NEMT glossary

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].

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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 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.

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.