NEMT glossary

The federal regulation establishing that state Medicaid programs must provide non-emergency medical transportation to beneficiaries who have no other means of getting to covered medical services. The legal foundation for all state NEMT programs.

A healthcare delivery model where state Medicaid programs contract with managed care organizations (MCOs) to provide or arrange covered services including NEMT for enrolled beneficiaries. MCOs receive capitated payments and are responsible for ensuring adequate transportation networks.

The section of the Social Security Act requiring state Medicaid programs to ensure that beneficiaries can access covered medical services, which has been interpreted to require the provision of non-emergency medical transportation as an administrative expense.

A unique 10-digit identification number assigned by CMS to healthcare providers. Required for all Medicaid billing and enrollment. Free to obtain through NPPES, typically processed in 2–5 business days.

The CMS online portal where healthcare providers apply for and manage their NPI number. Registration is free and processing takes 2–5 business days.

The federal database for entities doing business with the U.S. government. Registration is required for Medicaid contracts and takes 7–10 business days to process. Free to register.

A 9-digit tax identification number assigned by the IRS for business entities. Required for opening business bank accounts, filing taxes, and hiring employees. Free and available instantly online.

A unique identifier assigned by the Federal Motor Carrier Safety Administration (FMCSA) to commercial motor carriers operating in interstate commerce. Required for most NEMT operations. Free to obtain, takes 3–5 business days.

An operating authority number issued by FMCSA that authorizes for-hire interstate transportation of passengers. Required in addition to a USDOT number if transporting passengers across state lines.

The federal agency within the U.S. Department of Transportation that regulates the trucking and bus industries, including NEMT providers operating commercial vehicles. Issues USDOT and MC numbers.

A standardized code that identifies a healthcare provider's specialty or service type. For NEMT providers, the primary taxonomy code is 343900000X (Non-emergency Medical Transport — Van). Required on your NPI application and used by Medicaid and brokers to classify your provider type.

NEMT broker operating in multiple states including Iowa and Kansas. Part of the MTM family. Contracts with MCOs to coordinate transportation for managed care members.

Arizona Health Care Cost Containment System — Arizona's Medicaid program and one of the most unique in the country. AHCCCS assigns NEMT responsibility to participating health plans (MCOs), which contract with brokers like Veyo. The program requires PT-28 certification, 72-hour advance scheduling, and GPS-verified loaded miles for all claims.

Alabama Medicaid Agency — state agency administering Medicaid in Alabama. Operates a fee-for-service NEMT model with direct state billing — no statewide broker. Relies on mileage reimbursement and volunteer driver programs.

AHCCCS Provider Enrollment Portal — Arizona's online system for NEMT provider registration, credential management, and document uploads. Providers submit their PT-28 certification, insurance documents, and driver credentials through APEP.

Washington State's Medicaid program administered by the Health Care Authority (HCA). Provides healthcare coverage including NEMT benefits to eligible residents.

Wisconsin's primary Medicaid managed care program covering low-income families, children, pregnant women, and adults. NEMT is a carved-in benefit managed by each MCO.

Bureau of Automotive Repair — a California state agency under the Department of Consumer Affairs that oversees automotive repair and vehicle inspection standards. BAR-certified stations perform the Vehicle Safety Systems Inspection (VSSI) required for NEMT provider enrollment in California. BAR also administers the state's Smog Check program for emissions compliance.

Bureau for Medical Services — West Virginia's Medicaid agency under DHHR. Manages NEMT through a statewide broker (currently MTM).

Coordinated Care Organization — Oregon's regional managed care entities that coordinate healthcare for OHP members. Each CCO contracts with transportation brokers to provide NEMT in their region.

New Mexico's Medicaid managed care program administered by HSD. MCOs coordinate NEMT through designated transportation brokers for enrolled members.

Community Health Automated Medicaid Processing System — Michigan's Medicaid enrollment and claims portal. NEMT providers must enroll through CHAMPS to become authorized Michigan Medicaid transportation providers.

Community HealthChoices — Pennsylvania's managed long-term care program. CHC MCOs (AmeriHealth Caritas, PA Health & Wellness, UPMC CHC) contract with NEMT providers for transportation services to their enrolled members. CHC is a separate revenue stream from MATP.

Care Management Organization — Georgia's term for the private managed care plans contracted by the Department of Community Health (DCH) to deliver Medicaid benefits. Georgia Medicaid members are enrolled in a CMO for medical services, but NEMT is carved out and managed separately through the regional broker system (Verida). Major Georgia CMOs include Peach State Health Plan, CareSource, and Amerigroup.

Department of Financial Institutions — Wisconsin state agency where LLCs file Articles of Organization and annual reports. Not to be confused with DHS (Department of Health Services).

Division of Health Care Financing and Policy — Nevada state agency administering Medicaid. Nevada is expanding MCOs statewide in 2026, transitioning from a mixed model to full managed care.

Department of Health and Social Services — Alaska state agency formerly administering Medicaid (now reorganized as Department of Health). Alaska's NEMT program is unique nationally, with the majority of expenditures on air and ferry transportation rather than ground transport.

Department of Health and Welfare — Idaho state agency administering Medicaid. Manages NEMT through a statewide broker (currently MTM).

Division of Medical Assistance and Health Services — the division within New Jersey's Department of Human Services that administers NJ FamilyCare (Medicaid). DMAHS contracts with ModivCare for statewide NEMT management.

Department of Medical Assistance Services — Virginia's Medicaid agency. DMAS manages NEMT through regional arrangements with ModivCare for trip coordination. Virginia publishes NEMT rates publicly, providing transparency for provider financial planning. Providers enroll through the Virginia Medicaid Web Portal (PRISM).

Division of Medicaid and Medical Assistance — Delaware state agency administering Medicaid. Manages NEMT through MCO-designated transportation brokers. PCS required for specialized transport.

