# How to Become an FTSB Medicaid Transportation Provider in 2027

Canonical URL: https://nemtguide.com/brokers/ftsb/ · Updated 2026-09-29

To become an FTSB Medicaid transportation provider, form your company, get Taxi or Disabled Persons Vehicle authority from Kentucky's Division of Motor Carriers, and call FTSB at 859-233-0066 to subcontract. FTSB reviews the contract with you, inspects your vehicles, collects your insurance, and signs your Kentucky Medicaid application. As of September 2026, it brokers Medicaid rides in 24 counties, including Louisville, Lexington, and Northern Kentucky.

- FTSB is the Kentucky Medicaid ride broker for Regions 6, 9, 10, and 11: 24 counties around Louisville, Northern Kentucky, and Lexington.
- You need Taxi or Disabled Persons Vehicle authority from the Division of Motor Carriers before FTSB can subcontract with you.
- Every new provider keeps at least three approved drivers and three working vehicles in the program.
- The Transportation Cabinet, not FTSB, sets the rate for each service type, and FTSB must pay you within 3 business days of being paid.
- House Bill 2 of 2026 requires a GPS device in every vehicle on Medicaid trips, paid for by the broker.

FTSB, short for Federated Transportation Services of the Bluegrass, Inc., is a Lexington nonprofit incorporated in 1981. It runs public transit in Bourbon, Harrison, Nicholas, Lewis, and Rowan counties, and it is the Medicaid ride broker for 24 counties in Kentucky's Human Service Transportation Delivery (HSTD) program. FTSB takes every Medicaid ride request in those counties and sends each trip to its own vehicles, which it has run since 2005, or to a subcontracted transportation company.

For Medicaid broker trips in those 24 counties, FTSB is the only broker. Your contract is with FTSB, not with the Commonwealth, but the Kentucky Transportation Cabinet reviews your subcontract, inspects vehicles, and sets your rates.

## Which counties and riders FTSB serves

Kentucky's Department for Medicaid Services (DMS) pays the Kentucky Transportation Cabinet (KYTC) a monthly [capitation](https://nemtguide.com/glossary/capitation/) rate for each Medicaid member. KYTC's Office of Transportation Delivery contracts one broker in each of 15 regions, and the rate is paid out to each region's broker every month for the members assigned to it. As of September 2026, KYTC lists FTSB for four regions.

| Region | Counties | FTSB broker since | Broker's monthly rate per member (Nov. 2025) |
|---|---|---|---|
| 6 | Bullitt, Henry, Jefferson (Louisville), Oldham, Shelby, Spencer, Trimble | 2008 | $11.50 |
| 9 | Boone, Campbell, Carroll, Gallatin, Grant, Kenton, Owen, Pendleton | 2017 | $8.74 |
| 10 | Fayette (Lexington) | 1998 | $7.76 |
| 11 | Bourbon, Clark, Estill, Harrison, Madison, Montgomery, Nicholas, Powell | 2013 | $6.88 |

The start years come from FTSB's own history. The monthly rates are the ones DMS and KYTC showed lawmakers on November 5, 2025. They are what the region's broker receives per member, not what a provider earns per trip. KYTC sets provider rates separately, as explained below.

KYTC picks each region's broker by request for proposals under KRS Chapter 45A. Under 603 KAR 7:080, each broker contract runs one year, July 1 to June 30, with four one-year renewal options, and Kentucky's waiver application says each region follows its own bidding timeline. When one company holds regions that touch, KYTC runs them as one region for operations and monitoring, and the broker must keep an operating office inside its area.

### Which riders qualify

A member qualifies when the trip goes to or from a medically necessary, Medicaid-covered service and the member has no vehicle. A member who owns one still qualifies with a note from a clinician, employer, school, mechanic, or transportation authority saying the vehicle does not run or cannot be used (907 KAR 3:066). Qualified Medicare Beneficiaries (QMB) and KCHIP Phase III children are excluded. Rides stay within the member's county and the counties that touch it, unless a clinician's referral on the state's Medical Referral Form is on file. The [Kentucky state guide](https://nemtguide.com/states/kentucky/) covers eligibility in detail.

The program also carries some riders who are not on Medicaid NEMT. 603 KAR 7:080 includes Kentucky Works Program (TANF) participants going to jobs, job interviews, training, and child care, plus vocational rehabilitation and aging services riders.

