How to Start a NEMT Business in Arizona (2027)

Arizona runs Medicaid through AHCCCS, and most members get rides from their health plan. MTM Health arranges rides for three plans, Mercy Care contracts transportation companies itself, and AHCCCS pays providers directly for fee-for-service members. The rules below follow AMPM Policy 310-BB (effective October 1, 2026), Chapter 14 of the fee-for-service billing manual (revised July 31, 2026), and the provider type 28 packet (revised September 2026).

How Medicaid rides work in Arizona

The Arizona Health Care Cost Containment System (AHCCCS) pays health plans a capitation rate for each member, and the plans arrange rides and pay the companies that drive them. AHCCCS Complete Care (ACC) plans serve members by region, and the AHCCCS plan list revised June 30, 2026 shows three:

Region	Counties	ACC health plans
Central	Maricopa, Gila, most of Pinal	All six: Arizona Complete Health, Banner, Health Choice, Mercy Care, Molina, UnitedHealthcare
North	Apache, Coconino, Mohave, Navajo, Yavapai	Arizona Complete Health, Health Choice
South	Cochise, Graham, Greenlee, La Paz, Pima, Santa Cruz, Yuma	Arizona Complete Health, Banner, and UnitedHealthcare in Pima

Pinal County ZIP codes 85542, 85192, and 85550 belong to the South region. Long-term care (ALTCS) members who are elderly or physically disabled are with UnitedHealthcare, Banner, or Mercy Care, depending on the county. ALTCS members with developmental disabilities are with the DES Division of Developmental Disabilities. American Indian members can choose the American Indian Health Program (AIHP), which AHCCCS runs as fee for service, like Tribal ALTCS.

AHCCCS covers a ride when the member cannot provide, secure, or pay for their own transportation and no free ride is available. It goes to and from a covered medical or behavioral health service at the nearest appropriate AHCCCS registered provider, or to pick up Medicare Part D prescriptions. Federal Emergency Services Program members get no NEMT.

Three rules catch new providers:

• Pharmacy trips. For plan members in Maricopa and Pima counties, a pharmacy ride is covered only within 15 miles of the pickup, one way, unless the plan approves a specialty pharmacy.
• Booking notice. Under the Policy 310-BB version effective October 1, 2026, a plan may ask members to book up to three calendar days ahead, and no more. Dialysis, chemotherapy and radiation, urgent visits, hospital and emergency room discharges, prenatal care, transplants, sleep studies, and short-notice appointments are exceptions.
• Minors. Members under 18 who are not emancipated ride with a legal guardian or an adult the guardian authorizes. A plan can let a 16 or 17 year old ride alone with the guardian’s signed release (Policy 310-BB Attachment A) if the driver holds a Level I fingerprint clearance card from the Department of Public Safety. Fee-for-service minors never ride alone with a NEMT company.

Mercy Care’s provider manual defines four ride types: taxis, ambulatory vehicles (vans, cars, and minibuses), wheelchair vans, and stretcher vans. Plans must offer public transit where it runs, and rideshare companies take Medicaid trips only through a broker.

Which brokers to join

Each plan decides how it buys rides. The plans’ own provider manuals and notices show this as of September 2026:

Health plan	How it buys rides
Arizona Complete Health	MTM Health (formerly MTBA), its only NEMT vendor since October 1, 2021
Blue Cross Blue Shield of Arizona Health Choice	MTM Health
UnitedHealthcare Community Plan	MTM Health, for ACC, ALTCS, and DDD members
Mercy Care	Contracts transportation companies through its Network Management department
Banner University Family Care	Credentials NEMT vendors and transportation companies
Molina Healthcare	Ask Molina’s provider services team

Arizona Complete Health’s vendor was Medical Transportation Brokerage of Arizona (MTBA), which MTM Health bought on July 1, 2023. See our MTM Health guide.

AHCCCS registration comes first, whoever you drive for. Federal rule 42 CFR 438.602(b) requires the state to enroll every plan network provider, and a plan may sign you before approval for only 120 days. See how to contract with Medicaid health plans.

