How to Sell a NEMT Business in 2027: Value, Buyers, and Broker Contracts

Selling a NEMT company is different from selling a few vans. The buyer is paying for trips that keep coming after you leave. Most of those trips depend on approvals that do not move on their own: your Medicaid enrollment, your broker agreements, and your licenses.

What a NEMT business is worth and what drives the price

A buyer pays for earnings they can check and expect to keep. Lenders work the same way. Under the Small Business Administration’s rules for 7(a) loans that fund a change of ownership, effective October 1, 2026, the lender must get a business valuation. Any part of the price above it must be covered by the buyer’s equity, not the loan. When the price is over $350,000, or buyer and seller are closely related, an accredited appraiser hired by the lender must do the valuation.

For first acquisitions and expansions priced at $3 million or more, SBA also requires a quality of earnings report. It adjusts your profit for one-time costs, owner pay above or below market, and deferred maintenance. It also tests how much revenue depends on one customer and whether contracts will continue after the sale. Expect any serious buyer to ask the same questions.

What the buyer checks	What raises your price	What lowers it
Contract mix	Trips from several brokers, health plans, facilities, and private pay riders	Most trips from one broker or one health plan
Contract terms	Agreements that can move to a new owner	Agreements the other side can end on short notice
Facility and private pay work	Signed facility contracts and steady repeat riders	Work that follows your personal relationships
Fleet	Clean titles, current inspections, maintenance records	Liens, overdue repairs, worn-out vans
Trip records	A complete log for every leg that matches each claim	Missing logs, open audits, recoupments
Books	Statements that match your tax returns and bank deposits	Cash that cannot be traced
Your role	A manager or dispatcher who runs the day	An owner who dispatches, drives, and bills alone
Driver files	Every license, check, and training record current	Expired credentials

Concentration matters because broker work can end fast. MTM Health’s standard provider agreement, in the January 1, 2023 version Pennsylvania posts, runs three years. Either side can end it on 30 days’ written notice, and it guarantees no minimum number of trips. Health plans also switch brokers. Blue Cross and Blue Shield of Texas moves its Medicaid members from Modivcare to MTM Health on October 1, 2026, and recurring trips after that date go to MTM Health. Facility contracts and private pay riders spread that risk. See NEMT facility contracts.

In an asset sale, both sides report how the price splits across asset classes on IRS Form 8594. Vehicles are generally Class V. Licenses, permits, and a noncompete agreement are Class VI, and goodwill is Class VII. Whatever the buyer pays above the value of your vans is payment for your earnings.

Who buys NEMT companies

Each kind of buyer wants something different, and each changes how the deal works.

• Another operator in your area wants your drivers, vans, and trip volume. If it already works with your brokers, it can take over your trips with less delay. It may want only your assets.
• A larger regional company wants your territory, contracts, and credentialed staff. Expect a longer document list and a request to stay through a transition.
• A first-time buyer may borrow through the SBA 7(a) program. For a first acquisition, SBA requires the buyer to put in at least 10 percent of project costs. A seller note counts toward that only on full standby, meaning no payments for the life of the loan, and only for up to half of it.
• A key employee of at least 24 months can buy out a sole owner under SBA’s separate owner buyout rules.

Check every buyer before you share details. Search each owner on the HHS OIG exclusion list, because the state will. States must check everyone with an ownership or control interest against federal exclusion databases, at least monthly for the main lists (42 CFR 455.436). They must also deny or end enrollment when a 5 percent owner was convicted of a Medicare or Medicaid crime in the last 10 years, unless the state documents why that is not in the program’s best interest (42 CFR 455.416).

Asset sale or stock sale: why it matters for Medicaid

In an asset sale, the buyer’s company buys your vans, phone number, name, and whatever contracts can move. Your company keeps its legal identity and its past. In a stock sale, or a sale of LLC membership interests, the buyer buys the company itself. It comes with its enrollment, contracts, and history, including any overpayments from before the sale.

	Asset sale	Stock or membership sale
EIN	The buyer uses its own	Usually unchanged. The IRS lists the changes that need a new one.
Medicaid enrollment	The buyer usually enrolls as a new provider	Stays, but new owners must be disclosed within 35 days, and some states want a new application
NPI	The buyer uses its own	Stays. Update NPPES within 30 days.
Broker agreements	Need the broker’s written consent or a new agreement	Still reportable. MTM Health requires a new agreement after a change of ownership.
Old liabilities	Mostly stay with your company, though some states make the buyer share Medicaid overpayments	Move to the buyer with the company
Vehicles	Each title transfers to the buyer	Titles stay in the company’s name
Employees	Become the buyer’s new hires	Same employer
Taxes	Both sides file IRS Form 8594	Different rules apply. Ask your CPA.

