How to Become a PACS (Pennyrile Allied) Medicaid Transportation Provider in 2027

PACS is Pennyrile Allied Community Services, Inc., a community action agency in Hopkinsville. It formed on July 1, 1974, when the Pennyrile Community Action Agency and the Hopkins-Muhlenberg Community Action Agency, both created in 1966, merged and took in four more counties. The merger lined the agency up with the nine-county Pennyrile Area Development District in western Kentucky, and PACS still serves those nine counties.

As of September 2026, PACS is the Medicaid ride broker for Region 2 of Kentucky’s Human Service Transportation Delivery (HSTD) program. All Medicaid ride requests in those nine counties are booked through PACS, which sends each trip to its own vehicles or to an approved subcontractor. You would sign with PACS, but the state still makes the big calls: the Kentucky Transportation Cabinet (KYTC) approves each subcontractor, licenses its vehicles, and sets the trip rates.

Who PACS is and where it brokers rides

KYTC lists PACS for Region 2 as of September 2026. PACS runs its transportation from two offices, according to its 2025 to 2026 annual report:

Office	Counties	Address and local line
Hopkinsville	Christian, Todd, Trigg	1111 S. Clay Street, Hopkinsville, 270-886-7999
Madisonville	Hopkins, Muhlenberg, Caldwell, Crittenden, Lyon, Livingston	190 Madison Square, Suite D, Madisonville, 270-821-3232
Medicaid transportation	All nine Region 2 counties	1111 S. Clay Street, Hopkinsville, 270-886-6641 or 1-800-467-4601

The counties next door belong to other brokers. McCracken, Marshall, and Calloway in Region 1 and Union, Webster, McLean, and Ohio in Region 3 book through GRITS. Butler and Logan, east of Muhlenberg and Todd, are in Region 5 and book through LKLP. If your garage sits near a line, check which broker covers the counties your riders live in, because a rider books with the broker for the county of residence.

PACS drives more than Medicaid riders

PACS is a carrier as well as a broker, and its vehicles carry other riders alongside Medicaid. These are the other services it lists as of September 2026:

Service	What it is	Price and booking
Hopkinsville Transit	Three deviated fixed routes in Hopkinsville, run with the City of Hopkinsville, weekdays 7 a.m. to 4 p.m.	$2 regular fare, $4 for a stop up to 3/4 mile off route, booked 48 hours ahead at 270-890-6055
Individual rides	Rides for anyone, booked through the local office	$1.25 per mile per person in the region, $1.50 out of the region, $3.75 minimum
Nashville intercity	Weekday runs from the Christian County office to the VA Medical Center, Vanderbilt, the airport, and the bus station, leaving 6 a.m. and returning 3 p.m.	$12.50 one way or $25 round trip, booked 24 hours ahead at 270-886-7999
Veteran rides	Rides to medical appointments for eligible veterans	$1 per mile, $3 minimum, booked 24 hours ahead

How big PACS transportation is

PACS’s 2025 to 2026 annual report lists 79,673 PACS Medicaid trips covering 1,388,155 miles, and separately 47,436 subcontractor trips, over 310 days of service. The same report says PACS bought more than 30 new vehicles and has onboard cameras on about 90% of its fleet. In its unaudited figures, transportation cost $12,481,079 in the fiscal year ending June 30, 2026, or 53% of the agency’s expenses.

How PACS is paid

Kentucky Medicaid pays KYTC a monthly capitation rate for each member, and KYTC passes it to each region’s broker. In a November 5, 2025 briefing to lawmakers, the Region 2 rate was $10.83 per member per month. KYTC’s report for state fiscal year 2023 showed $8.85. That money runs the whole region. What you earn per trip is a separate rate, covered below.

Brokers win their regions through a competitive bid run under KRS Chapter 45A. 603 KAR 7:080 sets each contract at one state fiscal year, July 1 through June 30, renewable four times. The federal waiver that covers the program for April 1, 2025 through March 31, 2027 says each region bids on its own timeline.

