Tips On How To Run Your NEMT Business


Systems such as medicaid can cover around ¼ of Americans, but it is shown that around 3.6 Americans do not actually get medical care per year due to transportation issues. 

Chronic health conditions are on the rise and the elderly population in the U.S. is set to double within the next 30 years, NEMT businesses are needed more than ever. 

Even though they are very lucrative, it is not easy to figure out where to begin as how you do it will vary per state, so remember this before you get started. Understanding business in your state is something you need to be aware of, check out as you learn more about this. 

It will take time for the state to give you all the information that you need to start up, and your competition might not want to share any details. So, you have some research to do yourself. 

But, we are here to get the ball rolling for you.

What Is An NEMT Business?

To start, let’s first understand exactly what an NEMT business is. 

This is a business that provides on-the-ground transportation, or even a shuttle service to those who need aid in getting to medical appointments. 

There are frequent users of NEMT services such as residents or nursing homes and dialysis patients. 

NEMT businesses will usually operate on an independent driver provider basis, this is done under different models of service dependent on the state in which you live. 

How Much Money Does NEMT Bring In?

NEMT businesses will operate through Medicaid funding, the usual funding for transport services will be around $3 billion. However, since pricing for Medicaid reimbursements in NEMT will vary per state, the amount you will make will also vary. 

In places such as New York, providers of NEMT services will be paid per mile and per trip. 

An example of this would be that an NEMT taxi service in NYC could be paid anywhere from $21 to $68 per trip as it may depend on the patient classification, they will then get $2.25 per mile additionally. 

If you only have one vehicle for the business and your average rate per trip is around $44.38 overall, and you made 10 trips in a day averaging at 5 miles, then your revenue would be $443.80. 

The mileage revenue would be about $112.50. So you would have a total revenue of $556.30 per day. 

However, in some states, NEMT services are only paid per mile. Which can be a massive difference in pay. 

This is why it is imperative that you understand how your state will pay you before you start up the business, so you know you will be happy with what you get. 

Steps To Take

Always be aware that the entire process varies from state to state, it will not be the same from one place to another, so ensure that you know what you are getting yourself into. 

Firstly, you need to register your business. You will need a taxpayer ID number to get set up in a majority of states. You could set up as a new business under a single proprietorship with a DBA class or as an LLC class. 

Then you need to get an NPI. All healthcare providers that provide services in Medicare and Medicaid are legally required to get an NPI. 

Now it is time to apply to be a Medicaid NEMT provider. Every state will have their own website for this. The requirements for the application will vary in each state as well. New York only required a legal business entity and the fee, but California has 14 requirements! 

Once you have done your application, have your fleet at the ready. Choose how many vehicles you will start up with. To get an idea of what you need, check with the Medicaid brokers of your state and other providers to see if there are any requirements upon the size of your fleet. 

Do note that NEMT is not paratransit, and you can function without wheelchair-accessible vans. 

Now you need to get commercial insurance. 

You need to ensure you are insured for any liabilities. California is a state that requires workers’ compensation insurance for NEMT. You also need Commercial auto insurance by law as well. 

All that is left after this is to get livery plates, apply for a vehicle license if you need to, apply to the broker for your local Medicaid and find a billing company to aid with reimbursements.