an ambulance with medical staff aboard. The core building blocks are the same as any small transportation company (vehicle, insurance, business license) plus three things that are unique to NEMT: state Medicaid provider enrollment, broker credentialing, and driver/vehicle compliance documentation that has to be renewed regularly, more than filed once. A realistic first-year cost picture, for planning purposes only (these are ranges, not projections of what you'll earn): a decent used wheelchair van runs anywhere from roughly $15,000 to $45,000 depending on age, mileage, and whether the lift/ramp system is newer or worn. Commercial NEMT insurance premiums vary widely by state and driving record but often land somewhere in the $4,000 to $10,000+ per year range for a single vehicle. Add background check fees, driver training course fees (often $50 to $300 per driver depending on the course), and state licensing or permit fees that vary by state. None of these numbers are guarantees, they're just the categories you need to budget for. Most new owner-operators underestimate how long credentialing takes, not how much the van costs. Give yourself 60 to 120 days from "I bought the van" to "I'm accepting trips," and don't quit a day job until you have a signed broker agreement in hand.

how do you start a medical transportation business with one van

You can absolutely start with a single wheelchair van; most successful NEMT owner-operators did exactly that. Running a one-van operation just means you are the driver, dispatcher, and biller, at least at first, so plan for the time cost of wearing all three hats. With one van, focus your energy in this order: get the vehicle inspected and compliant first, get your Medicaid provider number and broker agreement second, and don't chase private-pay or out-of-network trips until your credentialed pipeline is actually sending you rides. A lot of new operators try to hustle side work (assisted living facility contracts, private-pay airport runs) before their Medicaid credentialing clears, and end up with a van sitting mostly idle because they built the wrong side of the business first. One practical note: brokers often require a minimum number of vehicles or a certain service radius before they'll fully activate your account in some regions, though a single van is enough to get credentialed in most areas; confirm the specific requirement with your broker and state Medicaid agency, since this rule varies a lot state to state and even broker to broker within the same state.

how to start a non-emergency medical transportation business (state and broker steps)

Business license/EIN	Usually required	Usually required
Vehicle inspection	Sometimes, state-run	Almost always, broker-run
Driver background check	Sometimes required directly	Almost always required
Insurance minimums	Set by state	Set by broker (often higher)
Ongoing reporting	Annual/periodic	Trip-level, often software-based
Reimbursement source	State Medicaid claims	Broker-negotiated rates	Rates, forms, and exact minimums differ by state and by broker; always confirm current requirements with your broker and your state Medicaid agency directly rather than relying on secondhand summaries, including this one. For a walk-through of broker-specific paperwork, see nemt and nemt transportation.

The two credentialing tracks (state Medicaid enrollment and broker credentialing) usually run in parallel but aren't identical, and mixing them up costs people time. State Medicaid enrollment typically means: filling out a state Medicaid provider enrollment application (often through the state's Medicaid Management Information System portal), submitting your business license, vehicle registration, insurance certificates, and sometimes a surety bond, and waiting for a state Medicaid provider number. Every state Medicaid agency publishes its own transportation provider requirements; find yours on your state's official .gov Medicaid or Health and Human Services site and confirm current forms and fees directly there, since requirements and fee schedules change. Broker credentialing means applying directly with whichever broker holds the transportation contract for your service area, commonly Modivcare, MTM, Access2Care, or SafeRide, though many states use their own regional brokers too. Brokers typically want: proof of state Medicaid enrollment (or proof you've applied), vehicle inspection records, driver background check results, insurance certificates naming the broker as an additional interest, and a signed provider agreement outlining reimbursement rates and trip standards. Here's a quick side-by-side of what each track usually checks: | Requirement | State Medicaid enrollment | Broker credentialing |

what happens after you're credentialed: staying compliant

Getting your Medicaid provider number and broker agreement is the finish line for launch, but it's the starting line for compliance, which is ongoing. Brokers audit trip records, GPS data, and driver logs. States periodically revalidate Medicaid provider enrollment, often every few years, and will terminate a provider number if paperwork lapses. The things that trip up new operators most often after launch: letting a driver's background check or CPR certification expire without re-running it, letting commercial insurance lapse for even a day (which can trigger immediate broker suspension), and failing to report vehicle changes (a new van, a different lift model) promptly. None of these are complicated fixes, they're just easy to forget when you're busy driving. Build yourself a simple compliance calendar the day you get credentialed: insurance renewal date, vehicle inspection due date, each driver's background check and training renewal dates, and your state Medicaid revalidation date. A spreadsheet with reminders is enough. Losing a broker contract over a missed renewal date is one of the most avoidable failures in this business.