How the 72-hour rule shapes PACS trips

A Medicaid rider in Region 2 must call PACS at least 72 hours before the appointment. Weekends and holidays count toward the 72 hours. A rider with a Monday 9 a.m. dialysis chair time has to call by Friday at 9 a.m. The rule comes from Section 14 of 603 KAR 7:080, and PACS repeats it on its Medicaid page.

Kind of trip	Notice the rider gives	When it runs
Regular appointment	At least 72 hours, weekends and holidays counted	Weekdays 6 a.m. to 8 p.m., Saturdays 8 a.m. to 1 p.m.
Urgent care, when the rider must be seen within 12 hours	None, once a clinician confirms it	24 hours a day, 7 days a week, holidays included
Hospital discharge	None	During regular transport hours
Special circumstance	As the broker arranges	After regular hours, at the broker’s discretion

Scheduling, rides, and the office close on New Year’s Day, Memorial Day, July 4, Labor Day, Thanksgiving, and Christmas, except for urgent care. Every broker must keep a paging service after hours for urgent trips.

Who can waive the notice

To skip the 72 hours for urgent care, a physician, physician assistant, advanced practice registered nurse, or qualified mental health professional must confirm the need. They can call, send letterhead with the rider, or fax or email letterhead from their office to PACS. KRS 281.876 fines a broker $1,000, and puts its contract at risk, if it refuses a ride backed by that verification.

What PACS takes down at booking

PACS asks riders for their Medicaid number, the date, time, and place of the appointment, the medical reason for the trip, special needs such as a wheelchair, and who else is riding. The state rule adds the pickup and drop-off addresses, a phone number, and needs such as a child safety seat or a lift. PACS gives the rider a confirmation number, and riders can call their local office to check the pickup time.

What the rule means for your schedule

• Most trips arrive days ahead. You can build routes early, and the rule tells PACS to group riders who need no special vehicle when it can.
• Some trips arrive the same day. Discharges and urgent care come without notice. Ask PACS how it offers them and how fast it expects an answer.
• Riders have duties too. A rider has to be ready 15 minutes before the pickup time and cancel no later than 24 hours before the trip. A rider who does not show gets a letter from the Cabinet, so note every no-show and late cancel on your manifest.
• Trips stay close to home. A ride stays inside the rider’s medical service area: the home county plus every county bordering it. A farther trip needs a referral on the state’s Medicaid Medical Referral Form, good for six months, to the closest provider of that care.

Our guide to hospital discharge transportation covers same-day work in more depth, and advance notice explains how booking windows compare in other states.

Steps to become a PACS subcontractor

KYTC sets one process for every regional broker. The order matters: under 603 KAR 7:080, PACS cannot sign a subcontract with you until the Cabinet approves you, and that approval comes after your state authority and Medicaid numbers are in place.

1. Set up the company. Depending on its form, file with the Kentucky Secretary of State. Get an employer identification number from the IRS and an NPI.
2. Buy insurance and a vehicle. Your insurer files a Form E with the Division of Motor Carriers, and at least one vehicle needs a county clerk plate.
3. Pass inspections and checks. Have an automotive service technician inspect every vehicle. Each driver’s nationwide criminal background check must come from a screening company on the Division’s approved list.
4. Apply for authority. In the Motor Carrier Portal, request a Taxi or Disabled Persons Vehicle (DPV) certificate. Allow up to 14 business days. Motor Carriers then issues a plate and a fee receipt card for each vehicle.
5. Call PACS Medicaid Transportation. Tell the office at 270-886-6641 you hold a certificate and want to subcontract. PACS goes over the subcontract, inspects each vehicle, and keeps copies of your certificate, fee receipt cards, insurance, registrations, and proof of workers’ compensation coverage.
6. Enter the testing pool and train. All of your employees and drivers go into Kentucky’s random drug and alcohol testing pool. Anyone in a safety-sensitive job needs a background check and pre-employment drug and alcohol tests, and drivers take the required training.
7. Enroll with Kentucky Medicaid. Fill in a separate MAP-811 for every service type you want. Sign each one and give it to PACS, which signs page 12 as the broker and hands it back. Then upload the application in the Kentucky Medicaid Partner Portal (KY MPPA), along with the signed page 12, your certificate, and the IRS letter with your EIN printed on it. Medicaid will not take a W-9 instead.
8. Give PACS your welcome letters. Each approved type comes with a welcome letter carrying your Medicaid provider number. PACS sends your file to the Office of Transportation Delivery, the Cabinet approves the subcontract, and PACS holds your orientation before your first trip.

