# Tennessee F Endorsement for NEMT Drivers: Who Needs It, the Test, and What TennCare Checks

Canonical URL: https://nemtguide.com/guides/tennessee-f-endorsement/ · Updated 2026-10-02

In Tennessee, anyone whose main job is driving people for hire in a car or van needs the for-hire (F) endorsement on a Class D license. The driver must be 18 or older with two years of unrestricted driving, pass a vision screening and a for-hire knowledge test at a Driver Services Center, and pay $4.50. For TennCare trips, a Class A, B, or C CDL also qualifies.

- Every TennCare driver needs a Class D license with the F endorsement or a Class A, B, or C CDL, even an owner who drives part time.
- The F endorsement takes a vision screening and a for-hire knowledge test at a full Driver Services Center, and costs $4.50 as of October 2026.
- A driver needs two years of unrestricted driving before applying, so check the license history before you make an offer.
- The endorsement lasts as long as the license, which renews every eight years with no new test.
- Drivers report any moving violation or suspension to you at once, and you report it to the health plan or broker.

## Who needs the F endorsement in Tennessee

Tennessee adds a for-hire endorsement, marked F, to a regular Class D license. The Department of Safety says anyone whose main job is driving or carrying people or property in a passenger (Class D) vehicle needs it. Its examples are taxi drivers, shuttle drivers, couriers, and delivery drivers. Under T.C.A. 55-50-102, the endorsement is what lets a licensee drive a Class D vehicle as a chauffeur.

A NEMT driver hired to take riders to dialysis and doctor visits fits that rule. People who drive as part of a different job, such as plumbers and meter readers, do not need it.

The state rule has two gaps that TennCare closes:

- **Volunteers.** The Department of Safety says volunteers driving Class D vehicles do not need the endorsement.
- **Other main jobs.** An office manager or owner whose main job is not driving falls outside the main-job test, even when they cover a route now and then.

TennCare's contract with its health plans, in the version with Amendment 25 effective July 1, 2026, requires every driver to be at least 18 and hold a Class D license with the F endorsement or a Class A, B, or C CDL. It applies to all drivers except fixed route bus drivers. If someone drives a TennCare trip for your company, that person needs the endorsement or a CDL, whatever the state rule says. The Department of Safety also warns that an employer may require the endorsement for insurance, so ask your insurer what it expects.

### When a CDL replaces it

A commercial license covers Class D vehicles too, so a driver with a Class A, B, or C CDL needs no separate Class D license, and TennCare accepts the CDL in place of the F endorsement. The F endorsement only covers Class D vehicles. A vehicle designed to seat 16 or more people, driver included, needs at least a Class C CDL with the passenger endorsement. [Do NEMT drivers need a CDL](https://nemtguide.com/guides/do-nemt-drivers-need-a-cdl/) explains how seats are counted.

### Drivers who live out of state

TennCare's contract accepts a Tennessee license or the equivalent license issued by the driver's state of residence. A driver who lives in Kentucky, Georgia, or another neighboring state can use that state's equivalent, so ask your broker what it has accepted before you hire.

A driver who moves to Tennessee is different. The driver manual says a new resident must apply for a Tennessee license once they have lived in the state more than 30 days, are working in Tennessee, or would qualify to register to vote here. A new resident whose out-of-state license is valid needs only a vision screening for the Class D, but adding the F endorsement still takes the knowledge test.

## Who qualifies for the F endorsement

T.C.A. 55-50-302(f) and the Department of Safety's page set these conditions:

- **Age.** At least 18. The only exception lets a 16-year-old deliver goods for a family business.
- **Experience.** At least two years of unrestricted driving experience before the date of application.
- **Character and fitness.** The department must be satisfied with the applicant's good character, competency, and fitness for the job.
- **Vehicle.** The driver will operate a passenger (Class D) vehicle.
- **Documents.** Proof of U.S. citizenship or lawful permanent residency, and proof of Tennessee residency.

The statute adds one limit for young drivers. The endorsement does not let anyone under 19 drive a commercial motor vehicle as federal rules define it (49 CFR 390.5). That definition covers a vehicle rated 10,001 pounds or more, or one designed or used to carry 9 or more people, driver included, for pay, when it is used in interstate commerce, such as a trip that crosses a state line. If you hire a driver under 19, keep that driver off trips across state lines in vans of that size.