An asset sale leaves old liabilities behind but restarts the approvals. A stock sale keeps approvals in place but hands the buyer the company’s past. Settle that trade-off with a CPA and a health care attorney before you sign a letter of intent.

A stock sale still needs paperwork. California requires a new application after a cumulative 50 percent change in owners. New York accepts a stock purchase agreement as proof of a change of ownership.

What happens to your Medicaid enrollment and NPI

Your Medicaid enrollment belongs to your company, not to the vans. In every state, a Medicaid provider must disclose each person with an ownership or control interest within 35 days after any change in ownership (42 CFR 455.104). That covers anyone holding 5 percent or more, directly or indirectly, plus officers, directors, and partners. If a 5 percent owner does not give timely, accurate information or cooperate with screening, the state must end the enrollment.

The Medicare rules in 42 CFR 424 apply only if your company is also enrolled in Medicare, for example as an ambulance supplier. Then you report a change of ownership to CMS within 30 days, and you may never sell your Medicare billing number.

States add their own rules for companies enrolled with the state Medicaid program:

State	Deadline	What the rule requires
Florida	At least 60 days before the sale	The seller notifies AHCA and the buyer applies for enrollment. Skip it and both are jointly liable for all overpayments (2026 Florida Statutes, 409.907).
Texas	30 calendar days after	The new owner applies with a copy of the contract of sale naming who is liable for overpayments on earlier dates of service (TMPPM, September 2026)
California	35 days for smaller changes	A change of ownership, a new tax ID, a sale of 50 percent or more of the assets, or a cumulative 50 percent change in owners needs a new application (22 CCR 51000.30)
Washington	7 calendar days	Report any ownership or control change in writing. A new federal tax ID ends the provider agreement that day (WAC 182-502-0018).
Illinois	On the purchase date	The new company enrolls with a new NPI and provider number, and prior approvals must be redone (HFS handbook, March 2024)
New York	35 days (federal rule)	Report it in the Provider Services Portal with proof such as a bill of sale, and pay the $750 application fee (eMedNY, May 2026)

Check your state’s provider manual, and see our state guides. If a broker handles enrollment in your state, ask it for its steps too. For what the buyer goes through, see how to become a Medicaid transportation provider.

Does the buyer need a new NPI?

The NPI belongs to a legal entity, so it follows your company. CMS says an NPI is meant to last through changes of name or address. It also says organizations may need a new one after certain changes of ownership or because of the terms of a purchase. The deal structure usually decides it.

• Stock sale. The company keeps its NPI. Update NPPES within 30 days, as CMS requires for any change.
• Asset sale. The buyer’s company uses its own Type 2 NPI. Illinois requires the new company to enroll with a new NPI and bars billing under the purchased company’s NPI.

Keep your old NPI active until your last claims are paid. Texas warns that after a change of ownership with a new NPI, the original can be deactivated. That cuts off portal access to remittance reports and claim status. See how to get an NPI number for NEMT.

What happens to your broker contracts

Do not assume a broker agreement moves with the business. MTM Health’s standard agreement, in the January 1, 2023 version Pennsylvania posts, shows what to look for:

• A change of ownership, FEIN, or legal name requires a new agreement (section 2.C).
• You must report any change in ownership, officers, directors, or controlling interest immediately (section 11.B).
• You cannot assign the agreement without MTM’s written consent (section 12.A).
• After a termination notice, MTM holds unpaid claims until it audits the service records, and it can offset penalties against them (section 14.E).

That last point affects your cash at closing. Final broker payments may arrive after the sale, minus offsets, so cover them in the purchase agreement.

Other brokers use their own agreements. Find the assignment, change of ownership, and termination sections in every broker and health plan agreement you hold. Then ask each broker’s provider relations team, in writing, how it handles a new owner and how long credentialing takes. See our broker directory and how to get NEMT broker contracts.

Facility and private pay contracts are ordinary business contracts. Check each one for an assignment clause, and get any needed consent in writing before closing.

Vehicles, insurance, permits, and staff

Vehicles. In an asset sale, each title is signed over to the buyer’s company. Check every title for liens and have payoff letters ready. In a stock sale, titles stay in the company’s name. Either way, the buyer will want each van’s maintenance and inspection records.

Insurance. MTM’s agreement requires insurance in force at all times. In an asset sale, the buyer’s company needs its own policy active on the closing date, with certificates that meet each broker’s limits. In a stock sale, tell your insurer about the new owners before closing.

