Key facts
From one van to the first trips
- 1
Pick the work
Ambulatory riders only, or wheelchair users too: that decides the van.
- 2
Form and insure the business
Company registration, commercial auto insurance at the limits your broker or contracts require.
- 3
Get credentialed
Medicaid provider enrolment and broker or plan credentialing, per your state.
- 4
Win the first private work
Dialysis and therapy centres, care homes and private-pay families, while credentialing runs.
- 5
Document every trip
Times, addresses, passenger, driver and any signature the payer requires.
Which van should a one-van NEMT business buy?
The one that fits your passengers: an ambulatory minivan if you will carry people who can walk, or a lift- or ramp-equipped van if you will carry wheelchair users, built to the federal accessibility standards where they apply.
Standards and training: how to start a wheelchair transportation business.
How does a one-van provider get Medicaid trips?
Through the state's broker, manager or plans after credentialing. In New York the Department of Health's transportation manager arranges trips, members ask at least 72 hours ahead and every trip is prior-approved, which lets a small provider plan its day.[2]
When should you add a second van?
When standing orders fill the first van's day and you are turning trips away. Before that, use spare hours for private-pay and facility work.
Plan the van's day car by car on the timeline, with repeat appointments as standing orders.
Frequently asked questions
Can one person run a NEMT business?
Yes, as owner-driver, though brokers and contracts will expect cover for sickness and holidays, so plan for a second qualified driver early.
How far ahead are NEMT trips booked?
It varies by state; New York asks members to request transportation at least 72 hours before the appointment.
Sources
Fees and rules change. Each source is the official page we read, with the date we read it; check it before you apply or pay.
- [1] eCFR: 42 CFR 431.53, assurance of transportation (read 3 Nov 2026)
- [2] New York State Department of Health: Medicaid transportation (read 3 Nov 2026)