1. Take the AHCCCS NEMT certification course. Only the business owner takes it. Create a non-state worker account in AZLearns, the state’s learning platform, and complete course HCNEMT2026. Questions go to dmpstraining@azahcccs.gov.
2. Register in APEP as provider type 28. Apply in the AHCCCS Provider Enrollment Portal as an atypical facility, agency, or organization; no NPI is needed. Upload the course certificate as a License document named AHCCCS Division of Fee for Service (NEMT), plus the signed provider type 28 profile, vehicle insurance, vehicle registrations, your ADOT Vehicle for Hire permit, and any tribal business licenses.
3. List every driver in APEP with full legal name, date of birth, Social Security number, and employment dates. Report changes within 30 days.
4. Set up direct deposit. Send the EFT form with a blank check or bank letter through the AHCCCS Solutions Center, or the application is denied.
5. Apply to MTM Health. Its steps are application, interview, contracting, credentialing, training, and a first trip. With no need in your area, MTM keeps your file and calls when one opens.
6. Write to Mercy Care. Send a letter of interest with your AHCCCS ID, locations, services, and insurance declaration pages, plus a W-9 and the Arizona Association of Health Plans (AzAHP) Organization-Facility Application. Send it to Network Management by fax at 860-975-3201 or by the email in section 2.01 of Mercy Care’s provider manual. To join, Mercy Care requires your AHCCCS registration to be complete.
7. Apply to Banner and the other plans. Banner uses the AzAHP application, takes up to 90 days, and re-credentials at least every 36 months.

Once registered, you can also bill AHCCCS directly for AIHP and other fee-for-service members, who book with a registered NEMT company themselves.

How AHCCCS screens you

AHCCCS rates NEMT as a high risk provider type (see provider risk levels). That means:

• A site visit, which also checks the company logo on every vehicle. See our site visit guide.
• Fingerprints through the Department of Public Safety for anyone owning 5 percent or more and for the directors, CEOs, and presidents on your Arizona Corporation Commission record. Another state’s clearance card does not count.
• A $750 enrollment fee for calendar year 2026, refunded only in limited cases, such as an approved hardship exception.
• Database checks, including the OIG exclusion list.

AHCCCS generally processes applications within 60 days, enrollment usually starts on the approval date, and providers generally revalidate every four years. The moratorium on new NEMT enrollment ended December 9, 2024. AHCCCS Provider Assistance answers at (602) 417-7670, or 1-800-794-6862 outside Maricopa County.

Licenses and registrations

Your company

Form an LLC or corporation with the Arizona Corporation Commission (ACC). LLC Articles of Organization cost $50, or $85 expedited, under the fee schedule revised March 2026. Regular review typically takes 14 to 16 days, expedited 3 to 5.

Every LLC keeps a statutory agent with an Arizona address. If that address is in Maricopa or Pima County, the ACC posts your filing notice online; elsewhere you publish it in a newspaper. LLCs file no annual report, and corporations pay $45 a year.

Get your EIN from the IRS, which never charges for one, and a completed W-9 for AHCCCS. You can add an NPI later if a plan asks; see how to get an NPI number.

To pick up or drop off on tribal land, you need that tribe’s business license on file with AHCCCS, a rule in place since October 1, 2014. Without it, AHCCCS denies prior authorization and recoups claims. AHCCCS posts a monthly list of licensed NEMT companies by tribe, including the Navajo Nation and the Tohono O’odham Nation. See NEMT on tribal lands.

Arizona Department of Transportation

The ADOT Motor Vehicle Division licenses taxi, livery, and limousine companies under A.R.S. 28-9503, and no company may operate without a Vehicle for Hire permit. AHCCCS requires it too. A livery vehicle has up to 15 seats, driver included, charges a flat rate by zone or area, and may run prearranged trips.

1. Register your business or trade name with the ACC or the Secretary of State.
2. Apply once through the DocuSign link on ADOT’s livery application page. ADOT’s company application is form 36-0100, and ADOT emails you when yours is processed.
3. Print the permit from ServiceArizona and keep a copy in every vehicle.

The permit lasts three years and renews online. Livery vehicles pay no application fee; the $24 per vehicle fee, capped at $1,000, is for taxis. Report account changes within 10 business days and ownership changes within 30 days. Violations can cost up to $1,500 each. ADOT’s Vehicle for Hire unit answers at 602-712-5948.

Vehicle	What you need
Up to 8 seats, driver included	Vehicle for Hire permit and an ADOT-approved plate
9 to 15 seats	The permit plus a commercial registration and plate
16 or more seats	Too large for a livery permit; drivers need a commercial license

For licensing layers across states, see NEMT license requirements.