sacramento-specific and california-specific considerations

California's Medicaid program is called Medi-Cal, and NEMT/NMT (non-medical transportation) benefits are administered through Medi-Cal managed care plans in most counties, including Sacramento. That means if you want to become a credentialed NEMT provider serving Sacramento-area Medi-Cal members, you'll likely be dealing with whichever managed care plans operate in Sacramento County (historically Health Net and Kaiser Permanente are major Medi-Cal managed care plans there, though plan participation can change with each contract cycle) and the transportation broker(s) each plan uses. California also runs its Medi-Cal provider enrollment through the Department of Health Care Services (DHCS), and NEMT vendors typically need to enroll through the state's provider enrollment portal in addition to whatever broker credentialing the managed care plan requires. Confirm current Sacramento County managed care plan assignments and DHCS NEMT/NMT provider enrollment requirements directly on the DHCS website, since plan contracts and county assignments are rebid periodically and details you find elsewhere may be outdated ^[4]. If you're outside Sacramento, the same logic applies: find your state's Medicaid transportation unit page, identify which managed care plans and brokers operate in your specific county, and don't assume a rule that applies in one California county applies statewide, let alone in another state.

where a launch kit fits into this (and where it doesn't)

Somewhere around week three of chasing state PDFs and broker credentialing portals, most new owner-operators wish someone had just organized the paperwork checklist for them. That's the gap a resource like RideCredential's $199 one-time State + Broker NEMT Launch Kit is built to fill: a structured starting point for the state Medicaid enrollment and broker credentialing paperwork, not a guarantee of approval and not a substitute for reading your specific state's and broker's current requirements yourself. No kit, checklist, or article (including this one) can promise you'll get approved. Approval depends on your state's rules, the broker's current capacity in your service area, your vehicle's condition, and your background check results, none of which any third party controls. What a good checklist can do is keep you from missing a form or submitting things out of order, which is where most of the actual delays happen.

what is non emergency medical transportation, one more time, plainly

Non-emergency medical transportation is transportation for people who need help getting to medical care but don't need an ambulance. Think dialysis three times a week, a wheelchair user going to physical therapy, or someone getting picked up for a same-day surgical follow-up. It's not urgent in the 911 sense, but it's medically necessary; without it, the person often can't get to care they're entitled to under Medicaid. The federal backbone for this benefit sits in Medicaid regulations requiring states to arrange necessary transportation for beneficiaries ^[1], and CMS's own guidance describes NEMT as covering transportation to "medical care and services" for eligible individuals with no other means of getting there ^[2]. States implement this differently: some run it in-house, most contract it out to brokers like the ones mentioned throughout this piece. If you want a broader entry point into how this system works across different states, non emergency medical transportation services is a good next read.

Frequently asked questions

What is NEMT?

NEMT (non-emergency medical transportation) is transportation to and from medical appointments, dialysis, and therapy for people who don't need an ambulance but can't get there on their own because of a disability, age, or medical condition. Medicaid is required by federal regulation to ensure this transportation is available for eligible beneficiaries ^[1].

Does Medicaid cover ambulance rides?

Yes, generally, when transport is medically necessary for an emergency or urgent situation, but that's a separate benefit category from routine NEMT van trips. Coverage details, prior authorization rules, and reimbursement vary by state; confirm specifics with your state Medicaid agency.

Does Medicare cover medical transportation?

Medicare Part B covers ambulance transport when other means would endanger health, and covers non-emergency ambulance trips only in limited cases, often requiring a physician's Certificate of Medical Necessity ^[3]. Original Medicare generally doesn't cover routine wheelchair-van or NEMT trips; some Medicare Advantage plans add NEMT as a supplemental benefit, but that varies by plan.

How do I start a medical transportation business?

Buy or lease an appropriate vehicle, form a business entity, get commercial insurance rated for NEMT use, enroll with your state Medicaid agency, credential with the transportation broker in your area, and get drivers background-checked and trained. Order and timelines vary by state, so confirm sequencing with your specific state Medicaid agency early.

How do I start a NEMT business specifically, versus a general medical transportation company?