The state’s floor for a new provider is three approved drivers who are active in the program and three passenger vehicles in running order. Kentucky Medicaid charges transportation providers (type 56) no enrollment fee. The federal fee, $750 in 2026, applies to other types, such as ambulance suppliers and hospitals.

Operating authority and its costs

Certificate	Vehicles it covers	Costs as of September 2026
Taxi	Up to 8 regular seats, for riders who need no lift or ramp	$250 to apply, $250 each year to renew, $30 per vehicle each year
Disabled Persons Vehicle	Must be ADA accessible with a built-in lift or ramp; 15 regular seats at most; riders who walk may ride too	$250 to apply, $250 each year to renew, $30 per vehicle each year

A city or county may add its own vehicle license of up to $30 a year (KRS 281.631). Background checks are redone for each driver every 3 years. Miss a renewal by more than a calendar year and the certificate becomes void.

Insurance minimums

KRS 281.655 sets these per-vehicle minimums as of September 2026, and PACS also needs proof of Kentucky workers’ compensation coverage:

Regular seats in the vehicle	Each injured person	All injured people, one accident	Property damage
7 or fewer	$100,000	$300,000	$50,000
8 or more	$100,000	$600,000	$50,000

Ask PACS whether its subcontract asks for more. The NEMT insurance requirements guide explains each coverage.

Which Medicaid numbers to request

On each MAP-811, box 7 takes provider type 56 and box 8 takes the specialty code from this table. A for-profit company can apply for up to three numbers, Types 02, 07, and 08, and a nonprofit for 04, 07, and 08.

Type	Riders	Specialty code
02	Walk and need no special help, for-profit carrier	263
04	Walk and need no special help, nonprofit bus	262
07	Walk but are disoriented and may need an escort	264
08	Use a wheelchair	265

Driver and vehicle rules PACS must enforce

PACS has to pull any vehicle that fails licensing, authority, or safety rules from service at once. These standards come from 603 KAR 7:080 as of September 2026.

Drivers and escorts

Each driver or escort on a PACS trip must:

• Be 18 or older and hold a Kentucky license for the vehicle they drive.
• Have no more than two moving violation convictions in the last three years.
• Have no conviction for a sexual or violent crime.
• Pass a pre-employment drug test and stay in random drug and alcohol testing.
• Finish first aid, bloodborne pathogens, and passenger assistance training, plus intellectual or developmental disability awareness training when the Cabinet offers it.
• Wear a name tag and carry a company photo ID, which the broker must require of every subcontractor’s drivers.

Anyone convicted of a misdemeanor or felony in the last five years may drive or escort only after PACS, your company, and the Cabinet all approve. See NEMT driver drug testing for how a random pool works.

What every vehicle carries

Item	What the rule asks
Seat belts	Working and clean for every seat, stored off the floor, plus two seat belt extensions
Safety tools	A seat belt cutter above the driver’s door, a working fire extinguisher with a current inspection tag, and three triangle reflectors on stands
First aid and spill kits	A full first aid kit, and a spill kit with absorbent, latex gloves, waste bags, a scrub brush, and disinfectant
Step	A retractable step or an 8 1/4 inch metal step stool with four nonskid legs when the floor is over 12 inches high
Signs outside	Your legal company name on the driver and passenger side doors in 2-inch block letters
Signs inside	Your name, the vehicle number, and the customer service number, plus “No Smoking, Eating or Drinking” and “All passengers shall use seat belts”
Cab	Heat and air conditioning that work, two outside mirrors, an inside mirror, a working speedometer and odometer, and maps or GPS
Paperwork	Registration, insurance card, vehicle card, and accident forms in the driver’s area
Contact	A way for dispatch and the driver to reach each other, used in line with HIPAA

Vehicles that fall outside 601 KAR 1:005, the regulation that applies federal motor carrier safety rules in Kentucky, need a yearly inspection by an automotive technician, and written proof of a passed inspection before they carry a rider. Our vehicle inspection checklist follows most of these items.

