What Is a NEMT Broker and What Does It Do for Transportation Providers?

What a NEMT broker does

A broker sits between the Medicaid program and the companies that drive the rides. The state or health plan pays the broker to run its non-emergency transportation benefit. The broker then contracts with local transportation providers like you.

Day to day, a broker:

1. Takes ride requests. Members, or someone helping them, call the broker to book. Indiana’s fee-for-service broker, Verida, runs a statewide toll-free scheduling line.
2. Approves each ride. It checks that the member is eligible and the appointment is covered, then issues a trip number. MTM Health’s Virginia handbook says providers may only perform trips MTM has authorized.
3. Picks the type of ride. Federal rules bar a broker from choosing a ride that is not the most appropriate and cost-effective for the member for financial gain. See least costly appropriate transportation.
4. Builds a network. It signs and credentials providers and checks their vehicles and drivers.
5. Assigns trips. It sends each approved trip to a provider in its network.
6. Pays providers. You bill the broker, and it pays you under your contract.
7. Watches quality. It tracks complaints and on-time rates and reviews each provider’s performance.

The federal rules behind NEMT brokers

Congress gave states this option in section 6083 of the Deficit Reduction Act of 2005, which added section 1902(a)(70) to the Social Security Act. CMS explained it to states in letter SMDL #06-009 on March 31, 2006. Before that, a state that covered rides as a medical service needed a section 1915(b) waiver to use a broker.

The rule today is 42 CFR 440.170(a)(4). It lets a state run a brokerage program without the usual Medicaid rules on statewide operation, comparability, and free choice of provider. So a brokerage program can limit which ride companies members may use. In return, the broker must:

• be chosen by competitive bidding, based on its experience, performance, references, resources, qualifications, and costs,
• have procedures to monitor member access and complaints, keep rides on time, and make sure transport staff are licensed, qualified, competent, and courteous,
• be audited regularly by the state, and
• sign a written contract with conflict of interest rules, and pay the full cost of any prohibited referral.

Conflict of interest. The broker, including its owners, investors, officers, and employees, may not give rides itself or send trips to a provider it or an immediate family member has a financial relationship with. There are four exceptions: rural areas with no other qualified provider, rides so specialized that no one else can do them, too few other providers, and government brokers that meet cost and accounting conditions. CMS’s Transportation Coverage Guide (SMD 23-006, September 28, 2023) says a state must document the need with data in a state plan amendment. It also says the state should limit the broker’s own vehicles to trips no network provider can take.

Rules that protect providers and members. Providers may not pay brokers anything, including kickbacks, rebates, cash, gifts, or free services, to get trips. Brokers may not withhold a needed ride. The same 2023 guide says states should make sure a broker does not pay so little that local providers refuse to join.

Rules every provider and driver must meet. Section 1902(a)(87) of the Social Security Act, explained in the 2023 guide, requires at minimum that each provider and driver is not on the OIG exclusion list, each driver has a valid license, and each provider has a process for drug law violations and for sharing drivers’ driving history with the state.

For the full rule in plain English, see federal NEMT broker requirements.

Who hires the broker

Who hires it	Example	What it means for you
The state, for fee-for-service members	Virginia uses MTM Health (handbook approved August 10, 2026). Indiana uses Verida (module published August 19, 2025).	Contract with that broker to get the state’s fee-for-service trips
A Medicaid health plan, for its own members	Blue Cross and Blue Shield of Texas moves its Medicaid rides from Modivcare to MTM Health on October 1, 2026	A plan can switch brokers, so you need a contract with the new broker to keep driving its members
A county, tribal agency, or regional coordinator	In Minnesota, ride companies cannot bill the state directly for curb-to-curb or door-to-door rides. They contract with MTM-MNET, SmartLink, or the local county or tribal agency, which pays them and bills the state (DHS page revised July 31, 2026).	Contract with the coordinator for the counties you serve
No broker	Texas runs its fee-for-service Medical Transportation Program itself. Providers enroll with the state’s claims administrator and bill it directly.	Enroll with the state program instead of a broker
A public agency	SMD 23-006 names regional transportation authorities, state transportation departments, and transit agencies as possible brokers	Special rules apply when a government broker gives rides itself

The state’s fee-for-service broker may cover only part of the program. MTM Health’s Virginia handbook says that, as of July 2024, about 94 percent of Virginia Medicaid members received NEMT through managed care and about 6 percent through fee-for-service. To find who manages rides where you work, see NEMT brokers by state and how states run NEMT.

What working with a broker looks like day to day

Getting in

Brokers credential providers before they send trips. In Indiana, a provider must be enrolled with Indiana Medicaid, sign a provider agreement with Verida, and finish credentialing within 60 days of signing (module version 6.1, policies as of September 1, 2023). See NEMT broker credentialing and NEMT broker contracts.