Vehicle rules

AHCCCS inspects at its site visit. ADOT does not inspect when you apply, but its compliance staff inspect on complaints and at random. State law makes each vehicle meet state safety and emissions standards and get a yearly brake and tire inspection by a qualified party, with records kept two years.

Every vehicle needs:

• A sign or logo with your company name.
• An inside sign with your business name, address, and driver’s name. For contract rides it says fares are set by contract with a government agency.
• Your ADOT permit, insurance documents, and registration on board.
• No more riders than the manufacturer’s seating, all inside the vehicle and following state restraint laws.
• Child restraints for children under 5, and for children 5 to 7 who are 4 feet 9 inches or shorter in vehicles built for 10 or fewer passengers.
• Good working order, with any stop along the way tied to a covered service.

Wheelchair vans need doors wide enough for a wheelchair, a lift that loads and unloads safely, and restraints that secure each wheelchair. AHCCCS pays for one only when the member must ride in a wheelchair. Mercy Care’s manual describes stretcher vans as built for a secured, medically approved stretcher, for members unable to sit or stand.

Use our vehicle inspection checklist before the site visit.

Driver rules and training

A person cannot drive for you if they:

• Lack a valid Arizona driver’s license. Keep a copy for AHCCCS.
• Have not had a criminal background check. Run it before hire and keep written proof for ADOT.
• Were convicted of an offense requiring sex offender registration under A.R.S. 13-3821.
• Lack current CPR, first aid, and HIPAA training. The owner signs an attestation for every driver.

You also need a zero-tolerance policy on drugs and alcohol, posted on your website or in the vehicle. When a rider complains, suspend the driver and investigate, and remove the driver for good if the complaint holds up. Keep those records two years. See NEMT driver background checks.

On the job:

• Never sign for the member. A relative, guardian, caretaker, or escort can sign, or the member can leave a fingerprint. The driver never signs, even if also a relative.
• Call before leaving a facility. Never leave a nursing facility or assisted living pickup without calling to confirm whether the member is available, and help the member into the destination.

Keep each driver’s license copy, background check, and certificates. The AHCCCS provider agreement requires records for six years from the date of payment.

Trip rules and how you get paid

Under Policy 417, effective October 1, 2026, plans hold their vendors to this standard:

• Arrival. On time, but no more than one hour before the appointment.
• Return. No more than one hour of waiting after treatment ends.
• No early pickups. Never before treatment is finished.
• Target. 95 percent of pickups and drop-offs on time each quarter, with monthly vendor checks.

Billing fee-for-service trips

You bill AHCCCS on a CMS 1500, an 837P, or the AHCCCS Online portal. Chapter 14 sets the rules:

• The Daily Trip Report. Every claim needs the AHCCCS Daily Trip Report (Exhibit 14-1), no other version. Record addresses, clock times, and odometer readings at pickup and drop-off, the vehicle, and signatures, and correct errors with a single line. Our trip log template captures the same details.
• One claim per member per day. Line 1 is the number of trips, line 2 the loaded miles, line 3 any wait time. Each member on a shared ride gets a separate trip report, and since November 1, 2022 claims list pickup and drop-off addresses.
• Prior authorization is needed when one member’s trips top 100 miles in a day.
• Wait time (T2007) is paid only when returning to base was impractical. It is never paid for one-way trips, waits under 30 minutes, destinations within 10 miles, or when the odometer moves.

The schedule effective October 1, 2026 pays these dollar amounts. Urban trips start in the Phoenix or Tucson metro area; all others are rural and carry the TN modifier. AHCCCS describes A0120 as minibus, mountain area, and other trips, and S0215 as general mileage; wheelchair and stretcher vans have their own codes.

Service	Urban	Rural (TN)
Ambulatory trip (A0120)	$6.64	$7.27
Ambulatory mile (S0215)	$1.28	$1.63
Wheelchair van trip (A0130)	$11.15	$12.21
Wheelchair van mile (S0209)	$1.54	$1.66
Stretcher van trip (T2005)	$49.09	$86.70
Stretcher van mile (T2049)	$1.54	$1.66
Wait, per 30 minutes (T2007)	$4.59	$4.59

The only change from October 1, 2025 is rural ambulatory mileage, up from $1.53. Health plans and MTM Health pay the rate in your contract, which can differ from this schedule. See rural NEMT for long-trip math.

