How to Start an NEMT Business in Tennessee: Complete 2026 Guide

Why Tennessee Is a Strong NEMTNEMT — Non-Emergency Medical TransportationTransportation services for Medicaid beneficiaries and other patients who need to get to and from medical appointments but do not require emergency ambulance…View in glossary → Market

Tennessee's MedicaidMedicaidThe joint federal-state health insurance program for low-income individuals. Medicaid is the primary payer for NEMT services. Each state administers its own…View in glossary → program — TennCareTennCareTennessee's Medicaid managed care program administered by the Division of Health Care Finance and Administration. All Medicaid services, including NEMT, are…View in glossary → — covers approximately 1.7 million members through managed care organizations. The state's mix of major urban centers (Nashville, Memphis, Knoxville, Chattanooga) and extensive rural Appalachian communities creates consistent demand for NEMT services across every vehicle type.

Tennessee's NEMT model routes through MCOMCO — Managed Care OrganizationA health insurance company that contracts with a state Medicaid agency to manage benefits for enrolled members. Many states use MCOs to administer NEMT…View in glossary →-contracted brokers, meaning you need to understand which MCOs use which brokers and enroll with both to capture maximum trip volume.

Understanding Tennessee's NEMT Model

TennCare requires its MCOs to provide NEMT as a covered benefit. Each MCO contracts with a transportation broker:

VeridaVeridaA minority-owned NEMT management company (formerly Southeastrans), headquartered in Villa Rica, Georgia. As of April 1, 2026, Verida is the sole NEMT broker…View in glossary → (formerly SoutheastransSoutheastransA major NEMT transportation broker operating in Georgia (now part of Verida). Southeastrans coordinates Medicaid NEMT services in several of Georgia's five…View in glossary →): Serves BlueCare and TennCareSelect members. Verida is headquartered in Georgia with offices in Chattanooga and Memphis. Contact: 1-855-735-4660 (BlueCare) or 1-866-473-7565 (TennCareSelect).

Tennessee CarriersTennessee CarriersTennessee's largest NEMT broker, serving UnitedHealthcare and Wellpoint TennCare members. Headquartered in Memphis with statewide coverage.View in glossary →: Tennessee's largest and most established NEMT broker, serving UnitedHealthcare and Wellpoint MCO members. Headquartered in Memphis. Contact: (901) 795-7055.

Members must schedule rides at least two business days in advance. For hospital discharges, the broker has 3 hours (urban) or 4 hours (non-urban) from notification to provide pickup.

Step 1: Form Your Business Entity

File with the Tennessee Secretary of State. LLCLLC — Limited Liability CompanyThe most common business structure for NEMT startups. An LLC protects your personal assets from business debts and lawsuits while offering flexible tax…View in glossary → filing fee is $300 per member (minimum $300). Annual reports cost $300, due on the first day of the fourth month after your fiscal year end. Register with the TN Department of Revenue.

Step 2: Complete TennCare Registration

Before enrolling with either broker, you must be registered as a TennCare provider. Follow the instructions in the broker's Provider Information Packet to verify your TennCare registration status. This registration is separate from the broker enrollment process.

Step 3: Enroll with Tennessee Carriers and Verida

Tennessee Carriers: Download the application from tenncarriers.com under the NEMT section. All sections must be completed — incomplete applications are rejected. Email to [email protected]. Selection is based on network needs, capabilities, experience, and location. Not all applicants are accepted.

Verida: Submit a Request for Qualifications Form plus driver and vehicle lists through verida.com. Verida reviews applications to determine if there is a need in your proposed service area. If a need exists, they'll contact you for an interview and additional documentation.

Both brokers emphasize that acceptance is competitive — they select providers based on regional network gaps and quality standards, not on a first-come basis.

Step 4: Vehicle and Driver Requirements

Vehicles

All vehicles must be titled and licensed in Tennessee, smoke-free, equipped with adequate heating/AC, two rearview mirrors (one each side), passenger capacity not exceeding manufacturer specs, first aid kit, fire extinguisher, and clean interior/exterior. ADAADA — Americans with Disabilities ActFederal civil rights law requiring transportation providers to accommodate passengers with disabilities. For NEMT, this means wheelchair-accessible vehicles,…View in glossary →-compliant wheelchair vans require functioning lifts and securements.

Drivers

Valid Tennessee driver's license, criminal background check (including exclusion check per Section 1128 of the Social Security Act), clean driving record, drug and alcohol process maintained by the company, CPR/First Aid certification, defensive driving training, and passenger assistance training. Drivers must not be excluded from federal healthcare programs.

Step 5: Insurance

State-required liability insurance on all vehicles. Brokers typically require $1 million combined single limit or higher. Workers' compensation as required by TN law. Budget $7,000–$12,000 per vehicle annually.

Step 6: Operations and Billing

Both brokers determine the transportation method — members cannot choose providers or request specific modes (Lyft/Uber are last resort only). Trip assignments come through broker dispatch systems.

Mileage Reimbursement Program (MRP): Members with their own vehicles can receive mileage reimbursement coordinated through the broker. This reduces the number of vehicle trips needed.

Documentation: Trip logs, GPS tracking, member signatures, and medical appointment verification per broker requirements.

Geographic Strategy

Nashville Metro: Highest growth, multiple major hospitals (Vanderbilt, Saint Thomas), strong demand.

Memphis: High Medicaid population, Tennessee Carriers headquarters, significant dialysis and behavioral health transport volume.

Knoxville/Chattanooga: Mid-size markets with growing demand and moderate competition.

Rural East TN / Appalachian Region: Limited providers, longer trips, potential for higher negotiated rates.

Timeline

Weeks 1–2: Form LLC ($300), EINEIN — Employer Identification NumberA 9-digit tax identification number assigned by the IRS for business entities. Required for opening business bank accounts, filing taxes, and hiring employees.…View in glossary →, TN Department of Revenue registration. Weeks 2–4: TennCare provider registration, vehicle acquisition, insurance. Weeks 4–8: Submit applications to Tennessee Carriers and Verida. Weeks 8–12: Broker review, interviews, inspections, contract signing.

Plan for 8–12 weeks from formation to first trip.

Key Contacts

TennCare: tn.gov/tenncare — program information and provider registration.

Tennessee Carriers: tenncarriers.com — [email protected]

Verida: verida.com — Tennessee provider enrollment page.

TN Secretary of State: sos.tn.gov — business formation.

Ready to Launch?

Tennessee's dual-broker system means you should enroll with both Tennessee Carriers and Verida to capture trips across all MCOs. Our complete Tennessee NEMT Startup Package covers both enrollment processes, TennCare registration, and financial projections for Nashville, Memphis, and rural operations.