How PACS pays you

KYTC, not PACS, decides what each trip pays. Every provider in Region 2 gets the same rate for the same service type, and that includes PACS’s own vehicles. By regulation, the rate reflects terrain, trip distance, the number of riders, nearby medical and job sites, labor and economic conditions, and how much the service is used. Brokers get 45 days’ warning before a rate change. KYTC’s state fiscal year 2023 report says Region 2’s rates changed on May 1, 2023, and that rates are open to quarterly review.

Step	Deadline
You send PACS a valid invoice	By the 1st of the month. A later invoice rolls to the next month
PACS reports to KYTC	By the 7th
KYTC pays PACS	By the 15th, once all reports are in
PACS pays you	No later than 3 business days after KYTC pays PACS (KRS 281.875)
Billing cutoff	6 months from the date of service

PACS reports every trip to the Cabinet with the amount paid for each one-way leg. Keep encounter data, trip invoices, and your other program records for five years, and report any moving violation or accident on a trip to PACS right away. Clean trip documentation is what protects that pay in an audit.

How PACS decides who gets a trip

KRS 281.874 lets Type 07 and Type 08 riders pick any eligible subcontractor in the region, or PACS itself. They still call PACS to book, even when they name your company. PACS may offer the same choice to Type 02 riders.

When a rider names no one, 603 KAR 7:080 sets the order PACS uses: coordination with other trips first, then cost, and if neither decides it, rotation of Type 07 and 08 trips among all providers, PACS included. The rider’s own clinician sets whether they ride as Type 07 or 08, and PACS cannot change it.

Once a trip is yours, you run it; it cannot be passed to another provider. Subcontractors also stay out of deciding who qualifies or what kind of vehicle a rider needs, and they may never solicit Medicaid trips.

What House Bill 2 changes in Region 2

Kentucky’s House Bill 2 became 2026 Acts Chapter 179 on April 14, 2026, when lawmakers overrode the governor’s line-item vetoes. Section 14 applies to PACS like every other regional broker:

• GPS. Every vehicle on Medicaid rides needs a GPS device that shows the broker where it is during trips, paid for by the broker. Ask PACS which device it will use. See GPS tracking for NEMT.
• Performance pay. The state withholds 2% of each broker’s capitation, which the broker can earn back in full or in part by hitting targets such as trips completed, delayed, or canceled, average trip time and miles, and rider satisfaction.
• Spending floor. Brokers must spend at least 85% of capitation on services for the state fiscal year starting July 1, 2026, and the floor climbs to 90% from July 1, 2029.
• Facility rides. Hospitals and skilled nursing facilities may drive their own patients and residents, paid by the broker at the mileage rate it pays a contracted driver.

Our House Bill 2 report covers the rest of the law.

Who to call

For	Contact
PACS Medicaid Transportation (subcontracts, MAP-811 signature)	270-886-6641, 1111 S. Clay Street, Hopkinsville, KY 42240
PACS Medicaid ride booking	1-800-467-4601
PACS main office	270-886-6341 or 800-264-0643, 1100 S. Liberty Street, P.O. Box 549, Hopkinsville, KY 42241
PACS local transportation, Christian, Todd, Trigg	270-886-7999
PACS local transportation, Hopkins, Muhlenberg, Caldwell, Crittenden, Lyon, Livingston	270-821-3232
Division of Motor Carriers, for Taxi or DPV authority	502-564-1257
Office of Transportation Delivery, for program rules	502-564-7433, 8 a.m. to 4:30 p.m. Eastern on weekdays
State HSTD hotline, for complaints and denials	888-941-7433
KY MPPA contact center, for Medicaid enrollment	877-838-5085

Before your first call to PACS, gather your certificate, vehicle list, insurance declarations, and driver roster; the credentialing checklist keeps them together. The Kentucky state guide covers the statewide program, and FTSB shows how the broker for Louisville, Lexington, and Northern Kentucky works.