How Many NEMT Companies Are There in 2027? Registered Companies in Every State and How Fast New Ones Start

Owners ask this before they buy a van. The closest public count comes from the federal NPI file, where a company that bills Medicaid registers its main service. This page counts that file for the 50 states and DC as of September 2026, shows how fast new companies are registering, and says plainly what the count misses.

How many NEMT companies are registered in the United States

CMS publishes the National Plan and Provider Enumeration System (NPPES) file every month. The September 2026 file holds records through September 13, 2026, and only active NPIs. Each organization picks one primary taxonomy code on its record, the code that says what kind of provider it is. The NEMT taxonomy code guide explains how to pick yours.

As of that file, the national picture looks like this:

• 29,167 organizations in the 50 states and DC list a NEMT van code as their primary taxonomy. 27,496 use 343900000X, Non-emergency Medical Transport (VAN), and 1,671 use 343800000X, Secured Medical Transport (VAN). These are the companies in the table below.
• 8,017 individuals hold their own NPI with a van code as primary, and 7,944 of them are flagged as sole proprietors in NPPES. A sole proprietor is a person who runs a business under his or her own name. They are counted apart from companies, and 1,575 of them registered in 2025 or 2026.
• Three other transportation codes sit beside the van codes: 2,138 organizations use Private Vehicle, 1,498 use Taxi, and 1,144 use Transportation Network Company as primary.

Those three codes are left out of the company count because they are not van codes. NUCC defines Taxi and Private Vehicle as non-emergency transportation with no mention of medical riders, so those codes alone do not show that a company carries Medicaid members. The Transportation Network Company code is described as ride-sharing that provides non-emergency medical rides, so a wider count would add its 1,144 organizations.

The secured transport code deserves a note. NUCC describes it as vehicles equipped for safety and passenger restraint, staffed by people trained to work with patients in crisis from mental illness or substance abuse. Texas Medicaid uses it for ordinary ride work: its provider manual (October 2026) recommends 343800000X on claims from demand response transportation service providers, and 1,116 of Texas’s 2,986 companies use it as their primary code.

How many NEMT companies are in each state

California has the most registered NEMT companies at 3,597, followed by Texas at 2,986 and Florida at 1,959. Vermont has 4, Wyoming 5, and Montana 18. The table counts organizations with a NEMT van code as primary taxonomy and a practice address in the state, in the September 2026 NPPES file.

The last column divides each state’s Medicaid and CHIP enrollment for June 2026 by its company count, rounded to the nearest 10. CMS reported 73,167,389 people enrolled in the 50 states and DC that month, and the state figures are preliminary. The column shows how thinly a state’s members spread across registered companies. It does not say how many riders each company has.

State	NEMT companies	New since Jan. 2025	Members per company
Alabama	149	36	6,250
Alaska	32	3	6,460
Arizona	866	175	1,860
Arkansas	163	35	4,750
California	3,597	802	3,240
Colorado	639	119	1,860
Connecticut	125	39	7,160
Delaware	52	19	4,520
District of Columbia	66	15	3,590
Florida	1,959	483	1,820
Georgia	1,051	257	1,730
Hawaii	75	14	5,220
Idaho	104	15	2,950
Illinois	957	186	3,060
Indiana	554	135	2,450
Iowa	203	60	3,320
Kansas	161	36	2,450
Kentucky	139	41	9,100
Louisiana	1,793	350	710
Maine	31	6	10,570
Maryland	368	118	3,770
Massachusetts	424	111	3,600
Michigan	821	163	2,590
Minnesota	966	168	1,170
Mississippi	294	56	1,990
Missouri	303	102	4,100
Montana	18	3	11,410
Nebraska	93	34	3,550
Nevada	113	46	6,300
New Hampshire	73	40	2,300
New Jersey	618	163	2,790
New Mexico	117	20	5,750
New York	1,200	167	5,320
North Carolina	1,301	361	2,160
North Dakota	55	23	1,890
Ohio	1,889	393	1,380
Oklahoma	90	40	11,030
Oregon	103	38	12,280
Pennsylvania	389	128	7,590
Rhode Island	62	11	4,580
South Carolina	296	93	3,240
South Dakota	74	11	1,870
Tennessee	864	121	1,600
Texas	2,986	647	1,310
Utah	49	14	6,570
Vermont	4	1	36,370
Virginia	1,838	336	890
Washington	153	60	11,640
West Virginia	84	10	5,770
Wisconsin	801	279	1,380
Wyoming	5	0	11,870
United States	29,167	6,583	2,510

Montana, Ohio, and West Virginia count anyone enrolled at any time in the month rather than on one day, so their last column runs a little high. Treat that column as a rough guide. Louisiana has about 700 members for each registered company and Vermont about 36,000, but neither number says how many of those companies run trips, or how many members use rides. For what each state spends, see NEMT spending by state. The directory on this site lists the companies in each state and town.

