Orientation guide for Medicaid-focused NEMT providers
How to start a non-emergency medical transportation (NEMT) business
This is a general overview of starting a NEMT business that serves Medicaid and managed care members. Requirements differ by state, Medicaid program, brokers, and health plans. Always verify details with your state Medicaid agency, transportation broker, and licensing authorities.
1. Define your NEMT model
Clarify what type of transportation you will provide and who you will serve. This determines vehicle needs, insurance, and which brokers or payers you can contract with.
- Ambulatory, wheelchair, or stretcher transport (as allowed in your state).
- Private-pay, Medicaid, managed care, or mixed payer sources.
- Stand-alone NEMT business vs. part of a home care or HCBS agency.
2. Business setup and insurance
NEMT businesses typically need commercial insurance and vehicle coverage in addition to standard business registration and banking.
Business setup
- Register an LLC or corporation with your Secretary of State.
- Obtain an EIN from the IRS.
- Open a dedicated business bank account.
- Confirm any city/county business license requirements.
Insurance & permits
- Commercial auto insurance meeting state/broker minimums.
- General liability coverage; workers’ compensation where required.
- For-hire/transportation permits or DOT registration, if applicable.
- Any local vehicle-for-hire licensing that applies to NEMT.
Insurance limits, permits, and registration rules vary by state and locality. Please verify with your state transportation department, local licensing office, and insurance broker.
3. Vehicles, equipment, and safety
Your fleet and safety practices must match the level of service you advertise and the standards in your broker or payer contracts.
Vehicles & equipment
- Vehicles that meet state and payer standards for NEMT.
- Wheelchair ramps/lifts and securement systems, if transporting mobility devices.
- Preventive maintenance and documented inspection schedules.
- Clean, professional appearance inside and out.
Safety & policies
- Policies for accidents, incidents, and emergency procedures.
- Seatbelt and securement rules for all passengers.
- Infection control and vehicle cleaning procedures.
- Documentation for incidents and client complaints.
4. Credentialing and payer contracts
Many NEMT providers contract with Medicaid brokers, managed care organizations (MCOs), and sometimes directly with Medicaid programs.
- Identify which brokers, MCOs, or state agencies coordinate NEMT in your state.
- Complete provider applications, credentialing, and any required trainings.
- Understand trip types, authorization requirements, and rates.
- Set up internal processes for trip documentation and timely submission for payment.
Each broker or MCO has its own credentialing packet and contract terms. Always review provider manuals and signed contracts before accepting trips. Please verify.
5. How Softiya can help NEMT agencies
Softiya can be used by agencies that provide both home care and NEMT, allowing you to keep client, trip, and payer information in one ecosystem.
Operational workflows
- Track trips and basic schedules for NEMT alongside home care visits.
- Document pickups, drop-offs, no-shows, and cancellations.
- Associate trips with riders, drivers, and funding sources.
- Use reporting to track volume, revenue, and cancellation trends.
Integrated environment
- Keep client, payer, and documentation consistent across NEMT and home care.
- Use Softiya as the daily operational system while following broker/MCO portals.
- Prepare exports aligned to broker or plan templates where supported.
- Support multi-program agencies that run PCA, HCBS, and NEMT together.
State NEMT brokers and common models
Many Medicaid programs contract with a transportation broker to manage non-emergency medical transportation (NEMT). Others use county, MCO, or fee-for-service models without a single statewide broker. The table below summarizes common patterns by state. Names and models can change; always confirm with current Medicaid and broker guidance for your state. Please verify.
| State | Broker / NEMT model |
|---|---|
| Maine | Statewide brokered NEMT model. Modivcare is listed as the Medicaid NEMT broker (verify in current MaineCare guidance). |
| Minnesota | No single statewide broker. NEMT is largely coordinated by counties and managed care plans; requirements vary by payer. |
| North Carolina | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Pennsylvania | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| California | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Wisconsin | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Alabama | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Alaska | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Arizona | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Arkansas | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Colorado | Statewide brokered NEMT. IntelliRide has been identified as the NEMT broker for Health First Colorado members (confirm current contractor). |
| Connecticut | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Delaware | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Florida | Brokered NEMT that varies by Medicaid managed care plan. Common brokers include Modivcare and other vendors; check each plan’s provider manual. |
| Georgia | Regional brokerage system with brokers such as Modivcare and Verida coordinating Medicaid NEMT (confirm current regions and contracts). |
| Hawaii | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Idaho | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Illinois | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Indiana | Statewide brokered NEMT model with Modivcare listed as the transportation broker for Indiana Medicaid (please verify current contracts). |
| Iowa | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Kansas | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Kentucky | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Louisiana | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Maryland | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Massachusetts | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Michigan | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Mississippi | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Missouri | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Montana | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Nebraska | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Nevada | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| New Hampshire | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| New Jersey | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| New Mexico | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| New York | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| North Dakota | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Ohio | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Oklahoma | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Oregon | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Rhode Island | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| South Carolina | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| South Dakota | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Tennessee | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Texas | Brokered NEMT for many Medicaid managed care plans; Modivcare is contracted by some plans. Exact process depends on the MCO. |
| Utah | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Vermont | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Virginia | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Washington | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| West Virginia | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| Wyoming | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
| District of Columbia | NEMT is coordinated by the state Medicaid program, transportation brokers, and/or managed care plans. Models may be brokered, county-based, or fee-for-service. Please verify current process and contractors for this state. |
This table is for orientation only and does not replace official guidance. Brokers, regions, covered services, and procedures change over time. Before signing contracts or building any interfaces, confirm the current NEMT process with your state Medicaid agency, managed care plans, or transportation broker. Please verify.
This guide is for general operational planning and is not legal, regulatory, tax, or insurance advice. NEMT rules differ by state, Medicaid program, broker, and health plan. Always confirm requirements with official regulations, broker/MCO contracts, and your professional advisors before acting on any strategy. Please verify.