Division of Medical Services — the division within Arkansas Department of Human Services that administers Medicaid, including the NET Program for non-emergency transportation.

Department for Medicaid Services — Kentucky state agency administering Medicaid, including oversight of NEMT regional broker contracts and MCO managed care programs.

Division of Medicaid — Mississippi state agency administering Medicaid. Uses MTM as statewide FFS broker and regional MCO brokers for the MississippiCAN managed care program.

Department of Public Health and Human Services — Montana state agency administering Medicaid. Enrolls and pays NEMT providers directly on established fee schedules. Uniquely offers meal and lodging reimbursement for long-distance medical travel.

Department of Social Services — Connecticut state agency administering Medicaid. Connecticut is one of the few states without traditional managed care MCOs, operating primarily as fee-for-service with NEMT carved out to a statewide broker.

Department of Vermont Health Access — state agency administering Vermont Medicaid. Vermont is one of the few states without traditional MCOs, operating primarily as fee-for-service with NEMT managed through a statewide broker (MTM).

Executive Office of Health and Human Services — Rhode Island state agency administering Medicaid. NEMT is carved out of MCO services and managed through a statewide broker (currently MTM).

Wisconsin's Medicaid program administered by the Department of Health Services. Includes BadgerCare Plus and SSI Managed Care. Used for provider enrollment and claims processing.

Family and Social Services Administration — Indiana state agency that administers Medicaid (IHCP), child welfare, aging services, and disability programs.

Georgia Medicaid Management Information System — the primary web portal for Georgia Medicaid, PeachCare for Kids, and related waiver programs administered by the Department of Community Health (DCH). GAMMIS provides provider enrollment, claims processing, eligibility verification, and access to provider manuals including the NEMT policies and procedures manual. Access at mmis.georgia.gov.

General Excise Tax — Hawaii's broad-based tax on business gross income. All businesses operating in Hawaii must obtain a GET license. Applies to NEMT providers on gross revenue, not just profit.

Vermont's integrated healthcare system that coordinates healthcare and transportation planning. Reflects Vermont's approach to connecting healthcare access with transportation availability.

Health Care Authority — Washington State agency that administers Apple Health (Medicaid) and other public health programs, including oversight of NEMT broker contracts.

Department of Health Care Policy and Financing — Colorado state agency that administers Health First Colorado (Medicaid) and CHP+. Oversees NEMT benefit including broker contracts.

Colorado's Medicaid program administered by HCPF. Provides healthcare coverage including NEMT benefits to eligible residents. Uses broker/FFS hybrid model for transportation.

South Carolina's Medicaid program administered by SCDHHS. Most members are enrolled in managed care organizations that coordinate NEMT through designated brokers.

Louisiana's Medicaid managed care program through which most members receive healthcare benefits. MCOs arrange NEMT through designated transportation brokers.

Nebraska's Medicaid managed care program. MCOs contract with transportation brokers MTM and ModivCare to coordinate NEMT for enrolled members.

Department of Healthcare and Family Services — the Illinois state agency that administers Medicaid (known as Illinois Medical Programs). HFS manages NEMT provider enrollment and oversees MCO transportation contracts. Contact HFS Provider Enrollment Services at 217-782-5565.

Indiana's CHIP managed care program providing healthcare coverage for children up to age 19 and pregnant individuals. NEMT is a carved-in MCO benefit.

Human Service Transportation Office — the Massachusetts state office that coordinates MassHealth NEMT policy statewide. HST works with regional transit authorities (RTAs) like MART and GATRA to manage NEMT service delivery. Strict electronic trip logging is mandatory — paper logs are not accepted.

Regional administrative units in North Dakota through which Medicaid services including NEMT are approved and provided. Zones and tribal offices handle trip authorization using state-prescribed forms.

Iowa's Medicaid managed care program. Three MCOs participate in IA Health Link, all contracting with Access2Care as their NEMT broker. FFS members use MTM as statewide broker.

Indiana Health Coverage Programs — Indiana's Medicaid program administered by FSSA. Includes Traditional Medicaid, Hoosier Healthwise, Hoosier Care Connect, HIP, and PathWays for Aging.

Iowa Medicaid Enterprise — the division within Iowa's Department of Health and Human Services that administers the state's Medicaid program, including NEMT benefits through IA Health Link MCOs and FFS.

MTM-operated NEMT brokerage serving the 9-county Denver metro area in Colorado. Handles trip authorization, provider credentialing, and claims processing through its online portal.

Kansas's Medicaid managed care program administered by KDHE. All Medicaid recipients must enroll in one of three KanCare MCOs (Aetna, Sunflower Health Plan, UnitedHealthcare). NEMT is a carved-in MCO benefit.

Kansas Department of Health and Environment — state agency overseeing the KanCare Medicaid managed care program and public health initiatives in Kansas.

Louisiana Department of Health — state agency administering Medicaid and the Healthy Louisiana managed care program. Publishes the NEMT minimum fee schedule.

Maine's Medicaid program administered by the Office of MaineCare Services (OMS). NEMT is carved out of MCOs and provided through regional brokers across eight Medicaid districts.

Montachusett Area Regional Transit — one of Massachusetts's regional transit authorities that manages MassHealth NEMT in the Montachusett area. MART contracts with NEMT providers for trip assignments and manages scheduling, authorization, and payment.

Massachusetts's Medicaid program, administered by the Executive Office of Health and Human Services (EOHHS). MassHealth covers over 2 million members and administers NEMT through the Human Service Transportation (HST) Office and regional transit authorities. Massachusetts has among the highest NEMT reimbursement rates nationally.

Medical Assistance Transportation Program — Pennsylvania's unique county-based NEMT system. Unlike states with a single statewide broker, MATP gives each of PA's 67 counties flexibility in how they deliver NEMT. Philadelphia County uses ModivCare as a broker; 54 counties operate in-house or through vendors; 12 counties have DHS-managed transit agency agreements.