Licenses and permits. Operating licenses can be stricter than Medicaid. New Jersey’s rules for mobility assistance vehicle providers, readopted in 2023 and in effect until September 25, 2030, require notice to the Department of Health at least 30 calendar days before any ownership change. After a change in controlling interest, the new owner must apply for licensure, and no rides can run until the licenses are granted. Licenses become void if control changes first. See NEMT license requirements.

Drivers and staff. In an asset sale, your employees become the buyer’s new hires. USCIS lets the buyer complete new I-9s, or keep yours and accept responsibility for any errors on them. The buyer will also want each driver file: license, driving record, background check, drug test, and training. MTM’s agreement, for example, requires a yearly motor vehicle record covering the previous three years. Plan who tells your dispatcher and drivers about the sale, and when.

Due diligence: the documents a buyer will ask for

Build this file before you list. Share summaries first, and documents only after a signed letter of intent and a confidentiality agreement.

Document	Why the buyer asks
Formation documents and a certificate of good standing	Proves who owns the company. MTM can ask for the certificate.
IRS letter confirming your EIN, and your NPI record	Must match every enrollment. New York will not take a W-9 instead.
Medicaid enrollment approvals and revalidation dates	Shows what the buyer is relying on
Broker, health plan, and facility agreements, with scorecards	Shows what can move and on what terms
Two fiscal years of tax returns and financials, the last 12 months, and bank statements	SBA lenders check them against IRS transcripts
Claims history, remittance advice, and receivables aging	Shows what is owed and how fast payers pay
Audit letters, overpayment notices, and recoupments	Shows liabilities a buyer might inherit
Trip logs and signatures for every leg	Backs up each paid claim. MTM requires records kept for 10 years.
Vehicle list with VINs, titles, liens, inspections, and maintenance	Values the fleet
Insurance policies and loss runs (your insurer’s claims history)	Shows what coverage will cost
Driver files, staff roster, pay rates, and I-9s	Shows who can drive on day one
Licenses, permits, HIPAA policies, and business associate agreements	Shows what must be reissued and how rider data is protected

Trip records carry rider health information. If your company is a HIPAA covered entity, and the buyer is or will become one, the Privacy Rule counts the sale and its due diligence as health care operations (45 CFR 164.501). The minimum necessary rule still applies. MTM’s agreement goes further and bars sharing member information without MTM’s written consent. Share counts, totals, and samples with names removed, and ask the broker before sharing more. See HIPAA for NEMT providers.

How to sell a NEMT business, step by step

1. Clean up your records. Close your books monthly and match them to your bank statements. Fix any trip without a complete trip log.
2. Read every contract. Mark the assignment, change of ownership, and termination terms in each broker, plan, facility, lease, and loan agreement.
3. Get a valuation. Use an appraiser with a credential SBA accepts: ASA, CBA, ABV, CVA, or BCA. An SBA lender will order its own later.
4. Choose the structure. Decide on an asset or stock sale with your CPA and a health care attorney.
5. Screen buyers. Check owners against the OIG exclusion list and ask how they will pay. Sign a confidentiality agreement first.
6. Sign a letter of intent. Set the price, structure, what is included, and the due diligence period. Keep your receivables. Federal rules generally bar a state Medicaid program from paying anyone but the provider that gave the ride (42 CFR 447.10).
7. Open due diligence. Share the checklist documents in stages.
8. Line up approvals before closing. File advance notices, such as Florida’s 60 days, and get the buyer credentialed with each broker. Close when the buyer can run trips.
9. Sign the purchase agreement. Name who is liable for Medicaid overpayments on trips before the sale. Texas requires that language in the contract of sale.
10. Close and file. Report new owners to Medicaid within 35 days, or sooner where your state requires. Update NPPES within 30 days of any change, and notify each broker. In an asset sale, both sides attach Form 8594 to their tax returns for the year of the sale.
11. Hand over and collect. Bill your own dates of service and keep copies of every record. In Texas, a provider with a new NPI can file claims within 95 days after its enrollment is complete, as long as it is within 365 days of the date of service.

Common deal-killers and how to avoid them

• Hidden overpayments. Florida will not approve the buyer until overpayments are paid or on a written plan. Disclose them early.
• One broker. Add a second broker, facility work, or private pay before you sell.
• Books that do not match your tax returns. SBA lenders verify your numbers against IRS transcripts. Income that never reached a return cannot support the price.
• A buyer who fails screening. A 5 percent owner with a Medicare or Medicaid conviction in the last 10 years can block enrollment.
• Billing under your numbers after the sale. Illinois warns that a new owner’s claims under the prior owner’s provider number can lead to recoupment and sanctions.
• Expired driver or vehicle files. Renew anything close to expiring before due diligence starts.
• An earnout with an SBA buyer. SBA prohibits seller earnouts on these loans. Agree on a fixed price instead, with a seller note if the buyer needs one.