Getting trips

MTM Health’s Virginia handbook, approved August 10, 2026, lays out a typical trip flow:

When	What happens
First	Standing order trips set to a provider go to that provider automatically
7 days before the appointment	Trips go to eligible providers based on capacity, hours, trip distance, and credentialing status
At least 24 hours before pickup	Deadline to turn back a trip you cannot cover
5 days before	All open trips in your service area show on the trip marketplace
4 to 5 days before	Dispatchers call providers to confirm open trips

Each trip manifest lists a unique trip ID for billing, the member’s name and phone, addresses and times, the ride type and level of assistance, any escort, the member’s weight with equipment, and special instructions. See NEMT broker trip offers.

State rules also shape who gets which trip. Louisiana’s Medicaid manual, in the transportation chapter issued July 14, 2025, tells its brokers to:

• assign the least costly ride that meets the member’s level of service, including free or public transit when possible,
• let the member pick a preferred company when two or more cost the same,
• when several companies meet the least-cost standard, send the trip to one whose main service region is the member’s home region,
• send trips to companies outside that region only with documentation that no willing and available in-region company can meet the time standards, or that the outside company costs least, and
• watch for companies that turn down local trips in favor of long ones. A pattern can lead to fewer trips or other sanctions.

Meeting the standards

The same handbook sets the standards MTM Health measures in Virginia:

Standard	Requirement
First pickup of a scheduled trip	15 minutes before to 15 minutes after the scheduled time
Drop-off	No later than the appointment time
Will-call return	Arrive within 45 minutes of the call
Hospital discharge	Arrive within 3 hours of the call
Shared rides	No more than 45 minutes over the average direct travel time
On-time performance	Above 95 percent
Provider no-shows	Below 0.25 percent

Missing them can lead to an improvement plan, liquidated damages, or removal from the network. See NEMT broker scorecards.

Getting paid

Brokers pay on their own schedules. MTM Health’s Virginia handbook gives providers 6 months from the date of service to submit a clean claim. Each claim needs an electronic trip log with the trip ID, the scheduled and actual pickup times, departure and arrival times, and the member’s signature. The rate comes from the Virginia rate sheet, based on miles, ride type, and shared rides. You have 365 days to appeal a denied claim.

In Indiana, under the module’s policies as of September 1, 2023, Verida pays clean claims submitted by Wednesday within 14 days, by check or electronic funds transfer, with a remittance advice for each cycle. See how to bill NEMT brokers.

Some states set a floor under broker pay. Louisiana’s manual says brokers must pay at least the published fee-for-service rate on the date of service, unless the broker and the provider agree otherwise in the provider agreement. On its fee schedule effective October 1, 2025, a T2003 trip leg is $13.50 plus $1.10 per mile, and a wheelchair van leg (A0130) is $21.50 plus $1.30 per mile. So read the rate section of any agreement before you sign it.

Broker guides on NEMT Guide

To see which broker manages rides in your state, start with NEMT brokers by state. Each guide below covers who the company arranges rides for, how to join its network, and how trips and payment work:

• Alivi
• American Logistics
• Area Agency on Aging of Southeast Arkansas
• Arizona Complete Health
• Bay Cities Brokerage
• Bluegrass Community Action Partnership (BGCAP)
• Call the Car
• CareCar
• Cascades East Transit
• Cascades West Ride Line
• Central Arkansas Development Council
• Central California Alliance for Health
• Community in Motion
• Coordinated Transportation Solutions (CTS)
• Federated Transportation Services of the Bluegrass (FTSB)
• GATRA
• GOBHI Transportation Services
• GRITS (Audubon Area Community Services)
• Health Plan of San Joaquin
• Hopelink
• Inland Empire Health Plan
• Licking Valley Community Action Program (LVCAP)
• LKLP Community Action Council
• MART
• Medical Answering Services (MAS)
• MediDrive
• MediTrans
• Modivcare
• MTM Health
• Northwest Regional Council
• NW Rides
• One Call
• PACS (Pennyrile Allied Community Services)
• Paratransit Services
• Partnership HealthPlan of California
• Penquis
• People for People
• Provide A Ride
• rabbittransit
• ReadyRide (AllCare CCO)
• Ride Health
• Ride to Care
• RideSource
• RTEC (Rural Transit Enterprises Coordinated)
• SafeRide Health
• Sandy Valley Transportation Services (SVTS)
• Sentry
• SmartLink Mobility Management
• Special Mobility Services
• Tennessee Carriers
• Transdev Health Solutions
• TransLink (Rogue Valley Transportation District)
• Upper Peninsula Health Plan
• Ventura Transit System
• Verida
• VPTA (Vermont)
• WellTrans