### Stretcher rides are separate

Nonemergency ambulance stretcher rides are not part of the broker program. Kentucky's 1915(b) waiver renewal, for April 1, 2025 through March 31, 2027, says members in a Medicaid health plan get stretcher rides through the plan and other members through fee-for-service Medicaid. FTSB will not send you stretcher trips. See [how to start a stretcher transportation business](https://nemtguide.com/guides/start-a-stretcher-transportation-business/).

## How to become an FTSB subcontractor

KYTC publishes the steps every regional broker follows. As of September 2026, they are:

1. **Form your company.** Depending on how you set it up (LLC, corporation, or sole proprietor), you may need to file with the Kentucky Secretary of State.
2. **Get operating authority.** Call the Division of Motor Carriers at 502-564-1257 and ask for a Taxi or a Disabled Persons Vehicle (DPV) application. Under DPV authority every vehicle must have a wheelchair lift or ramp, though it can still carry riders who walk. Your insurer files a Form E with Motor Carriers before you apply, and you need at least one vehicle with a county clerk plate, technician inspections, and nationwide background checks done first. Allow up to 14 business days.
3. **Qualify each vehicle.** Motor Carriers issues a license plate and a fee receipt card for every vehicle.
4. **Call FTSB.** Tell FTSB you hold a certificate and want to subcontract for its counties. FTSB schedules a time to review the contract, inspect your vehicles, and copy your insurance, registrations, workers' compensation proof, certificate, and fee receipt cards.
5. **Set up testing and training.** Every employee and driver goes into a statewide random drug and alcohol pool. Safety-sensitive staff pass background checks and pre-employment drug and alcohol tests, and drivers finish the minimum training. FTSB walks you through it.
6. **Apply for Kentucky Medicaid numbers.** Print a MAP-811 for each service type, sign it, and give it to FTSB for the broker signature. FTSB returns it, and you submit it in the Kentucky Medicaid Partner Portal (KY MPPA) with the broker signature page and your operating certificate.
7. **Send FTSB your welcome letters.** Each approved service type gets a welcome letter with its Medicaid provider number. FTSB forwards your file to the Office of Transportation Delivery and is told when you are in the system and can start.
8. **Go to orientation.** 603 KAR 7:080 requires the broker to hold an orientation meeting with you before your first trip.

KYTC requires every new provider to keep at least three active, approved drivers in the program and three operational passenger vehicles in its fleet. A subcontractor also cannot sign with a broker until the Cabinet approves it.

### Fees for your operating authority

| Item | Cost as of September 2026 | Law |
|---|---|---|
| Taxi or DPV certificate application | $250 | KRS 281.630 |
| Certificate renewal, every year | $250 | KRS 281.630 |
| Motor carrier vehicle license, per taxi or DPV, every year | $30 | KRS 281.631 |
| City or county license, if charged | Up to $30 per vehicle a year | KRS 281.631 |

A certificate not renewed within one calendar year of its renewal date is void.

### Service types and Medicaid numbers

You enroll with Kentucky Medicaid once for each type of rider you will carry. Enter provider type 56 in box 7 of the MAP-811 and the specialty code in box 8.

| Type | Who rides | Specialty code | Who applies |
|---|---|---|---|
| 02 | Riders who walk and need no special help | 263 | For-profit companies |
| 04 | Riders who walk and need no special help (ambulatory bus) | 262 | Nonprofits |
| 07 | Riders who walk but are disoriented and may need an escort | 264 | For-profit and nonprofit |
| 08 | Wheelchair riders | 265 | For-profit and nonprofit |

The MAP-811 checklist also asks for proof of your [NPI and taxonomy code](https://nemtguide.com/guides/how-to-get-an-npi-number-for-nemt/) and your IRS letter showing your employer identification number. Any rides you give Kentucky Medicaid members before your enrollment effective date are at your own financial risk.

### What FTSB keeps on file

603 KAR 7:080 lists the papers a subcontractor gives the broker and what the contract must contain.

| You give FTSB | The subcontract includes |
|---|---|
| Your operating authority | Payment terms under KRS 281.875 |
| Proof of vehicle liability insurance and Kentucky workers' compensation | Hours of operation and scheduling rules |
| A copy of your agreement with FTSB | The rates for services |
| Every vehicle lease | Pickup and delivery standards |
| Your Medicaid enrollment letter | How long the contract runs, the termination clause, and penalties |
| | Signed HIPAA confidentiality statements for your employees |
| | A current list of your safety-sensitive staff |

Build your file with the [NEMT credentialing checklist](https://nemtguide.com/templates/nemt-credentialing-checklist/) before you call.