An NEMT business focuses on non-emergency Medicaid and private-pay rides using vans or sedans, not ambulance-level emergency service. The steps are the same as any transportation startup plus two NEMT-specific hurdles: state Medicaid provider enrollment and broker credentialing with whichever company (Modivcare, MTM, Access2Care, SafeRide, or a state broker) holds your area's contract.

Can I start a NEMT business with just one van?

Yes, most owner-operators start with a single wheelchair van. Get the vehicle inspected and compliant, then pursue Medicaid enrollment and broker credentialing before chasing side work like private-pay trips. Some brokers set minimum vehicle or service-radius requirements in certain regions, so confirm with your broker and state Medicaid agency.

How much does it cost to start a NEMT business?

Costs vary widely: a used wheelchair van often runs $15,000 to $45,000, commercial NEMT insurance often runs $4,000 to $10,000+ per year per vehicle, plus background check, training, and state licensing fees. These are planning ranges, not guarantees, and vary by state, insurer, and vehicle condition.

What is non-emergency medical transportation used for?

It's used for scheduled, non-urgent trips tied to medical care: dialysis, chemotherapy, physical therapy, dental appointments, and pharmacy pickups, primarily for Medicaid beneficiaries who lack another way to get there. It does not cover ambulance-level emergency transport.

How long does NEMT credentialing take?

There's no fixed national timeline; it depends on your state's Medicaid enrollment backlog and your broker's process. A realistic planning range for many new operators is 60 to 120 days from vehicle purchase to accepting trips, though it can run faster or slower depending on your state and broker workload.

What insurance do I need to run a wheelchair van for Medicaid trips?

You'll need commercial auto insurance specifically rated for livery or NEMT use, not a personal auto policy. Liability minimums are commonly cited around $1 million per occurrence in many state/broker requirements, but the exact figure depends on your state and broker; confirm current minimums directly with both.

Is Select Transport a national NEMT company?

Not that we're aware of; "Select Transport" or similar names typically belong to small, local, independently credentialed NEMT operators, not a single national chain. Most NEMT service in any metro area, including Sacramento, comes from small vendors credentialed through Medicaid managed care brokers, not one branded company.

Who administers Medi-Cal NEMT benefits in Sacramento?

Medi-Cal NEMT and NMT benefits in Sacramento County are administered through the county's Medi-Cal managed care plans and their contracted transportation brokers, with oversight from California's Department of Health Care Services (DHCS). Plan and broker assignments can change with contract cycles, so confirm current details on the DHCS website.

Do I need a special driver certification to drive a wheelchair van for Medicaid trips?

Most states or brokers require passenger assistance training, wheelchair securement training, background checks, and sometimes CPR/first aid certification for NEMT drivers. Exact requirements differ by state and broker, so confirm the specific certifications required in your service area before hiring or driving.

Sources

1. eCFR, 42 CFR 431.53 (Medicaid transportation assurance): States must ensure necessary transportation for Medicaid beneficiaries to and from providers, via direct payment, contracts, or brokers
2. Medicaid.gov, Non-Emergency Medical Transportation: NEMT is a distinct Medicaid benefit covering transportation to and from medical care and services for eligible individuals with no other means of transportation
3. Medicare.gov, Ambulance Services coverage: Medicare Part B covers ambulance services when other transportation would endanger health, and non-emergency ambulance transport typically requires physician certification of medical necessity
4. California Department of Health Care Services (DHCS), Medi-Cal NEMT/NMT program: Medi-Cal NEMT and NMT benefits are administered through managed care plans and DHCS provider enrollment, with county-level plan assignments subject to change
5. CMS, Medicaid Managed Care: Many states deliver Medicaid benefits including transportation through managed care plans that contract with brokers
6. 42 U.S.C. 1396a, State plans for medical assistance: The Social Security Act requires state Medicaid plans to provide methods of administration necessary for proper and efficient operation, the statutory basis underlying the transportation assurance regulation
7. GAO, Non-Emergency Medical Transportation: Updated Medicaid Guidance Could Help States (GAO-16-238): Federal oversight and guidance on Medicaid NEMT has historically been limited, with GAO recommending CMS provide states more updated program integrity guidance
8. IRS, Apply for an Employer Identification Number (EIN): New business entities, including single-vehicle NEMT operators forming an LLC, need to obtain an EIN from the IRS
9. CMS, Medicaid Program Integrity: NEMT provider enrollment screening requirements: States are required to screen and enroll Medicaid transportation providers under CMS program integrity rules before they can bill for NEMT services