• Timely filing. Claims are due within 6 months of the date of service and must be clean within 12 months. State law holds plans to the same limits.
• No-shows. The fee schedule has no no-show code, and unloaded miles are never billable, even for a prescription pickup. See no-shows.
• Disputes. File in writing within 12 months of the date of service or 60 days after a denial, whichever is later: with the AHCCCS Office of General Counsel for fee-for-service claims, or with the plan. An unfavorable decision leaves 30 days to request a state fair hearing.
• Members. Never bill an AHCCCS member for a covered ride or offer gift cards for their business.

Insurance requirements

State law (A.R.S. 28-4033) sets these minimums for carrying passengers for hire, and ADOT revokes a Vehicle for Hire permit if the coverage lapses. Seats include the driver, liability is a combined single limit, and the last column is uninsured motorist coverage.

Seats	Liability	Uninsured
Up to 8	$250,000	$250,000
9 to 15	$750,000	$300,000
16 or more	$5,000,000	$300,000

For 8 or fewer seats, the statute also accepts the taxi and livery option in A.R.S. 28-4039: $250,000 in liability per incident once a ride is accepted, with uninsured motorist coverage of at least $25,000 per person and $75,000 per incident. Send insurance documents to ADOT Mandatory Insurance, Mail Drop 526M, P.O. Box 2100, Phoenix, AZ 85001.

Policy 310-BB points to the AHCCCS Minimum Subcontract Provisions, which are part of the AHCCCS provider agreement and every plan contract. A large contract is worth $50,000 or more over its term; a small one is worth less.

Coverage	Large	Small
General liability, each occurrence	$1 million	$500,000
General liability, total	$2 million	$1 million
Auto liability	$1 million	$1 million
Employers’ liability	$1 million	$500,000
Professional liability	$1 million	$1 million
Abuse and molestation, if required	$500,000	$250,000

Liability policies name the State of Arizona as additional insured, cannot be canceled without 30 days’ written notice, and come from insurers rated A- VII or better by A.M. Best. Plans decide when to require abuse and molestation coverage for providers serving children or vulnerable adults. See NEMT insurance requirements.

Arizona’s workers’ compensation law covers every employer with regularly employed workers, part-year included. Only sole proprietors and independent contractors who sign the state waiver are exempt under the subcontract provisions.

What it costs and how long it takes

Arizona sets these fees. For vehicles and insurance, see startup costs.

Item	Cost	Paid to
LLC Articles of Organization	$50, or $85 expedited	ACC
EIN	Free	IRS
Vehicle for Hire permit, livery	No fee	ADOT
Vehicle for Hire permit, taxi	$24 per vehicle, up to $1,000	ADOT
AHCCCS enrollment fee, 2026	$750	AHCCCS
Corporation annual report	$45 a year	ACC

A workable order, from first call to first trip:

1. Call MTM Health and the plans in your region to ask where they need providers.
2. Form your company with the ACC (14 to 16 days, or 3 to 5 expedited) and get your EIN.
3. Register and insure your vehicles, with commercial plates for vehicles built for more than 8 passengers.
4. Get the ADOT Vehicle for Hire permit.
5. Hire drivers and complete background checks and CPR, first aid, and HIPAA training.
6. Finish the owner’s NEMT course and get any tribal business licenses.
7. Apply in APEP, pay the $750 fee, and complete fingerprints, the site visit, and EFT. Allow about 60 days.
8. Credential with MTM Health and the plans once AHCCCS approves you. Mercy Care requires a completed AHCCCS registration, and Banner’s credentialing can take up to 90 days.

Work beyond Medicaid

• ADOT’s Coordinated Mobility Program. ADOT’s Section 5310 funds buy vehicles and pay operating costs in small urban and rural areas, mainly for nonprofits that carry seniors and people with disabilities. Tribes count as local governments, and public agencies qualify in some cases. General applications open in odd years, and projects must fit the region’s coordinated transportation plan, which private providers help shape. See Section 5310 grants.
• Veterans. The VA pays for special mode transportation, an ambulance or specially equipped vehicle, when a VA provider decides the veteran’s condition requires it and VA approves the trip in advance. See VA transportation contracts.
• Facilities and private pay. Dialysis centers, hospitals, senior living, and self-paying riders add work beyond any one plan, but never charge an AHCCCS member for a covered ride. See how to get NEMT facility contracts.