Managed Care Plan — in the context of California's Medi-Cal program, an MCP is a health plan contracted by the Department of Health Care Services (DHCS) to deliver Medi-Cal benefits to enrolled members in specific counties. MCPs are responsible for arranging NEMT for their members, typically through contracted transportation brokers like ModivCare or MTM. Major California MCPs include Kaiser Permanente, Anthem Blue Cross, Health Net, Molina, and L.A. Care.

Maryland Department of Health — the state agency administering Maryland Medicaid. Maryland stands out as one of the few states operating NEMT as a fee-for-service (FFS) program, meaning providers bill MDH directly rather than through a broker. This eliminates the broker middleman and can result in higher per-trip reimbursement.

Michigan Department of Health and Human Services — the state agency administering Michigan Medicaid. NEMT is currently carved out of managed care, with ModivCare serving Wayne, Oakland, and Macomb counties (Detroit metro) and county MDHHS offices managing the rest of the state. A policy change may move NEMT to carved-in MCO coverage.

Hawaii's Medicaid managed care program administered by the Med-QUEST Division of the Department of Human Services. QUEST Integration health plans coordinate NEMT as a carved-in benefit.

Minnesota Health Care Programs — umbrella term for Minnesota's public healthcare programs including Medical Assistance (Medicaid), MinnesotaCare, and other state-funded health coverage.

Mississippi's Medicaid managed care program. Divides the state into three MCO regions with designated transportation brokers for each. Members receive NEMT through their regional MCO broker.

Minnesota Department of Transportation — administers the Special Transportation Service (STS) certification program for NEMT providers. Maintains vehicle lists and enforces safety standards.

Missouri's Medicaid program administered by the MO HealthNet Division under the Department of Social Services. NEMT is carved out of managed care and provided through a statewide broker.

Major national NEMT broker (formerly Providence Service Corporation/LogistiCare). Operates broker contracts in multiple states including Oregon, North Carolina, and others.

Montana Primary Care Health Quality — organization that verifies Medicaid NEMT trip eligibility and confirms appointments in Montana. Handles authorization only — not payment (DPHHS pays providers directly).

Mobile ticketing application used in Anchorage, Alaska for loading Medicaid bus passes onto smartphones. Alaska Medicaid loads transit passes through Mticket for eligible children and pregnant women in the Municipality of Anchorage.

Medical Transportation Management, Inc. — one of the nation's largest NEMT brokers, headquartered in Missouri. Operates statewide brokerage in Missouri and broker contracts in multiple other states including Colorado.

North Carolina Department of Health and Human Services — the state agency administering NC Medicaid. NCDHHS manages the transition to managed care (Medicaid Transformation), which affects how NEMT is delivered and reimbursed. Ongoing rate adjustments and broker transitions (ModivCare to MTM) are in progress.

North Carolina's Medicaid management information system used for provider enrollment, claims submission, trip authorization, and eligibility verification. All NC NEMT providers must enroll through NCTracks at nctracks.nc.gov. The system handles both traditional Medicaid and managed care claims.

North Dakota Health and Human Services — state agency administering Medicaid through the Medical Services Division. Operates NEMT as a fee-for-service program structured by regional human service zones and tribes. Lowest NEMT ambulatory mileage rate nationally ($0.70/mile).

Arkansas Non-Emergency Transportation Program — the state's NEMT system operated through regional brokers across 7 regions. Three NET brokers serve all regions: Verida, Central Arkansas Development Council, and Area Agency on Aging of Southeast AR.

Non-Emergency Transportation Services Prior Authorization Program — Illinois's authorization program for fee-for-service (FFS) Medicaid members not enrolled in an MCO. NETSPAP authorizes trips but does not arrange transportation — providers must be certified by Illinois Medicaid separately. NETSPAP maintains a list of approved transportation providers.

New Jersey's Medicaid program, administered by the Division of Medical Assistance and Health Services (DMAHS). NEMT is carved out of NJ FamilyCare MCO contracts and managed by a statewide broker (currently ModivCare). NJ applies a 20-mile limit on most NEMT trips when equivalent providers are available locally.

Ohio Department of Medicaid — the state agency that administers Ohio's Medicaid program, including NEMT provider enrollment and oversight. ODM manages Medicaid through seven managed care organizations (MCOs), each with their own NEMT broker arrangements. Providers enroll through ODM and then credential with individual MCOs.

Oregon Health Authority — state agency administering the Oregon Health Plan (Medicaid) and overseeing Coordinated Care Organizations (CCOs) that manage NEMT.

Oklahoma Health Care Authority — state agency administering SoonerCare (Medicaid) in Oklahoma. Oklahoma transitioned to managed care in 2024 and saw a significant 8.96% NEMT rate increase in FY2025.

The Ohio Secretary of State's online portal for LLC registration, business filings, and entity searches. Available at businesscentral.sos.state.oh.us. LLC filing fee is $99 with no annual report requirement.

Oregon Health Plan — Oregon's Medicaid program administered by OHA. Members receive healthcare including NEMT through regional Coordinated Care Organizations (CCOs).

Ohio Medicaid Enterprise System — the state's Medicaid management information system used for claims submission, provider enrollment, and eligibility verification. As of January 2026, OMES serves as the "One Front Door" portal for all claims, including dual-eligible members.

Provider Application and Validation for Enrollment — the online portal used by the California Department of Health Care Services (DHCS) for Medi-Cal provider enrollment. NEMT and NMT providers must submit their applications, vehicle documentation, driver credentials, and insurance proof through PAVE to enroll as Medi-Cal transportation providers. The PAVE Help Desk can be reached at (866) 252-1949.

Virginia Medicaid Web Portal — the online system used for provider enrollment, credentialing, and claims management in Virginia Medicaid. NEMT providers submit their enrollment applications and maintain their credentials through PRISM.

Provider Reimbursement and Operations Management Information System in Electronic format — Pennsylvania's Medicaid provider enrollment and claims management portal. NEMT providers must enroll through PROMISe to bill Pennsylvania Medicaid.