How fast new NEMT companies start

Registrations took off in 2023 and have stayed high. Of the 29,167 organizations still registered, 44 percent got their NPI in 2023 or later, and 6,583 got it from January 1, 2025 to September 13, 2026. That is the New since Jan. 2025 column above.

Year the NPI was issued	Companies still registered
2019	1,590
2020	1,292
2021	1,464
2022	1,893
2023	3,243
2024	3,108
2025	3,405
2026, through September 13	3,178

The spread between states is wide. In New Hampshire, 40 of 73 companies are new since January 2025, 55 percent. In New York it is 167 of 1,200, 14 percent, and in Minnesota 168 of 966, 17 percent. Some states pause new enrollment: the same Minnesota presentation says an NEMT provider moratorium in the metro counties took effect in January 2026. See Minnesota’s metro NEMT enrollment freeze.

Read the table with two limits in mind. Companies that closed and had their NPI deactivated are not in the file, so older years can be undercounted. And a new NPI is not always a new company. An owner can register a second location or a new LLC, and 789 of the 29,167 organizations are flagged as subparts of another organization.

How the Census and states count NEMT companies

The Census Bureau counts businesses by industry. Its 2022 industry index puts nonemergency medical transportation services, other than ambulances, under special needs transportation, NAICS 485991. In County Business Patterns, the latest year is 2023, and it found 3,920 locations with paid employees, 65,974 employees, and $2.5 billion in annual payroll. Self-employed owners with no payroll are outside the count.

Employees at the location, 2023	Locations	Share
Fewer than 5	1,854	47%
5 to 9	702	18%
10 to 19	593	15%
20 to 49	508	13%
50 to 99	157	4%
100 or more	105	3%

Nearly half of the locations with payroll had fewer than five employees. The Census number is far lower than the NPI count because the two measure different things. Louisiana shows it: 1,793 organizations hold a NEMT van code in NPPES, while Census found 66 special needs transportation locations with paid employees. For how much companies with payroll earn, see what a NEMT business makes.

A few states publish their own counts. Minnesota’s Department of Human Services gave the House Fraud Prevention Committee on March 2, 2026 program data counting 551 unique fee-for-service providers and 1,165 unique managed care providers in 2024. One provider can appear in both, so the combined number is lower than 1,716. NPPES shows 966 Minnesota organizations. Minnesota enrolls individual drivers as well as transportation organizations, which can explain part of the difference.

What the registered count misses

No single number equals the companies running trips today. Each one leaves something out:

• An NPI is not proof of service. CMS says an NPI does not ensure a provider is licensed or credentialed, guarantee payment, or enroll a provider in a health plan (NPI fact sheet, December 2024). The rule on deactivating an NPI names the dissolution of an organization, the death of an individual, and other circumstances that justify it (45 CFR 162.408). It does not name selling vans or stopping trips.
• Closed companies drop out. CMS says the monthly file holds only active provider data, so a company that asked for its NPI to be deactivated no longer appears.
• Some ride companies have no NPI. A few states let NEMT companies enroll with a state-issued number instead. Illinois’s transportation handbook (March 2024) tells providers to bill with an NPI, or a provider number if an atypical provider. See atypical provider.
• One owner can hold several NPIs. CMS says an incorporated individual can get one NPI for himself or herself and another for the corporation or LLC, and that organizations can have multiple NPIs.
• The address is the one on file. It is the practice location on the NPI record, not a map of where the company drives.
• The date is the NPI date. The enumeration date is when the NPI was issued, not when the company started, and a company can change its taxonomy later.

What the count means for your market

A state total tells you little about one county. A county with few registered companies and a broker short of drivers can be a better market than one with many companies and no open trips. The brokers and health plans that send the trips decide how many companies they need.

1. Count your own county. Search the NPI Registry for the taxonomy Non-emergency Medical Transport (VAN), code 343900000X, with your city and state. The market research guide shows how to read the results and what to compare them with.
2. Ask the broker whether its network is open. A broker with a full network may not take another company, whatever the registry says.
3. Check what your state spends. The spending by state page shows what each state pays for rides, and the NEMT business guide shows what the work earns and what can go wrong.
4. Register the right way. If you start, the NPI guide walks through the application and the code to choose.