## What Kentucky requires from drivers, vehicles, and insurance

### Drivers

Under 603 KAR 7:080 and KRS 281.6301, your drivers must meet these standards. The 603 KAR 7:080 rules cover escorts too.

| Rule | Standard |
|---|---|
| Age and license | At least 18, licensed in Kentucky for the vehicle they drive |
| Moving violations | No more than two convictions in the last 3 years |
| Crimes that bar a driver | Any sexual crime or crime of violence, or a Class A or B felony |
| Driving crimes that bar a driver | Leaving the scene of an accident, causing a death by negligent driving, or using a vehicle in a drug felony |
| Recent driving crimes | In the last 3 years, no conviction for driving on a suspended license, going 26 mph or more over the limit, or racing, and no more than three speeding or points convictions |
| Other convictions | Any misdemeanor or felony in the last 5 years needs approval from the broker, your company, and the Cabinet |
| Drug testing | A pre-employment drug test, then random testing |
| Training | Orientation and safety training, including first aid, bloodborne pathogens, and passenger assistance |
| Identification | A name tag and a company photo ID |

Your company runs each nationwide background check through a company on the Division of Motor Carriers' approved list, before the person starts, and keeps it at least 3 years. You also need a written drug and alcohol policy. Start from our [drug and alcohol policy template](https://nemtguide.com/templates/nemt-drug-and-alcohol-policy/) and keep each driver's papers in a [driver file](https://nemtguide.com/templates/nemt-driver-file-checklist/).

### Vehicles

Each vehicle passes a safety inspection by an automotive technician before its first HSTD rider and every year after, and you keep written proof. Vehicles covered by 601 KAR 1:005, Kentucky's adoption of the federal motor carrier safety rules, follow those rules instead. Under 603 KAR 7:080, each vehicle also needs:

- A two-way communication system with dispatch, used in a way that keeps rider information private under HIPAA.
- Working heat and air conditioning. A vehicle without it is out of service until fixed.
- A clean, working seat belt for every seat, stored off the floor, two seat belt extensions, and a seat belt cutter above the driver's door.
- Child safety seats as state law requires. FTSB requires federally approved seats and an adult with every child 12 or younger.
- A fire extinguisher with a current tag, three reflective triangles, a first aid kit, and a spill kit.
- A step or metal step stool when the floor is more than 12 inches up. A milk crate never counts.
- Your legal company name on the driver and passenger doors in 2-inch block letters, and inside, your name, vehicle number, and the program's customer service number.
- "No Smoking, Eating or Drinking" and "All passengers shall use seat belts" signs.
- A packet with the registration, insurance card, vehicle card, and accident forms, plus maps or a GPS unit.

Wheelchair vehicles must meet the ADA specifications in 49 CFR part 38. FTSB's rider rules say every wheelchair is strapped down, and a rider who refuses securement is not carried. Prepare with the [vehicle inspection checklist](https://nemtguide.com/templates/nemt-vehicle-inspection-checklist/) and our [wheelchair securement guide](https://nemtguide.com/guides/wheelchair-securement/).

### Insurance

Your insurer files proof with the Division of Motor Carriers, and the policy must cover every vehicle you run under your certificate. KRS 281.655 sets these minimums per vehicle as of September 2026:

| Vehicle | Injury or death, one person | Injury or death, all people | Property damage |
|---|---|---|---|
| Up to 7 regular seats | $100,000 | $300,000 | $50,000 |
| 8 or more regular seats | $100,000 | $600,000 | $50,000 |

FTSB also collects proof of Kentucky workers' compensation coverage. Ask FTSB which limits and certificate wording its subcontract needs before you buy a policy. See [NEMT insurance requirements](https://nemtguide.com/guides/nemt-insurance-requirements/) for how each policy works.

