How to Get NEMT Certified in 2027: What Certification Really Means

“NEMT certified” gets used for at least five different approvals, and none of them comes from a federal office. Each comes from a different office, and a company that takes Medicaid trips usually needs three or four at once. This page sorts out what each one means, who grants it, what it costs, and the order to get them in.

Is there a national NEMT certification?

No. There is no federal NEMT certificate. Federal rules reach a NEMT company mainly through Medicaid, plus federal motor carrier rules for some trips across state lines. CMS says in its Medicaid Transportation Coverage Guide (SMD 23-006, September 28, 2023) that federal Medicaid law sets only a short list of minimums, and that state agencies generally set driver and vehicle standards.

Those minimums come from section 1902(a)(87) of the Social Security Act. Every state must have a way, which may be a signed attestation, to make sure that:

1. The company and each driver are not excluded from federal health care programs or listed on the HHS OIG exclusion list.
2. Each driver has a valid driver’s license.
3. The company has a process to address any violation of a state drug law.
4. The company has a process to report each driver’s driving history, including traffic violations, to the state Medicaid program.

Everything else comes from your state and your brokers. That is why “how do I get certified” has a different answer in every state.

What “NEMT certified” can mean, and who grants each one

When someone says a company is certified, they usually mean one of these:

What people call it	What it really is	Who grants it	Do you need it?	Read more
State NEMT license or certificate	Permission to carry passengers for pay, in states that license NEMT or passenger carriers	A state DOT, DMV, utility commission, or health department	Only in states that have one	NEMT license requirements
Medicaid certified	Enrollment as a Medicaid transportation provider, with a signed provider agreement	Your state Medicaid agency	Yes, to bill Medicaid yourself, and Minnesota requires it of every NEMT provider	Become a Medicaid transportation provider
Broker approved	Credentialing of your company, drivers, and vehicles	Each broker or health plan	Yes, for every broker that sends you trips	NEMT broker credentialing
Driver certified	Course certificates such as PASS, CPR and first aid, and defensive driving	CTAA, a CPR course provider, or a trainer your broker approves	When your state or broker names the course	PASS certification
Accredited	A voluntary review of your whole company	NEMTAC	No	NEMT accreditation
Waiver transportation certified	Certification to give non-medical rides under a Medicaid waiver	A state aging or disability agency	Only for waiver rides	Waiver transportation provider

The last row causes confusion in some states. Ohio’s Department of Aging certifies providers of non-medical transportation under Ohio Administrative Code 173-39-02.18 (effective February 1, 2025). That rule excludes rides for a non-emergency medical purpose, so an Ohio waiver certificate does not cover NEMT.

State certificates and permits for NEMT carriers

Most states license NEMT through a general passenger carrier rule or not at all. A few issue a certificate or permit meant for NEMT. As of September 2026:

State	What it is called	Who issues it	Cost and renewal	What else it requires
Minnesota	Special transportation service certificate of compliance	Minnesota Department of Transportation (MnDOT)	$45 a year for each vehicle decal, with a yearly vehicle inspection	Form E commercial insurance, background studies, a vehicle inspection, and an online provider course within 90 days of the certificate
Virginia	NEMT carrier certificate	Virginia DMV, Motor Carrier Services	$50 filing fee and $3 a year for each vehicle, plus a $25,000 bond or letter of credit kept on file for three years	NEMT-designated registrations and plates. Only for carriers paid through Medicaid for trips arranged by DMAS, its broker, or a Medicaid health plan.
Rhode Island	NEMT certificate of operating authority	Division of Public Utilities and Carriers	$125 application and a public hearing, then $100 to renew by December 31 each year	Insurance of $1.5 million for personal injury and $100,000 for property damage, refiled each year, and a special license for each driver
Mississippi	NEMT permit	State Department of Health	Set by the department’s rules	A company under contract with a Medicaid broker needs no permit if the broker inspects its drivers and vehicles and certifies them to the department, but it must still register

A few details matter for planning:

• Minnesota tells applicants they may not carry riders until the certificate of compliance arrives. The certificate is canceled if the provider misses the 90-day course deadline. With a current certificate, no other state or local permit is needed to run those vehicles for that service, though general vehicle rules still apply.
• Virginia’s certificate fits a carrier that serves only Medicaid riders and is paid only through Medicaid. A company that also sells private rides may need a different Virginia operating authority.
• Rhode Island’s 2024 law makes the certificate a condition of providing NEMT in the state, except for RIPTA, licensed ambulances, certificated taxicab companies, and rideshare companies, and the Executive Office of Health and Human Services adds its own vehicle age, mileage, and sign rules.
• Mississippi’s statute, as amended by HB 610 effective July 1, 2025, requires the health department’s driver standards to include a fingerprint background check, yearly criminal and driving record checks, drug screens, and exclusion checks.