Washington State's Medicaid management information system used for provider enrollment, member eligibility verification, and claims processing.

The NEMT provider certification packet required by AHCCCS (Arizona Medicaid). The PT-28 includes business documentation, driver credentials, insurance verification, and completion of mandatory NEMT certification training through TraCorp. Business owners must create a Non-State Worker training account in TraCorp and upload the certificate to the AHCCCS Provider Enrollment Portal (APEP).

Pennsylvania Public Utility Commission — the state agency that regulates for-hire transportation businesses in Pennsylvania. NEMT providers typically need a Class D (paratransit) certificate from PUC to operate. This regulatory requirement creates a competitive barrier to entry.

Rhode Island Public Transit Authority — previously served as NEMT broker for all MCOs. CMS challenged widespread bus pass distribution; Rhode Island shifted to statewide broker (MTM) carved-out model.

South Carolina Department of Health and Human Services — state agency administering Healthy Connections Medicaid, including oversight of NEMT benefits and managed care contracts.

State Department of Assessments and Taxation — Maryland's business registration and annual filing agency. LLCs register with SDAT for $100 and file an annual Personal Property Tax Return ($300/year). Note: SDAT handles business filings, not the Secretary of State as in most other states.

Statewide Medicaid Managed Care — Florida's Medicaid delivery system in which most beneficiaries are enrolled in managed care plans. Under SMMC, NEMT is a carved-in benefit, meaning each managed care organization (MCO) is responsible for arranging transportation for its members. MCOs typically contract with brokers like ModivCare and MTM to manage their NEMT provider networks.

Oklahoma's Medicaid program administered by OHCA. Provides healthcare coverage including NEMT benefits. Recently transitioned to managed care model with MCO contracts.

The Texas Secretary of State's online filing portal for business entity formation. NEMT entrepreneurs use SOSDirect to file their Certificate of Formation for an LLC ($300 filing fee), check business name availability, and manage annual filings. The portal is available at sos.state.tx.us.

Special Transportation Service — Minnesota state certification required by MnDOT for all NEMT providers. Must be obtained before contracting with MCOs or providing Medicaid transportation.

The Florida Division of Corporations' online portal (sunbiz.org) for business entity filings. NEMT entrepreneurs use Sunbiz to file Articles of Organization for an LLC ($125 filing fee), submit annual reports ($138.75, due by May 1 with a $400 late penalty), and check business name availability.

Temporary Disability Insurance — Hawaii requires employers to provide short-term disability coverage for employees. One of only a few states with this mandatory requirement.

Tennessee's Medicaid managed care program administered by the Division of Health Care Finance and Administration. All Medicaid services, including NEMT, are delivered through contracted MCOs.

Tennessee's largest NEMT broker, serving UnitedHealthcare and Wellpoint TennCare members. Headquartered in Memphis with statewide coverage.

An MTM company operating as the statewide NEMT broker in Connecticut and other states. Part of the MTM family following its 2022 acquisition. Offers a digital-first model including individual driver opportunities similar to rideshare platforms.

The most populous metropolitan region of Utah, stretching along the Wasatch Mountains from Ogden to Provo through Salt Lake City. Contains approximately 80% of Utah's population and offers the highest NEMT trip density in the state.

A California-specific operating permit issued by the CPUC (California Public Utilities Commission) required for all for-hire passenger transportation including NEMT. Application involves insurance filing, vehicle inspection, and establishing a drug testing program.

The California state agency that regulates for-hire transportation providers, including NEMT operators. Issues TCP permits and enforces safety, insurance, and operational requirements specific to California.

California's electronic fingerprint submission system used by the Department of Justice (DOJ) and FBI for background checks. Required for all NEMT drivers in California. Results typically arrive in 3–7 days. Cost: $50–$75 per person at authorized LiveScan locations.

Florida's state agency that oversees Medicaid, including NEMT provider certification. AHCA sets vehicle, driver, and insurance standards for Florida NEMT providers and requires certification before you can serve Medicaid patients in the state.

Texas state agency that administers Medicaid, including the NEMT program. HHSC oversees the Medical Transportation Program (MTP) and sets provider enrollment requirements through TMHP/PEMS.

The organization contracted by Texas HHSC to handle Medicaid provider enrollment and claims processing. NEMT providers in Texas enroll through TMHP's PEMS portal. Contact center: 800-925-9126.

Texas TMHP's online portal for Medicaid provider enrollment, reenrollment, and revalidation. This is the single system where Texas NEMT providers manage their Medicaid enrollment status. Processing takes 30-60 days.

New York's statewide NEMT transportation broker. MAS schedules and coordinates all Medicaid transportation in the state — providers must be credentialed with MAS to receive Medicaid trip assignments. All trips require MAS authorization and GPS verification.

New York's state health agency that regulates NEMT providers under Article 30 of the Public Health Law. NEMT providers must register with NYSDOH as ambulette service providers before operating in the state.

New York City's agency regulating all for-hire vehicles, including NEMT providers operating in the five boroughs. NYC NEMT operators need a TLC base license, TLC-licensed vehicles, and TLC-licensed drivers — requirements on top of state NYSDOH registration.

Georgia's state agency that administers Medicaid. DCH carves out NEMT from its managed care contracts, managing it separately through a regional broker system with ModivCare and Southeastrans/Verida across five regions.

California's state agency administering Medi-Cal (California's Medicaid program). DHCS sets credentialing standards for NEMT drivers transporting Medi-Cal patients, including LiveScan background check requirements.

A Texas-specific entity contracted by HHSC to coordinate NEMT services in designated regions. MTOs manage trip scheduling and provider networks for Medicaid members not enrolled in managed care plans.

New York's Vehicle and Traffic Law provision governing bus driver qualifications, applied to NEMT drivers operating vehicles with 10+ passenger capacity. Requires annual medical exams, biannual driving record reviews, and state-approved driver training programs.