## How FTSB sends trips and pays you

### The booking rules riders follow

Members call FTSB at 888-848-0989. These rules come from 603 KAR 7:080.

| Rule | Standard |
|---|---|
| Notice | At least 72 hours before the appointment, weekends and holidays included |
| Reservation hours | 8 a.m. to 4:30 p.m. weekdays, 8 a.m. to 1 p.m. Saturday |
| Ride hours | 6 a.m. to 8 p.m. weekdays, 8 a.m. to 1 p.m. Saturday |
| Closed | New Year's Day, Memorial Day, July 4, Labor Day, Thanksgiving, Christmas |
| Urgent care | 24 hours a day, for a member who must be seen within 12 hours, verified by the member's clinician |
| Hospital discharges | During ride hours, with no 72-hour notice |
| After-hours treatment | The broker may schedule dialysis, chemotherapy, or radiation outside normal hours |
| Rider readiness | Ready at least 15 minutes before the scheduled pickup |
| Rider cancellations | At least 24 hours ahead, unless there is an emergency |

### How FTSB assigns trips

Riders classified as Type 08 (wheelchair) or Type 07 (walks but may need an escort) may pick any eligible subcontractor in the region, or FTSB itself, and they still book through FTSB (KRS 281.874). When a rider has no preference, 603 KAR 7:080 tells the broker to assign trips by coordination first, then cost, and then by rotating Type 07 and 08 trips among providers, the broker included. Riders who walk can be grouped with others, or sent by taxi, bus, or private auto.

Once a trip is yours, you drive it. A subcontractor may not hand a trip to another provider, decide a rider's eligibility or type of transport, or solicit Medicaid trips.

### Rates and the payment calendar

KYTC sets one rate for each service type in each region, the same for every provider there, FTSB included. It weighs terrain, trip distance, population, medical and job sites, labor costs, and use of services, and it gives brokers 45 days of notice before a change. Its fiscal year 2023 report says subcontractor rates are reviewed each quarter and can change during the year. Your subcontract lists the current rates.

| Step | Deadline |
|---|---|
| Your invoice to FTSB | Dated by the first of the month to make that month's billing. Later invoices roll to the next month |
| FTSB's reports to the Cabinet | By the 7th of the month |
| The Cabinet pays FTSB | By the 15th, when the reports are in |
| FTSB pays you | Within 3 business days of being paid (KRS 281.875) |
| Your last chance to bill a trip | 6 months after the date of service |

For example, an invoice dated April 1 goes into April's billing. If the Cabinet pays FTSB on April 15, FTSB owes you payment within 3 business days after that. See [how to bill NEMT brokers](https://nemtguide.com/guides/how-to-bill-nemt-brokers/) for keeping invoices clean.

### Records and reports

- Report any moving violation or traffic accident on a trip to FTSB right away. The broker reports it to the Cabinet within 24 hours.
- Report any allegation of Medicaid fraud or criminal wrongdoing in the program to the Transportation Cabinet at once.
- Keep encounter data for every trip and all program records for 5 years.
- Have every employee sign a confidentiality statement.

Good [trip documentation](https://nemtguide.com/guides/nemt-trip-documentation/) protects you in an audit.

## What House Bill 2 changes for FTSB providers

Kentucky's HB 2 became Acts Chapter 179 on April 14, 2026, when the General Assembly overrode the governor's line-item vetoes. Section 14 changes how regional brokers such as FTSB work:

- **GPS in every vehicle.** Each vehicle used for Medicaid rides needs a GPS device that shows the broker its exact location during NEMT trips. The broker pays for it, not the state.
- **Performance pay.** 2% of each broker's capitation is held back and earned back on measures that include trips completed, trips canceled or rescheduled, delayed trips, average trip time and miles, time to schedule, and rider satisfaction.
- **Spending floors.** Brokers must reach a medical loss ratio of at least 85% in the state fiscal year that began July 1, 2026, rising each year to 90% from July 1, 2029, and pay back any excess capitation if they miss it.
- **Hospital and nursing facility rides.** A hospital or skilled nursing facility may drive its own patients or residents and be paid by the regional broker at the mileage rate the broker pays a contracted driver.

Ask FTSB which GPS device it will use and when it plans to install it. Our [HB 2 report](https://nemtguide.com/news/kentucky-hb2-nemt-changes/) covers the full law.

## Who to call at FTSB and the state

| For | Contact |
|---|---|
| FTSB main office | 859-233-0066, fax 859-233-1668, info@ftsb.org, weekdays 8 a.m. to 5 p.m. |
| FTSB reservations (riders) | 888-848-0989 |
| FTSB TDD | 800-648-6056 |
| FTSB mailing address | 1713 Jaggie Fox Way, Lexington, KY 40511 |
| Operating authority (Division of Motor Carriers) | 502-564-1257 |
| HSTD program questions (Office of Transportation Delivery) | 502-564-7433, weekdays 8 a.m. to 4:30 p.m. |
| HSTD customer service and complaints | 888-941-7433 |
| Kentucky Medicaid enrollment (KY MPPA contact center) | 877-838-5085 |

FTSB also runs a Providers Portal login, linked from ftsb.org. Before you call, have your certificate, vehicle list, insurance declarations, and driver roster ready, and ask which counties and service types FTSB needs most. To compare Kentucky's regional model with statewide brokers elsewhere, see [how states run NEMT](https://nemtguide.com/guides/how-states-run-nemt/).

