New York Class E License in 2027: What Medicaid Taxi and Livery Drivers Outside NYC Need

New York sorts drivers by what they carry, not only by what they drive. A Class D license covers the same cars and vans as a Class E, but it stops the moment a passenger pays. For a sedan or minivan company that drives Medicaid taxi trips upstate or on Long Island, the Class E is the one license every driver needs, and a few rules decide when it is not enough.

What a Class E license covers

Section 501 of the Vehicle and Traffic Law says a Class D license is not valid for a vehicle used to carry passengers for hire. A Class E covers everything a Class D does, plus carrying up to 14 passengers for hire. DMV’s license class chart, as of October 2026, puts it in plain terms: Class E is the for-hire class for taxis, liveries, and limos, for drivers 18 or older, in vehicles rated 26,000 pounds or less.

Medicaid ties your enrollment to it. Taxi companies outside New York City enroll in category of service 0603. eMedNY’s enrollment requirements (file dated October 23, 2025) say a 0603 company must keep records showing each driver has a valid Class E license and each vehicle is registered with livery plates. The same rule applies to taxi and livery work in category 0606, for programs of the Office for People With Developmental Disabilities. The state’s Medicaid Transportation Policy Manual (effective August 25, 2023) adds that every driver must be at least 18 and hold a current, valid license for the vehicle assigned. See livery vehicle for the plates and for-hire insurance side.

A commercial license works too. DMV’s taxi and livery page lets a driver use a Class A, B, or C commercial license instead of a Class E, as of October 2026.

Which license each vehicle needs

The vehicle, the passenger count, and the operating authority decide the class, as DMV and state law describe them in October 2026:

Vehicle and trip	License	Also required
Sedan or minivan, Medicaid taxi upstate or on Long Island	Class E	Livery plates and any local driver permit
Taxi or livery seating 9 or more, driver included	Class E, unless it counts as a bus (below)	Pre-hire and random drug and alcohol tests
Any vehicle carrying 15 or more passengers	Class C CDL or higher	Class B for vehicles over 26,000 pounds
Ambulette run under NYSDOT authority	CDL with P endorsement	Article 19-A qualification
Livery car in New York City	Class E	A TLC driver license

The 15-passenger line is DMV’s: Class C covers vehicles of 26,000 pounds or less that carry 15 or more passengers or carry passengers under Article 19-A.

How to upgrade from Class D to Class E

Most drivers already hold a Class D. DMV’s upgrade, as of October 2026, takes one office visit, and the only test on its list is the vision test:

1. Check your ID documents. If the driver also wants a REAL ID or Enhanced license, run DMV’s Document Guide first so one visit covers both.
2. Go to a DMV office. Check your county’s reservation rules before you go.
3. Surrender the Class D and apply for the Class E. The application form DMV lists is the MV-44.
4. Pay the fee. DMV figures it from the expiration date of the current license, so it cannot be quoted in advance.
5. Pass the vision test, or show you meet DMV’s vision requirements.
6. Wait for the card. DMV says to allow 2 weeks for the license to arrive by mail.

A new driver with no New York license applies for a Class E instead of a Class D. Both take the same vision, written, and road tests.

What a first Class E costs

DMV’s fee table for a first license, as of October 2026, prices the Class E by age at application and by home county. Residents of the Metropolitan Commuter Transportation District (the five boroughs plus Dutchess, Nassau, Orange, Putnam, Rockland, Suffolk, and Westchester) pay $1 more for every 6 months the license is valid:

Age when you apply	Outside the district	Inside the district
18 to 18½	$110.00	$120.00
18½ to 21	$103.75 to $110.00	$112.75 to $120.00
21 and older	$91.25 to $97.50	$100.25 to $107.25

An Enhanced license costs $30 more. Commercial license fees are separate.

Where a Class E is not enough

Three rules add to the Class E or replace it, and each one shows up in Medicaid work.

Vehicles that count as buses

Section 501 bars Class D and Class E licenses from any vehicle that is a bus under section 509-a. That section counts as a bus any vehicle a carrier must run under NYSDOT approval as a common or contract carrier of passengers. It also counts any vehicle seating more than 10 adult passengers, driver not counted, that carries people under 21 or people with disabilities to school, job training, religious instruction, day care, or camp.

Section 151 of the Transportation Law exempts for-hire trips in sedans and station wagons from NYSDOT authority, and NYSDOT’s exemption list names minivans with them. The same section’s definition of a sedan leaves out commercial vehicles that seat 11 or more, driver included. A larger van is exempt only in one of the cases that section lists, and its taxi and livery exemption outside New York City leaves out van service. Ask NYSDOT before you put a van that seats 11 or more on Medicaid trips: once a van needs authority, its drivers need a commercial license with a passenger endorsement and Article 19-A qualification.

Medicaid ambulettes need NYSDOT authority to enroll, so they always land here. The NYS Article 19-A guide covers that side.