A major NEMT transportation broker operating in Georgia (now part of Verida). Southeastrans coordinates Medicaid NEMT services in several of Georgia's five regions under contract with DCH.

A vehicle that meets Americans with Disabilities Act accessibility requirements including wheelchair ramp or lift, securement systems, adequate interior clearance, accessible door openings, and lowered floor or kneeling capability. Required for wheelchair NEMT service.

Basic Inspection of Terminal — a California Highway Patrol (CHP) inspection required for commercial vehicles with a Gross Vehicle Weight Rating (GVWR) over 10,001 lbs. The BIT program inspects the carrier's terminal facility, vehicle maintenance records, driver records, and vehicle condition. Applies to larger NEMT wheelchair vans and stretcher vehicles that exceed the weight threshold.

California Air Resources Board — the state agency responsible for California's vehicle emissions standards, which are the strictest in the nation. All NEMT vehicles registered in California must comply with CARB standards. This affects vehicle purchasing decisions for NEMT startups, as some vehicles that are legal to register in other states may not meet California emissions requirements.

NEMT service for patients who must remain in a supine (lying down) position during transport. Requires a specially equipped vehicle with a secured gurney/stretcher, medical-grade suspension, and trained attendants. The highest-rate NEMT service type.

A wheelchair-accessible vehicle with a mechanical or hydraulic lift platform that raises and lowers to load wheelchair users. Alternative to ramp-equipped vehicles. Requires regular maintenance and cold-weather preparation in northern states.

Scheduled vehicle maintenance performed at regular intervals to prevent breakdowns and ensure safety. NEMT providers must maintain documented PM schedules including oil changes, brake inspections, tire rotations, and fluid checks. Broker audits review PM records.

The combination of floor-mounted brackets, belts, and restraints used to secure a wheelchair and its occupant inside an NEMT vehicle during transport. Must meet FMVSS standards. Drivers must be trained in proper securement procedures.

The maximum age of vehicles allowed in an NEMT fleet, set by brokers or state regulations. Typically 8-10 years for sedans and 10-12 years for wheelchair-accessible vehicles. Older vehicles may be approved with additional inspections.

A comprehensive safety and condition check of an NEMT vehicle conducted before entering service and periodically thereafter. Covers mechanical systems, interior cleanliness, safety equipment, accessibility features, and insurance documentation. Required by brokers and some states.

Vehicle Safety Systems Inspection — a California-specific vehicle inspection required for NEMT provider enrollment through PAVE. VSSI inspections must be performed at Bureau of Automotive Repair (BAR)-certified stations and cover safety equipment, accessibility features, and general vehicle condition. The VSSI certificate is a required document for Medi-Cal transportation provider applications.

A non-emergency medical transportation vehicle specially equipped with wheelchair ramps or lifts for transporting patients who cannot use standard vehicles. In New York, ambulettes are regulated under Article 30 of the Public Health Law and require NYSDOH authorization, NYS DOT carrier authority, and (in NYC) TLC licensing. Also called an invalid coach.

A vehicle modified with a ramp or lift to accommodate passengers who use wheelchairs or mobility devices. WAVs must meet ADA accessibility standards including proper securement systems, adequate interior clearance, and accessible controls. Higher Medicaid reimbursement rates apply (typically $45–$120 per trip vs. $25–$90 for ambulatory).

Non-emergency transport of patients who must remain in a supine (lying down) position during transit. Requires specially equipped vehicles with secured stretcher systems. Commands the highest NEMT reimbursement rates, typically $100–$250+ per trip. Some states classify this separately from standard NEMT.

The centralized background screening portal operated by Florida's Agency for Health Care Administration. All NEMT drivers and staff in Florida must submit Level 2 fingerprints (FDLE + FBI) through the Clearinghouse. Fingerprints are retained for 5 years with annual re-screening required. Processing: FDLE 24–72 hours, AHCA review 5–7 business days. Contact: (850) 412-4503 or [email protected].

The process of confirming that a Medicaid beneficiary actually had a medical appointment on the date an NEMT trip was billed. Brokers verify appointments with medical facilities to prevent fraudulent billing. A common audit trigger when trip records don't match appointment records.

Bureau of Workers' Compensation — Ohio's state-run workers' compensation fund. Ohio is a "monopolistic" state, meaning employers must purchase workers' comp insurance through BWC rather than private insurers. NEMT providers register at bwc.ohio.gov. Rates are often lower than private-market WC in other states.

A formal written plan required by a Medicaid agency or broker when an NEMT provider is found to be non-compliant with program requirements. Details the deficiencies, required corrections, timeline for completion, and consequences for non-compliance.

Department of Family and Protective Services — a Texas state agency that maintains the Central Registry of substantiated findings of abuse, neglect, and exploitation. NEMT providers in Texas are expected to screen drivers against the DFPS Central Registry as part of the background check process. This screening is in addition to DPS criminal checks and FBI fingerprinting.

A comprehensive personnel file maintained for each NEMT driver containing their license, background check results, drug test records, training certificates, medical certification, and driving record. Required by NEMT brokers and subject to audit.

An individual or entity that has been banned from participating in federal healthcare programs (Medicare, Medicaid) due to fraud, abuse, or other violations. NEMT companies must screen all employees against the OIG exclusion list monthly.

Florida Department of Law Enforcement — the state agency that processes fingerprint-based background checks in Florida. All NEMT drivers in Florida must complete Level 2 fingerprint screening through FDLE and the FBI, submitted via the AHCA Clearinghouse. FDLE processing typically takes 24–72 hours, followed by 5–7 business days of AHCA review.

An annual state tax imposed on businesses for the privilege of operating in certain states. In California, all LLCs must pay an $800 annual franchise tax to the Franchise Tax Board (FTB), regardless of revenue — making it one of the highest LLC maintenance costs in the nation. Texas also has a franchise tax but exempts businesses under $2.65 million in revenue.

