NEMT Driver Pay in California in 2027: Metro Wages, City Minimums, and the Health Care Wage Rule

In California the pay floor changes by city, and some of the employers you compete with for drivers may pay under a different state wage law than you do. This guide gives the federal pay data by metro area first, then the minimum wages in 2026 and 2027, then the California health care wage rule and where it stops. For how the federal numbers work and the pay plans behind them, see NEMT driver pay.

What NEMT drivers earn in California

The federal Bureau of Labor Statistics counts NEMT drivers as shuttle drivers and chauffeurs (53-3053), a group whose definition names nonemergency medical transporters. In May 2025, the latest survey, California had 29,940 of them. The median was $21.50 an hour, the bottom 10 percent earned under $16.94, and the top 10 percent earned over $29.69. The survey counts employees only and leaves out overtime and benefits.

Pay differs a lot by metro area. This table shows the same group in 11 California metros, highest median first.

Metro area	Drivers employed	Bottom 10% earn under	Median
San Jose	1,140	$19.65	$24.06
Modesto	310	$16.97	$23.45
San Francisco and Oakland	4,540	$19.39	$23.26
Oxnard and Ventura	540	$17.29	$21.94
Los Angeles area	11,590	$17.06	$21.37
San Diego	2,350	$16.95	$21.00
Sacramento	1,690	$16.50	$20.87
Stockton	360	$16.50	$20.64
Fresno	710	$16.50	$18.58
Riverside and San Bernardino	1,930	$16.50	$18.28
Bakersfield	460	$16.50	$17.91

Two things stand out. In five of these metros the bottom 10 percent earned exactly $16.50, which was the state minimum wage in 2025, so pay at the low end sits at the legal floor. And the Central Valley and Inland Empire medians sit close to the 2027 floor: Bakersfield’s $17.91 is 51 cents above $17.40, and Riverside and San Bernardino’s $18.28 is 88 cents above it. Any driver paid under $17.40 on January 1, 2027 needs a raise, and so do the drivers just above them if you want to keep a pay ladder between new hires and experienced drivers.

California and city minimum wages for 2027

The California minimum wage is $16.90 an hour for all employers in 2026. It rises to $17.40 on January 1, 2027. The Department of Finance certified the increase on July 31, 2026, and the Labor Commissioner’s Office reminded employers of it on August 13, 2026.

Many cities and counties set a higher rate, and the state says employers must pay the higher local rate where one applies. These are the local rates in the metro areas above that set their own.

City or county	Minimum wage	In effect since	Next change
San Francisco	$19.61	July 1, 2026	Each July 1
Los Angeles County, unincorporated areas	$18.47	July 1, 2026	Each July 1
San Jose	$18.45	January 1, 2026	Check the city
City of Los Angeles	$18.42	July 1, 2026	Check the city
San Diego	$17.75	January 1, 2026	$18.35 on January 1, 2027
State of California	$16.90	January 1, 2026	$17.40 on January 1, 2027

San Francisco’s office lists its rate as effective July 1, 2026 through June 30, 2027, and Los Angeles County’s notice covers fiscal year 2026-27. The City of Los Angeles and San Jose rates come from the UC Berkeley Labor Center’s list of local minimum wages, which the state Labor Commissioner’s Office links for employers. Read the rate on each city’s own page before you set pay.

A city rate follows the work, not your office. San Diego’s ordinance covers an employee who works at least two hours in a calendar week inside the city and applies to each hour worked there, and San Francisco’s applies to employees performing work in San Francisco. A van that picks up in one city and drops off in another takes a different minimum for each part of the day. Record each driver’s hours by city, for example in a column added to the driver timesheet, and pay each hour at the highest minimum that covers it.

For per-trip and day-rate pay, the weekly minimum wage test in NEMT driver pay applies with the highest minimum that covers the hours. That guide also covers California’s separate pay for rest periods under piece-rate pay, and NEMT driver overtime covers daily overtime.

The $25 health care minimum and your drivers

California has a second, higher minimum wage for health care workers. Under Labor Code section 1182.14, a covered health care employee is an employee of a covered facility who provides patient care, health care services, or services supporting the provision of health care. Covered facilities include general acute care hospitals, dialysis clinics, community and rural clinics, urgent care clinics, and physician groups of 25 or more physicians. The main schedules below come from the Labor Commissioner’s Office FAQ dated June 2025. Facilities run by counties follow their own schedules.

Covered employer	Minimum from July 1, 2026	Next change
Health systems with 10,000 or more full-time employees, and dialysis clinics	$25.00	Inflation adjustment from January 1, 2028
Safety net hospitals	$19.28	$19.95 on July 1, 2027
Community, rural, and associated urgent care clinics	$22.00	$25.00 on July 1, 2027
All other covered facilities	$23.00	$25.00 on July 1, 2028

The law leaves out medical transportation by outside companies. It excludes medical transportation services in or out of a covered facility when the worker is not an employee of any person that owns, controls, or operates a covered facility (section 1182.14(b)(2)(C)(iv)). Two results follow:

• Your drivers are not covered. A NEMT company’s drivers stay on the state or city minimum even when they spend the day at a hospital’s or clinic’s door, because they do not work for the facility’s owner or operator.
• A facility’s own drivers are not excluded. The exclusion stops at the payroll of a facility’s owner or operator. A driver employed by a hospital, a health system, or a dialysis operator is not excluded, so the schedule above may apply to that driver when the work is patient care or supports it.

The difference is large for any driver this reaches. A dialysis operator’s covered employees must be paid at least $25 an hour from July 1, 2026, which is $3.50 above California’s $21.50 median for the group and $7.60 above the 2027 state minimum.

If a hospital or health system owns your NEMT company, or shares owners with it, do not assume the exclusion applies. The text asks whether the worker is an employee of a person that owns, controls, or operates a covered facility. Ask the Labor Commissioner’s Office at 833-526-4636, or an employment lawyer, how the law treats your drivers.

What else California adds to a driver’s cost

• Expense repayment. Labor Code section 2802 requires an employer to repay an employee for all necessary expenditures or losses incurred in direct consequence of the job. A personal phone or car you require a driver to use for work is the kind of expense it reaches. The statute sets no mileage figure, so write a policy and keep records of what you repay. The phone side is in NEMT driver phone policy.
• Posting and pay stubs. The Labor Commissioner’s Office says employers must post the statewide minimum wage order and the wage order for their industry, and must list wage rates on pay stubs.
• What you are paid per trip. Wages come out of what plans and brokers pay per trip, and your contract sets that rate. The fee-for-service maximums are in how to start a NEMT business in California.

What to do before January 1, 2027

1. Raise any rate under $17.40. Check every hourly rate, and recompute weekly pay for per-trip and day-rate drivers against the new floor. Bakersfield, Fresno, and Inland Empire companies have the least room.
2. Map each driver’s hours by city. Use the highest minimum that covers each hour, and read each city’s page for its next change.
3. Check your postings and pay stubs. The statewide minimum wage order and your industry’s wage order must be posted, and pay stubs must list each wage rate. The Department of Industrial Relations hosts the notices on its workplace postings page.
4. Know the $25 benchmark. If a hospital, health system, or dialysis operator in your area hires its own drivers, the health care minimum may set its pay, and your applicants can compare it with yours. Put your wages into the NEMT driver cost calculator to see what a raise costs per trip, and read how to hire NEMT drivers for where to find them.