Drug and alcohol testing at 9 seats

Section 507-a, as Chapter 2 of the Laws of 2020 amended it, reaches any taxi or livery that seats 9 or more passengers, including the driver. Every carrier running those vehicles must give their drivers pre-employment and random drug and alcohol tests that follow the federal procedures in 49 CFR Part 382, whatever license class the driver holds.

You file an affidavit of compliance with DMV by August 3 each year, using the For Hire AFCO web form DMV links. Without it, DMV may suspend, deny, or refuse to renew your for-hire registrations. Each violation carries a civil penalty of $500 to $2,500, and $500 to $5,000 for repeats within 18 months. A fleet of sedans and seven-seat minivans stays outside the rule.

New York City

The NYC Taxi and Limousine Commission licenses every taxi and livery driver in the city, and a Class E alone does not allow a pickup there. Livery is category 0605 and is limited to New York City. As of October 2026, a TLC driver license requires:

• Age 19 or older, with a Class A, B, C, or E license.
• No more than 5 DMV points in the 15 months before the latest conviction.
• A medical exam on the TLC’s form, completed by a licensed physician.
• A drug test ($34) and fingerprints and photo ($90.25).
• A 3-day course, wheelchair accessible vehicle training, and the TLC exam, all within 90 days of applying.
• A 6-hour defensive driving course within those 90 days, unless the driver finished one in the past three years.
• The $252 fee, for a three-year license.

The New York City guide covers TLC bases, paratransit licenses, and city rates.

County and city driver permits

New York Medicaid does not replace local rules. The policy manual says taxi and livery companies may need local licenses from a municipality or a Taxi and Limousine Commission, and that skipping them can end your Medicaid enrollment. Here is what the main local regulators ask of each driver, as of October 2026:

• Westchester County. The county TLC’s rules (version 4.4, June 29, 2026) require its driver permit for point-to-point trips in for-hire vehicles such as liveries and car services. Taxis licensed by a city or village follow that municipality’s rules. Drivers need a Class A, B, C, or E license held at least 6 months (or one from New Jersey, Connecticut, or Pennsylvania), a DMV defensive driving course within 6 months, fingerprinting by the county Department of Public Safety ($100), three notarized references, and a drug test. The permit costs $135 a year. A van that is not wheelchair accessible, carries 8 to 14 passengers, and is used only for medical trips paid through contracts such as Medicaid can run under a medical provider waiver, $200 a year since July 1, 2026, with a permitted driver at the wheel. Drivers of vehicles seating 15 or more also need a commercial license.
• Nassau County. The county for-hire driver license (application revised July 2026) costs $100 for two years. Drivers must be at least 19, licensed at least 6 months, hold a Class A, B, C, or E license, and have no more than 7 points in 18 months. They also need a 6-hour defensive driving course, a fingerprint check, and a drug test every year. It does not cover point-to-point trips inside a town, city, or village that licenses its own drivers, such as the Town of Hempstead. See the Nassau County page.
• Suffolk County. The county TLC’s driver application (April 2024) costs $50 and asks for a Class E, B, or other license with the right endorsements, a defensive driving course valid for the whole license term, fingerprints, and a drug screen. See the Suffolk County page.
• Upstate cities. Some cities license taxi drivers themselves, so check with the city clerk where your trips start. Rochester’s taxicab driver license costs $50 (the fee the city clerk lists as of July 1, 2018), expires June 30 each year, needs police approval and a DMV driving abstract dated within 10 days, and takes two to four weeks.

Taxi companies outside New York City that work in Westchester or Nassau also need a TLC base from that county to enroll in category 0603.

What Medicaid and the broker check for each driver

A Class E is the floor. The policy manual lists four federal minimums for every Medicaid driver and company: the driver is not on any federal exclusion list, holds a valid license, and works for a company with a process for state drug law violations and a process to report each driver’s driving history to Medicaid.

The paperwork follows each driver into every trip. Each trip record must show the driver’s license number and the vehicle plate, and since March 1, 2016, the driver’s printed name and signature attesting the trip was done. Taxi companies outside New York City must also own or lease each vehicle in their own name, so a driver cannot work in a personal car the way a New York City livery driver can.

Before a driver’s first Medicaid trip:

1. Confirm the license class on the card itself: Class E, or Class A, B, or C.
2. Get the local driver permit where your trips start, and keep a copy on file.
3. Add the driver to drug and alcohol testing if any of your taxis or liveries seats 9 or more.
4. Check the exclusion lists and pull the driving record.
5. Watch each driver’s record. DMV’s License Event Notification Service (LENS) notifies you of crashes, convictions, suspensions, revocations, and expirations. As of October 2026, it costs $7 to add a driver and $1 per notice, and DMV says to allow 2 weeks to process a new application.
6. Finish the broker’s credentialing and training. The MAS guide covers the driver checks and training that Medical Answering Services, the statewide broker, requires, and the New York guide covers Medicaid enrollment.

For how New York’s rules compare with other states, see NEMT driver requirements.