The three categories of improper Medicaid billing. Fraud is intentional deception for payment. Waste is overutilization of services. Abuse is practices inconsistent with professional standards. NEMT providers must have FWA training and compliance programs.

A state law enforcement agency that investigates and prosecutes Medicaid provider fraud including NEMT billing fraud. Operates under the state Attorney General in most states. Funded jointly by federal and state governments.

Physician Certification Statement — a medical necessity document signed by a licensed healthcare provider certifying that a patient requires non-emergency medical transportation. PCS forms are required for prior authorization of all NEMT services in California and many other states. The form specifies the mode of transportation needed and the duration of service, up to 12 months for recurring appointments.

The division within a state Medicaid agency responsible for preventing, detecting, and investigating fraud, waste, and abuse in Medicaid programs including NEMT. Conducts audits, data analysis, and provider reviews.

An in-vehicle observation session where a supervisor, broker representative, or compliance officer rides with an NEMT driver to evaluate service quality, safety practices, and passenger interaction. May be scheduled or unannounced.

Federal law that protects the privacy and security of patient health information (PHI). NEMT providers handle PHI including passenger names, addresses, medical conditions, and appointment details. Requires staff training, data security measures, and privacy safeguards.

Any individually identifiable health information held or transmitted by a covered entity. In NEMT, this includes passenger names, pickup/drop-off addresses, medical facility names, appointment types, and any mobility or medical needs noted for transport.

Federal civil rights law requiring transportation providers to accommodate passengers with disabilities. For NEMT, this means wheelchair-accessible vehicles, proper securement devices, trained drivers, and reasonable modifications to policies and practices.

A section of New York State Vehicle & Traffic Law that establishes special qualification requirements for bus drivers, including ambulette operators. Article 19-A mandates pre-employment and biennial medical exams, road tests by DMV-certified examiners, annual license abstract reviews, and an annual employer compliance affidavit filed by July 1.

Federal database maintained by the HHS Office of Inspector General listing individuals and entities excluded from participating in Medicare and Medicaid programs. NEMT providers must screen themselves, all employees, and contractors before hiring and monthly thereafter.

Florida's fingerprint-based background check conducted through FDLE (Florida Department of Law Enforcement), including a national FBI check. Required for all NEMT drivers in Florida. More thorough than standard criminal history checks and requires annual renewal.

Georgia's state law enforcement agency that conducts criminal background checks for NEMT drivers through the Georgia Applicant Processing Service (GAPS). Required for all NEMT driver applicants in the state.

An official state document showing a driver's complete driving history — accidents, violations, suspensions, and license status. Brokers pull MVRs during credentialing and typically require a clean record for the past 3 years. At-fault accidents, DUIs, and suspended licenses are common disqualifiers.

Non-emergency medical transportation for patients who can walk and transfer independently into a standard sedan or minivan without wheelchair or stretcher assistance. The most common and lowest-cost NEMT service type.

Ambulatory Transport Driver — one of three NEMT driver categories in Florida, alongside Wheelchair and Stretcher/Ambulette drivers. ATD drivers transport patients who can walk independently or with minimal assistance but cannot use public transportation due to medical conditions. Each driver category has specific training and vehicle requirements.

The process of applying to and being approved by an NEMT broker (such as ModivCare, MTM, or Veyo) to receive Medicaid trip assignments. Requires submission of business documents, insurance certificates, vehicle inspections, and driver qualification files. Typically takes 30-90 days.

A trip where the NEMT vehicle travels without a passenger — typically driving to a pickup location or returning to base after a drop-off. Deadhead miles are generally not reimbursed by Medicaid brokers and represent a direct cost to the provider.

A transportation service model where rides are scheduled in response to individual trip requests rather than operating on fixed routes. All NEMT services operate on a demand-response basis, with trips scheduled through the broker based on patient appointment times.

NEMT service that picks up the passenger at their residence door and delivers them to the entrance of the medical facility. The standard service level for most Medicaid NEMT trips, as opposed to curb-to-curb service.

Full Risk Broker — a type of NEMT broker in Texas that assumes full financial risk for managing transportation services in a designated region. FRBs receive a capitated per-member-per-month payment and are responsible for all trip costs within their service area. In Texas, ModivCare operates as an FRB in the DFW region and SafeRide Health serves the Houston/Beaumont area. FRBs differ from MTOs in that they bear the full cost risk.

Real-time vehicle location monitoring required by most NEMT brokers. Used for dispatch optimization, trip verification, mileage confirmation, and performance monitoring. GPS data serves as the primary evidence for trip completion and billing accuracy.

Transporting multiple passengers in the same vehicle during overlapping time windows. Also called shared-ride or grouped trips. Common in rural areas where multiple patients travel to the same medical facility. Increases per-vehicle revenue but requires careful scheduling.

The percentage of trips where the NEMT vehicle arrives within the broker-defined pickup window — typically 15 minutes before to 15 minutes after the scheduled time. A key performance metric that directly impacts trip volume allocation from brokers.

Training in safely helping passengers enter, exit, and ride in NEMT vehicles. Covers mobility device handling, transfer techniques, seatbelt assistance, and sensitivity for elderly and disabled passengers. Required certification for most NEMT drivers.

The second leg of an NEMT round trip — transporting the passenger from the medical facility back to their residence after their appointment. Return trips may be scheduled at a specific time or dispatched on-demand when the patient calls the broker after their appointment.

The concentration of NEMT trip pickups and drop-offs within a geographic area. Higher route density means more trips per vehicle per day, improving profitability. Urban areas have higher density than rural areas.

The geographic region in which an NEMT provider is authorized and willing to operate. Defined during broker credentialing by county, zip code, or mile radius. Providers may serve multiple non-contiguous areas.

A recurring NEMT trip that repeats on a regular schedule — such as dialysis transport three times per week. Standing orders provide predictable revenue and allow efficient route planning. Also called subscription trips or recurring trips.