Check the two-year rule before you make an offer. Ask when the applicant got a full, unrestricted license, and check the driving record for suspensions or restrictions.

## How to get the F endorsement, step by step

Adding the endorsement takes one visit for most drivers. These steps follow the Department of Safety's process as of October 2026:

1. **Check the record first.** Order the driver's motor vehicle record. A Tennessee resident can buy their own online through e-Services for $5. Businesses buy records through the state's TN Apps service. You need one anyway, because TennCare requires a [motor vehicle record](https://nemtguide.com/glossary/motor-vehicle-record/) from every state the driver has lived in.
2. **Study Section B of the driver manual.** The department says the for-hire knowledge test is built for the endorsement and draws on Section B of the Comprehensive Driver License Manual. That section covers getting familiar with the vehicle, Tennessee's safety belt laws, traffic signs and signals, rules of the road, interstate driving, night and bad-weather driving, alcohol and drugs, and driving responsibility. Each chapter ends with sample questions.
3. **Pick a full Driver Services Center.** Drivers apply for the F endorsement at a Driver Services Center, not a county clerk office or kiosk. Knowledge tests are given at every center except express service centers. Walk-ins take the test first come, first served, and select centers book knowledge test appointments online.
4. **Bring original documents.** Bring the current license, proof of citizenship or lawful permanent residency, and proof of Tennessee residency. The manual says photocopies are not accepted.
5. **Pass the vision screening.** The manual requires at least 20/40 vision in each eye and both eyes together, with or without glasses or contacts. A driver who fails can have an eye specialist fill out a statement for the department to review.
6. **Pass the for-hire knowledge test.** Under the driver manual, current as of July 1, 2022, the test runs on a computer. Centers with computer testing also offer it in Spanish, Korean, and Japanese, and select centers give oral tests by appointment to applicants who cannot read or have a learning disability. Phones stay off, and any cheating means a failed test and a 30-day wait.
7. **Pay $4.50.** As of October 2026, the endorsement costs $2.50 plus the $2.00 application fee. Centers take cash, check, money order, and major credit cards.
8. **Retest if needed.** A driver who fails waits at least one day, because no test may be repeated the same day.
9. **Copy the new license into the driver file.** Check that it shows the F endorsement before the driver's first trip, and keep the copy for audits.

## What it costs and how long it lasts

The F endorsement is the cheapest way to qualify a driver for TennCare work. Adding it costs $4.50, and it then renews with the license every eight years. These are the state's fees as of October 2026:

| License | State fee | How long it lasts |
|---|---|---|
| Class D, regular | $28.00 | 8 years |
| Class D with F endorsement | $30.50 | 8 years |
| Adding F to a current Class D | $4.50 | Until the license expires |
| Class B or C CDL | $62.00 | 8 years |

Tennessee licenses expire eight years from the date they are issued, not on the driver's birthday. A renewal needs no new test, and the endorsement carries over. Put each driver's expiration date on your calendar, because a lapsed license takes the driver off your schedule until it is renewed.

The fees are small next to the cost of the 32 hours of training TennCare requires before the first trip, so have each new driver add the endorsement before you start that training. See [NEMT driver training](https://nemtguide.com/guides/nemt-driver-training/) for building that program.

## What TennCare and the brokers check

The license is only the first item on the health plan's list. The same contract section sets the rest: a physical at least as thorough as the federal commercial driver exam, drug and alcohol testing, criminal background and registry checks, a driving record with no DUI in 10 years, and 32 hours of training. The [Tennessee state guide](https://nemtguide.com/states/tennessee/) covers those standards in full.

### How the license is checked

- **Monthly roster.** Each health plan sends TennCare a roster of your drivers every month with each driver's name, license number, and Social Security number. Report every new driver and every departure to your broker.
- **Monitoring.** The contract requires each plan to monitor driver licensure, driving records, experience, and training, along with random audits and on-street observations.
- **Immediate reports.** Drivers must tell you right away about any moving violation or a suspended or revoked license, and you must tell the plan right away.
- **Removal from service.** A driver found out of compliance is pulled from service and can return only after the plan confirms the problem is fixed.
- **Proof on file.** Keep proof of every driver requirement in the driver file, because audits can come unannounced.