Other states license wheelchair or paratransit service under other names. Ohio requires an ambulette service license from its State Board of Emergency Medical, Fire, and Transportation Services for wheelchair rides between hospitals, dialysis centers, nursing homes, doctors’ offices, and similar facilities (Ohio Revised Code 4766.04). Pennsylvania treats paratransit offered to the public as a class of common carrier service run under a certificate of public convenience (52 Pa. Code 29.13). Some states ask for none at Medicaid enrollment: North Carolina’s provider enrollment matrix, generated August 16, 2026, lists no certification, license, or accreditation for its NEMT van provider type. The license requirements guide covers more states, and your state guide has local detail.

Medicaid enrollment: the approval that lets you bill

Being “Medicaid certified” means being enrolled. Your state Medicaid agency must screen every provider it enrolls (42 CFR 455.410), and the depth of that screening depends on the risk level it gives your provider type (42 CFR 455.450):

Risk level	What the state checks
Limited	Federal and state requirements for the provider type, license verification, and database checks before and after enrollment
Moderate	Everything above, plus site visits
High	Everything above, plus fingerprint-based criminal background checks

CMS notes that transportation starts at the limited level, and states may raise it to moderate or high. North Carolina, for example, lists its NEMT van provider type as moderate risk, with a site visit, the federal fee, and a NEMT driver attestation form signed by the office administrator. See Medicaid provider risk levels and what a Medicaid site visit checks.

The state collects a federal application fee before it signs your provider agreement, unless you are already enrolled in Medicare or another state’s Medicaid program, or already paid the fee to one of them (42 CFR 455.460). CMS set that fee at $750 for applications filed from January 1 to December 31, 2026. Once enrolled, you are revalidated at least every 5 years (42 CFR 455.414). Get an NPI before you apply: Louisiana’s broker collects one in your business name, and Virginia’s broker must make sure even volunteer drivers have one.

Broker credentialing: approval from each broker

In states that run NEMT through a broker, the broker’s approval is what actually sends you trips. Each broker checks your company, every driver, and every vehicle against its contract before the first ride, and again as documents expire.

MediTrans, which arranges rides for several Louisiana Medicaid health plans, shows what that looks like as of September 2026:

1. Submit a letter of intent.
2. Run a criminal background check on every driver through MediTrans’s vendor.
3. Get commercial auto liability of at least $1 million per occurrence, general liability, and workers’ compensation or an approved waiver, with MediTrans as certificate holder.
4. Upload driver files: license, background check clearance, a defensive driving certificate, CPR and first aid, and drug test results.
5. Upload vehicle files: registration, an inspection report, the insurance declaration page, interior and exterior photos, and ADA documents where they apply.
6. Finish online provider training.

MediTrans says the process usually takes 2 to 4 weeks from the letter of intent to activation, and trip offers begin within 24 to 48 hours after that. Other brokers use other lists, so ask each one for its credential list in writing. The broker credentialing guide and the free credentialing checklist cover the full document set, and recredentialing covers keeping it current.

Driver certificates states and brokers ask for

Driver certificates are the part most people picture when they hear “NEMT certified.” No federal rule names a driver course, so the list comes from your state and brokers. Louisiana’s Medicaid manual (section 10.3, issued July 14, 2025) shows a full set, required before a driver carries anyone:

Certificate	What Louisiana requires	Where else it comes up
Defensive driving	An in-person or virtual course of at least 4 hours, renewed at least every 3 years	MediTrans; MTM Health in Virginia
CPR	An in-person course ending in an active certification from a licensed instructor	MediTrans (CPR and first aid); MTM Health in Virginia (first aid where it applies)
PASS and wheelchair securement	Renewed at least every 2 years. Drivers at companies with wheelchair vehicles take securement training in person.	MTM Health in Virginia requires PASS before transport
Child passenger restraints	Installation and use under Louisiana law	Varies by program
HIPAA privacy and security	Required training	MTM Health in Virginia pairs it with fraud, waste, and abuse training

PASS, from the Community Transportation Association of America, is the course named most often. As of September 2026, PASS Basic Online costs $28 for CTAA members and $55 for others, and the certificate is valid for two years. See PASS certification for the wheelchair add-on and renewals.