A daily document listing all assigned NEMT trips for a vehicle or driver, including passenger names, pickup/drop-off addresses, appointment times, special needs, and contact information. Generated by the broker dispatch system.

A minority-owned NEMT management company (formerly Southeastrans), headquartered in Villa Rica, Georgia. As of April 1, 2026, Verida is the sole NEMT broker for all five Georgia Medicaid regions. Verida partners with over 900 NEMT providers and manages more than 5 million trips annually. Their 4-step credentialing process includes application review, document submission, vehicle inspections and driver training, and a provider orientation session. Verida also operates in Arkansas, Indiana, Louisiana, Tennessee, and Washington D.C.

Transportation services for Medicaid beneficiaries and other patients who need to get to and from medical appointments but do not require emergency ambulance services. Includes ambulatory (walk-on) transport, wheelchair van service, and stretcher transport. A federally mandated Medicaid benefit since 1966.

A provider record maintained in the MAS system that contains your vehicle fleet details, insurance certificates, driver credentials, service area, and availability. MAS continuously monitors TPPs for compliance. Providers must keep their TPP current — outdated information can lead to suspension from the MAS network.

A nationally recognized training program administered by the Community Transportation Association of America (CTAA). Covers passenger assistance techniques, wheelchair securement, sensitivity training for passengers with disabilities, and emergency procedures. Costs $75–$150 per driver.

The national professional association for community and public transportation providers. Administers the PASS certification program and provides resources, training, and advocacy for NEMT and paratransit operators.

Emergency medical training required for NEMT drivers in most states. CPR (Cardiopulmonary Resuscitation) and BLS (Basic Life Support) certifications are typically obtained through the American Red Cross or American Heart Association. Must be renewed every 2 years.

Training in basic emergency medical care including wound treatment, choking response, and allergic reaction management. Required for NEMT drivers in many states alongside CPR/BLS. Available through the American Red Cross and typically valid for 2 years.

Technology platforms that manage trip scheduling, driver assignment, GPS tracking, route optimization, and billing for NEMT operations. Popular options include TripMaster, RouteGenie, and CTS Software. Essential for efficient operations and required by many Medicaid programs for electronic trip verification.

A technology requirement in many state Medicaid programs that uses GPS data to verify trip pickup and drop-off times and locations. Replaces paper logs and prevents billing fraud. Typically integrated into dispatch software or a dedicated mobile app used by drivers.

Miles driven without a passenger in the vehicle — traveling to a pickup location or returning from a dropoff. Deadhead miles cost you fuel and time without generating revenue. Route optimization software reduces deadhead by sequencing trips efficiently across your fleet.

When a scheduled NEMT passenger is not available for pickup at the designated time and location. No-shows cost providers time and fuel without generating revenue. Billing for no-shows as completed trips is Medicaid fraud — a serious federal offense. Dispatch software with automated passenger reminders reduces no-show rates.

The fixed fee charged for an NEMT trip before mileage charges are added. Base rates vary by service type (ambulatory, wheelchair, stretcher) and are negotiated during broker credentialing. Covers the cost of dispatching, pickup, and initial transport.

A fixed per-member-per-month (PMPM) payment made to an NEMT broker or managed care organization, regardless of how many trips a member actually takes. In Georgia, Verida receives a capitated rate from DCH based on the number of eligible Medicaid members in each region. The broker then pays transportation providers per trip from this capitated budget. Capitated models shift financial risk to the broker — if trip costs exceed the capitated amount, the broker absorbs the loss.

When a Medicaid broker or payer refuses to pay for an NEMT trip. Common reasons include missing documentation, exceeding timely filing limits, duplicate billing, trips not matching appointment verification, or service not pre-authorized.

A financial document submitted to state Medicaid agencies detailing the actual costs of providing NEMT services. Some states use cost reports to set or adjust reimbursement rates. Also used in rate hearings and legislative testimony.

Trip-level service records submitted by NEMT brokers or managed care organizations to state Medicaid agencies. Includes trip details, service dates, procedure codes, and costs. Used for program oversight, rate setting, and fraud detection.

A Medicaid payment model where the NEMT provider is paid a set rate for each trip completed. Contrasts with capitated payment where the broker receives a fixed per-member-per-month amount regardless of trip volume. Most NEMT providers operate on a fee-for-service basis.

One direction of an NEMT trip. A round trip consists of two legs: the pickup leg (home to medical facility) and the return leg (medical facility to home). Each leg may be scheduled, billed, and tracked separately.

Miles driven with a passenger in the vehicle, as opposed to deadhead miles. NEMT reimbursement is typically calculated based on loaded miles only. GPS verification confirms loaded mileage for billing purposes.

The per-mile reimbursement amount paid to NEMT providers for loaded miles (miles with a passenger). Added to the base rate to calculate total trip reimbursement. Rates vary by state, broker, and service type.

A capitated payment structure where a Medicaid managed care plan or broker receives a fixed monthly payment for each enrolled member, regardless of whether that member uses NEMT services. The broker then pays providers on a per-trip basis from this pool.

A document from the NEMT broker or Medicaid payer explaining payment for submitted claims. Lists each trip, the amount billed, the amount paid, and any adjustments or denials with reason codes. Essential for reconciling accounts receivable.

The deadline by which an NEMT claim must be submitted to receive reimbursement. Varies by state and broker — typically 90 to 365 days from the date of service. Claims submitted after the deadline are automatically denied regardless of validity.

The process of confirming that an NEMT trip was completed as scheduled. Methods include GPS tracking, electronic signatures, IVR phone check-ins, and manual trip logs. Required for billing and payment processing.

Time an NEMT driver spends waiting at a pickup or drop-off location beyond the scheduled window. Some brokers compensate wait time beyond a threshold (typically 15-30 minutes), while others do not. Excessive wait time reduces vehicle productivity.