### What each broker asks for

Each TennCare broker checks your drivers' paperwork too. As of October 2026, Verida's Tennessee checklist asks for driver credentials, criminal background checks, drug screens for owners and drivers, and a current driving record for every driver, and its training list includes the AAA Driver Improvement Program in Tennessee. See [Verida in Tennessee](https://nemtguide.com/brokers/verida/tennessee/) for its process. [Tennessee Carriers](https://nemtguide.com/brokers/tennessee-carriers/), which books UnitedHealthcare and Wellpoint riders, requires every provider to meet its standards for drivers, vehicles, insurance, and performance, keep meeting them, and prove it.

## A hiring checklist for Tennessee NEMT drivers

Use this order so no one reaches a rider before the license work is done:

1. Confirm the applicant is at least 18 and has two years of unrestricted driving experience.
2. Pull a driving record from every state the applicant has lived in, and screen it against the contract's limits.
3. Send the applicant to a Driver Services Center to add the F endorsement, or confirm a current CDL.
4. Schedule the physical, the drug test, and the background and registry checks.
5. Start the 32 hours of training once the endorsement is on the license.
6. Copy the license, endorsement, and every result into the driver file. The [driver file checklist](https://nemtguide.com/templates/nemt-driver-file-checklist/) lists each item.
7. Give your broker the new driver's name and license number before the first trip, so its roster stays current.

For the driver rules that apply in every state, see [NEMT driver requirements](https://nemtguide.com/guides/nemt-driver-requirements/).

## Frequently asked questions

### Do volunteer drivers need an F endorsement in Tennessee?

Not under the state's licensing rules. The Department of Safety says volunteers driving passenger (Class D) vehicles do not need the endorsement. TennCare is stricter: its health plan contract (Amendment 25, July 1, 2026) requires every driver except fixed route bus drivers to hold a Class D license with the F endorsement or a Class A, B, or C CDL, so a volunteer who drives TennCare trips for your company needs one too.

### Can a driver with an out-of-state license drive TennCare trips?

Yes, if the license fits. TennCare's contract accepts a Tennessee license or the equivalent license issued by the driver's state of residence, so a driver living in Kentucky or Georgia can use that state's equivalent. A driver who moves to Tennessee must get a Tennessee license, and the F endorsement, once the state's residency rules apply. Ask your broker which out-of-state licenses it has accepted before you hire.

### Should my drivers get a CDL instead of the F endorsement?

Only if they drive a vehicle that needs one. TennCare accepts a Class A, B, or C CDL in place of the F endorsement, and a CDL also covers Class D vehicles. A CDL takes more tests and costs $62 for a Class B or C license as of October 2026, while adding the F endorsement costs $4.50. Drivers of a vehicle designed for 16 or more people, driver included, need a Class C or higher CDL with the passenger endorsement.

### How long does the F endorsement last?

As long as the license it is added to. Tennessee licenses renew every eight years from the date they were issued, and a renewal needs no new test. A Class D license with the F endorsement costs $30.50 for the eight years as of October 2026. If the license is suspended or revoked, the driver cannot drive your trips until it is reinstated.

### What happens if a driver fails the for-hire knowledge test?

The driver waits at least one day and tries again. Under the Department of Safety's driver manual, no test can be repeated on the same day, and a one-day waiting period follows every failed knowledge test. The driver brings the same original documents back to the Driver Services Center. Build that delay into your hiring timeline so a new driver is not scheduled for trips too soon.

### Does the owner need an F endorsement to drive trips?

Yes, if you drive TennCare trips. The contract applies to all drivers, not only employees, so an owner who covers a route needs the F endorsement or a CDL like everyone else. The state rule turns on whether driving people is your main job, but the health plan rule does not, so get the endorsement before you put yourself on the schedule.

## Official resources

- [Tennessee Department of Safety: For-Hire (F) Endorsement](https://www.tn.gov/safety/driver-services/classd/classf.html)
- [Tennessee Comprehensive Driver License Manual (study Section B)](https://www.tn.gov/content/dam/tn/safety/documents/DL_Manual.pdf)
- [Tennessee Driver Services: find a center and book a knowledge test](https://www.tn.gov/safety/driver-services/locations.html)
- [Tennessee Driver License Fees](https://www.tn.gov/safety/driver-services/helpful-information/fees.html)
- [Tennessee Department of Safety: Order a driving record (MVR)](https://www.tn.gov/safety/driver-services/helpful-information/mvr.html)
- [TennCare: Statewide health plan contract (Attachment XI, NEMT driver standards)](https://www.tn.gov/content/dam/tn/tenncare/documents/MCOStatewideContract.pdf)