## Frequently asked questions

### Which counties does FTSB cover for Medicaid rides?

As of September 2026, the Kentucky Transportation Cabinet lists FTSB as the broker for four regions. Region 6 is Bullitt, Henry, Jefferson, Oldham, Shelby, Spencer, and Trimble. Region 9 is Boone, Campbell, Carroll, Gallatin, Grant, Kenton, Owen, and Pendleton. Region 10 is Fayette. Region 11 is Bourbon, Clark, Estill, Harrison, Madison, Montgomery, Nicholas, and Powell.

### Do I need a Kentucky Medicaid provider number to drive for FTSB?

Yes. You file a MAP-811 application for each service type you will run, under provider type 56, and FTSB signs it before you submit it in the Kentucky Medicaid Partner Portal (KY MPPA). A for-profit company applies for Types 02, 07, and 08, and a nonprofit for Types 04, 07, and 08. Your subcontract cannot start until the Transportation Cabinet approves you.

### How much does FTSB pay per trip?

The Kentucky Transportation Cabinet sets the rate, not FTSB. Under 603 KAR 7:080, the Cabinet sets a rate for each service type in each region, the same for every provider there, FTSB included. It weighs terrain, trip distance, population, medical and job sites, labor costs, and use of services, and gives brokers 45 days of notice before a change. Your subcontract lists the rates.

### How fast does FTSB pay?

Kentucky law requires a broker to pay subcontractors within 3 business days after the Cabinet pays the broker. The Cabinet pays brokers by the 15th of each month when their reports arrive by the 7th. An invoice dated after the first of the month goes into the next month's billing, and every invoice must reach FTSB within 6 months of the trip.

### Can I do stretcher trips for FTSB?

Not through the broker program. Kentucky's NEMT waiver and 603 KAR 7:080 leave nonemergency ambulance stretcher rides out of it. Members in a Medicaid health plan get stretcher rides through the plan, and other members through fee-for-service Medicaid, as nonemergency ambulance service.

### Can a Medicaid rider ask for my company by name?

Yes, if the rider is classified as Type 08 (wheelchair) or Type 07 (walks but may need an escort). Kentucky law lets those riders choose any eligible subcontractor in the region or FTSB itself, and they still book through FTSB. When a rider has no preference, FTSB assigns trips by coordination, then cost, then by rotating Type 07 and 08 trips among providers, FTSB included. You may never solicit Medicaid riders.

### What does House Bill 2 change for FTSB providers?

HB 2 became law on April 14, 2026. It requires a GPS device in every vehicle used for Medicaid rides, with the broker paying the cost, and it holds back 2% of each broker's capitation until the broker meets measures such as completed, canceled, and delayed trips. It also lets hospitals and skilled nursing facilities drive their own patients and be paid by the broker.

## Official resources

- [KYTC: How to become a subcontract NEMT provider](https://transportation.ky.gov/TransportationDelivery/Pages/Non-Emergency-Medical-Transportation-Provider.aspx)
- [KYTC: Regional brokers and the counties they serve](https://transportation.ky.gov/TransportationDelivery/Pages/Human-Services-Transportation.aspx)
- [FTSB: Medicaid Transportation](https://www.ftsb.org/medicaid-transportation)
- [Kentucky Division of Motor Carriers: Passenger vehicle certificates](https://drive.ky.gov/Motor-Carriers/Pages/Passenger-Vehicle.aspx)
- [Kentucky Medicaid: MAP-811 Provider Application](https://chfs.ky.gov/agencies/dms/MAPForms/Map811.pdf)
- [Kentucky Medicaid Partner Portal (KY MPPA)](https://medicaidsystems.ky.gov/Partnerportal/home.aspx)
- [Kentucky Administrative Regulations: 603 KAR 7:080](https://apps.legislature.ky.gov/law/kar/titles/603/007/080/)
- [HHS OIG: List of Excluded Individuals and Entities](https://oig.hhs.gov/exclusions/)