The joint federal-state health insurance program for low-income individuals. Medicaid is the primary payer for NEMT services. Each state administers its own Medicaid program with different enrollment processes, rates, and requirements. Reimbursement typically takes 30–90 days.

The federal agency that administers Medicare, Medicaid, and the Health Insurance Marketplace. CMS sets national guidelines that state Medicaid programs must follow, including NEMT benefit requirements.

The standardized medical coding system used for Medicare and Medicaid billing. NEMT providers use codes T2001–T2005 for per-trip billing and A0130 for wheelchair van transport. Each state may accept different code subsets and assign different reimbursement rates.

A health insurance company that contracts with a state Medicaid agency to manage benefits for enrolled members. Many states use MCOs to administer NEMT benefits, meaning you may need to credential with multiple MCOs in addition to or instead of the state Medicaid agency directly.

A company contracted by a state Medicaid agency or MCO to coordinate and manage NEMT services. Brokers receive trip requests, assign them to providers, and handle billing. Examples include Southeastrans, ModivCare (formerly LogistiCare), and MTM. You typically must credential with your state's broker to receive Medicaid trips.

New York State's Medicaid management information system for claims processing. NEMT providers billing Medicaid directly in New York submit claims through eMedNY. The system handles eligibility verification, claims adjudication, and payment processing.

A fixed per-member-per-month payment that a state Medicaid agency pays to a broker or MCO to cover all NEMT services for their enrolled population. The broker retains their margin from this payment and pays providers per-trip. This is why broker rates are typically 10-30% below direct Medicaid fee-for-service rates.

When NEMT is separated from managed care contracts, meaning the state (not the MCO) is responsible for providing transportation benefits. The state typically contracts with a statewide or regional broker.

A mile traveled with a Medicaid patient actually in the vehicle. Most states only reimburse loaded miles — deadhead miles (driving to pickup or returning empty) are not reimbursable. This distinction significantly affects profitability calculations.

Physician Certification Statement — a document signed by a healthcare provider certifying that a patient requires a specific level of NEMT (e.g., wheelchair or stretcher transport). Required in some states like Delaware and others for specialized transport authorization.

A requirement in some states (e.g., Arkansas, California) that NEMT trips be approved by the broker or Medicaid agency before transportation is provided. Trips without prior authorization may not be reimbursed.

A financial guarantee required by some states (e.g., Indiana) for NEMT provider enrollment. Protects the state against provider fraud or non-performance. Obtained through a licensed insurance broker.

The deadline by which NEMT providers must submit claims after completing a trip. Ranges from 90 days (Colorado, Pennsylvania) to 12 months (Oklahoma, Missouri). Claims submitted after the deadline are automatically denied.

A reimbursement structure used in some states (e.g., Mississippi Delta region) where NEMT rates vary by geographic zone — typically paying more for rural or hard-to-reach areas and less for urban zones with higher trip density.

An insurance policy structure that provides one total coverage amount for both bodily injury and property damage per accident, rather than splitting limits between the two. Most NEMT brokers require $1 million CSL minimum for commercial auto coverage.

Insurance coverage for vehicles that a business uses but does not own — such as employee personal vehicles used for business purposes or rented vehicles. Important gap coverage for NEMT companies whose drivers occasionally use personal vehicles.

A claims history document from a prior insurance carrier showing all claims filed against a policy over a specified period. New insurance carriers request loss runs to evaluate risk when quoting NEMT commercial auto coverage.

No-fault insurance coverage that pays for medical expenses and lost wages for the policyholder and passengers regardless of who caused an accident. Required in some states for all vehicles including NEMT.

Personal Injury Protection — a mandatory no-fault auto insurance coverage in Florida that pays for medical expenses and lost wages regardless of who caused an accident. PIP adds to the base cost of NEMT commercial auto insurance in Florida, contributing to the state having some of the highest NEMT insurance premiums in the nation. PIP coverage is required in addition to commercial auto liability.

An additional liability insurance policy that provides coverage beyond the limits of underlying auto and general liability policies. Recommended for NEMT providers to protect against catastrophic claims exceeding primary policy limits.

A state-mandated insurance program that provides coverage to high-risk operators when no standard carrier will write their policy. In New York, new NEMT operators in NYC frequently end up in the Assigned Risk pool due to limited carrier willingness, with premiums of $15,000-$22,000+ per vehicle. Processing through the pool can add 4-6 weeks to your insurance timeline.

Liability insurance covering vehicles used for business purposes. NEMT providers typically need $500,000 to $1,500,000 in commercial auto liability coverage depending on the state. Covers bodily injury and property damage during transport.

Business insurance covering third-party bodily injury, property damage, and advertising injury claims not related to vehicle operations. Protects against slip-and-fall at your office, damage to client property, and similar non-auto incidents.

Insurance that covers medical expenses and lost wages for employees injured on the job. Required in most states once you hire W-2 employees (drivers, dispatchers, office staff). Requirements and rates vary by state.

A section of the New York Public Health Law that governs ambulette and invalid coach services. Article 30 authorization from NYSDOH is required for ambulette providers and establishes the $1.5M CSL insurance minimum — the highest state-level NEMT insurance requirement in the country.

A special license required to operate large or heavy vehicles. For NEMT, a CDL is required when transporting 16 or more passengers (including the driver) or operating a vehicle with a gross vehicle weight rating (GVWR) of 26,001 lbs or more. Most standard NEMT operations do not require a CDL.

The most common business structure for NEMT startups. An LLC protects your personal assets from business debts and lawsuits while offering flexible tax treatment. Filing fees vary by state ($50–$500). Most NEMT consultants recommend an LLC over a sole proprietorship for liability protection.

California employment law establishing a strict "ABC test" for determining whether a worker is an independent contractor or employee. Under AB5, most NEMT drivers must be classified as W-2 employees rather than independent contractors, affecting payroll taxes, benefits, and labor obligations.