NEMT stands for Non-Emergency Medical Transportation. It refers to transportation services provided to individuals who need help getting to and from medical appointments but do not require an ambulance. This includes rides for patients who are elderly, disabled, or without access to a vehicle — often through Medicaid or private-pay options.

NEMT services can be paid for through several different sources, depending on the rider’s situation. Common payor sources include:

• Medicaid
• Managed Care
• Organizations (MCOs)
• Brokerages (like Modivcare, MTM, etc.)
• Private Pay
• Veterans Affairs (VA)
• Workers’ Compensation or insurance providers

Vehicle requirements can vary depending on your state, funding source, and the level of service you offer. Common standards include proper insurance, clean driving records, commercial registration, and ADA compliance for wheelchair-accessible vehicles. Some states also require specific inspections or decals. It’s essential to check with your state’s Medicaid office or transportation authority to ensure you meet all local laws and regulations before operating.

Training requirements vary by state and broker, but most include CPR and First Aid certification, defensive driving, and passenger assistance training. For wheelchair or stretcher transport, additional training in mobility device securement and safe transfers may be required. Drug testing, background checks, and driving record reviews are also commonly required.

Most states and brokers require commercial auto liability insurance (usually $1M or more), general liability, and sometimes professional liability. If you have employees, workers’ compensation insurance is also typically required. Some brokers (like Modivcare or MTM) may have additional specific insurance terms in their contracts.

A broker is a company that coordinates transportation services for Medicaid members on behalf of a state or Managed Care Organization (MCO). Brokers act as a go-between — they receive trip requests, verify eligibility, assign rides to NEMT providers, and handle billing and compliance.

If you want to accept Medicaid-funded trips, you’ll likely need to contract with the broker operating in your state. Each broker has its own application process, vehicle standards, insurance requirements, and operational protocols.

Yes — many providers operate independently of brokers by focusing on:

• Private-pay clients

• Veterans Affairs contracts

• Hospitals or senior living facilities

• Insurance companies or self-funded employers

While brokers provide a steady stream of Medicaid trips, working outside the broker system often allows for:

• Higher rates per trip

• Fewer restrictions

• More flexibility in scheduling and routing

However, it also means you’ll need to handle your own marketing, contracting, and billing — and build relationships directly with the people or organizations that need transportation.

Grants specifically for NEMT are limited, but some may be available through local government programs, healthcare initiatives, or nonprofit organizations focused on community health and accessibility. General small business grants may also be applicable, depending on your focus and location. It’s important to research your state’s opportunities and keep an eye on transportation or health equity funding initiatives.

I work with both! Whether you’re just starting out or looking to grow, optimize, or scale your existing NEMT business, I provide customized consulting services to help you succeed. From forming your business and applying with brokers to pricing, hiring, and long-term strategy — I’m here to support your goals every step of the way.