Two more trainings come from rules outside Medicaid. OSHA requires employers to train each employee with occupational exposure to blood at the start of that work and at least once a year, at no cost to the employee (29 CFR 1910.1030). And Colorado’s Medicaid rule requires providers to keep written policies on fraud, waste, and abuse and train staff on them. Track every date in a driver training log.

What a paid “NEMT certification” course gets you

A certificate from a private course is training. It is not a state license, a Medicaid enrollment, or a broker approval, and no federal rule requires one. Whether it counts depends on whether your state or broker accepts that course.

Virginia shows why that matters. Its fee-for-service rules, updated May 26, 2026, require every NEMT driver, attendant, taxi driver, and volunteer driver to complete the broker’s driver training program before transporting anyone. MTM Health’s Virginia handbook adds that a company running its own internal course needs written approval that it meets or beats the program’s training requirements. MTM Health runs its Virginia training program at no cost to providers, while basic first aid and defensive driving come from outside courses.

Before you pay for any course:

1. Ask each broker for its list of required and accepted courses, in writing.
2. Ask what the broker provides free. In Virginia, the broker’s own training program is required and free.
3. Buy only what the list names, such as PASS or an in-person CPR class.
4. Keep each certificate in the driver’s file with its expiration date.

For the full training plan, see NEMT driver training and NEMT driver requirements.

Accreditation: the optional certificate

NEMT accreditation is a voluntary review of your whole company. Federal Medicaid rules do not require it. As of September 2026, the program run by the NEMT Accreditation Commission (NEMTAC):

• Requires at least 12 months in service, a business license, an EIN, and an NPI
• Costs $3,000, including a $600 nonrefundable application fee, or the $600 fee plus $83.33 a month over the three years, for a total of $3,600
• Takes about 90 days after the application is submitted
• Lasts three years

Mississippi’s permit statute names it: any company with current NEMTAC accreditation counts as a NEMT provider under that law (HB 610, effective July 1, 2025). For whether accreditation pays for a small company, see NEMT accreditation.

How to get NEMT certified, step by step

1. Form your company and get your numbers. Register an LLC or corporation, then get a free EIN and an NPI.
2. Find your state’s carrier regulator. Ask your state DOT, DMV, utility commission, and health department whether they license NEMT or passenger carriers, as Minnesota, Virginia, Rhode Island, Mississippi, and Ohio do.
3. Line up insurance and vehicles. Meet the highest limits your state and brokers set. See NEMT insurance requirements and NEMT vehicle requirements.
4. Get the state certificate or permit before any paid trip where your state requires one.
5. Train your drivers in the courses your state and brokers name, after asking what the broker provides free.
6. Enroll with Medicaid. Pay the application fee, pass screening, and prepare for a site visit if your provider type is moderate or high risk.
7. Credential with each broker and health plan you want trips from.
8. Put every renewal on one calendar. Use the table below.
9. Consider accreditation after your first 12 months, if bids or facility contracts ask for it.

What each approval costs and how often you renew

Approval	Cost, as of September 2026	How often you renew
Medicaid enrollment	$750 federal application fee for 2026 applications, unless exempt	At least every 5 years
Minnesota certificate of compliance	$45 a year for each vehicle decal	Evaluated every year, decal every year
Virginia NEMT carrier certificate	$50 filing fee, $3 a year for each vehicle, and a $25,000 bond	Free renewal when DMV sends the notice, the vehicle fee each year with registration, and the bond kept on file for three years
Rhode Island NEMT certificate	$125 to apply	By December 31 every year, $100
PASS Basic	$28 for CTAA members, $55 for others	Every 2 years
Louisiana defensive driving	Set by the course	At least every 3 years
NEMTAC accreditation	$3,000	Every 3 years

A lapse in any one of these can stop your trips even when the others are current. Set reminders 60 days before each date, and check your state guide for rules this table does not cover.