Starting your own NEMT Business: Everything you didn’t know you needed to know.

The NEMT market is on the move, and it’s no surprise.

According to a report by, 32 million Non-Emergency Medical Transport (NEMT) users insured through Medicaid generated a staggering 61.5 million ride-days in 2018.

This 3 billion dollar Medicaid endeavor is bolstered by private-pay patients, medical facilities, and retirement communities, creating a healthcare transportation market that’s projected to balloon to 31 billion dollars globally in just four years.

The diagnosis: NEMT is the fastest-growing segment in medical transportation, period.

Healthcare meets a healthy opportunity.

NEMT does more than serve those who struggle with transportation-related barriers to healthcare. It also provides significant opportunities to those who wish to provide NEMT transportation.
But how do you get on the road to a successful NEMT business? Here are 6 tips to help you get rolling.

Step 1: Understand the business

As a NEMT provider, you’ll work as an independent driver-provider (IDP) to transport people to non-emergency medical appointments. These medical visits may include:

  • Dialysis treatments
  • Doctor’s visits
  • Follow-up appointments
  • Lab draws
  • Hospital discharges
  • Cancer and other ongoing treatments

Just as the needs are diverse, so are those you serve. You may be transporting:  

Medicaid users: People who are low-income, elderly, or disabled and are covered by a federal program that pays for their non-emergency medical transportation

Private-pay clients: Those who don’t meet the government’s criteria for Medicaid, but who need NEMT services

Medical facilities: Hospitals, dialysis centers, and medical centers that work with companies to provide NEMT to patients being discharged from their facility or who have ongoing appointments

Retirement communities: Assisted living facilities with people who need transportation for a variety of non-emergency medical needs

Take some time to assess these markets. Decide if you want to focus on one or pursue several. There are benefits and drawbacks to each. For example, while Medicaid payments may be relatively lower per trip or per hour, there is potential for greater volume and regularity.

Step 2: Make it official.

Next order of business: registering your business. Determine if you’d like to operate under a sole proprietorship, partnership, or limited liability corporation (LLC).

After you’ve registered your business, you’ll need to obtain a National Provider Identifier (NPI), per the Health Insurance Portability and Accountability Act (HIPAA).

Step 3: Get licensed.

As a NEMT provider, you’ll be an important cog in the healthcare wheel. As such, you’ll need to obtain appropriate licenses and certifications.

Requirements vary by state. They may include:

  • Application as a Medicaid NEMT provider if you intend to serve those who use Medicaid; this process will involve background checks and may require specialized training
  • Department of motor vehicle standards for medical transportation, such as number of penalty points on driving record, criminal background check, driver’s health, vehicle liability insurance, and negative drug screenings.
  • Livery plates for your vehicle, if state mandated
  • Licensing as a medical carrier or medical transportation provider, if state mandated

You may also consider basic emergency medical training for your staff, like CPR, how to check vital signs, how to operate a defibrillator, and more. Check with your state for current rules, regulations, and mandates.

Step 4: Complete your fleet

As a NEMT business, your fleet is one of the most important tools of the trade. If you’re going to serve Medicaid users, check with your state to see if there are requirements for fleet size and/or vehicle type. If your business has 15+ employees or operates for the benefit of the public, you’ll need a van or bus that meets the Americans with Disabilities Act (ADA) and the ADA Standards for Accessible Design.

Step 5: Ensure that you’re insured

You’ll want to ensure that you carry adequate commercial automobile and liability insurance that covers individual drives and the company as a whole. You may also be required to provide workers’ compensation insurance, depending on the state in which you’re operating.

Don’t cut corners on insurance. You want to make sure that you manage liability in the event of an accident.

Step 6: Map out the road to success with fleet management

Put yourself in the driver’s seat with fleet management. EverTransit is the only on-demand fleet management solution available. With EverTransit, you have:

Smarter, automated scheduling: Dispatch trips by location, medical needs, passenger count, driver certifications, pre-defined routes, availability, and more.

Live trip tracking: Use real-time vehicle tracking for peace of mind and improved efficiency by preventing delays before they happen.

Customer profile management: Personalize service to customers’ special needs, favorite drivers, and more to ensure a seamless experience and to streamline operations.

Secure trip imports and exports: Easily import CSV records from integrations and 3rd party vendors with a trip manifest upload, and export data anytime with an anonymized trip manifest.

Back-office management: Run your company more easily and efficiently than ever with a full back-end system for billing, customer management, and accounting.

Let's Roll

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