NEMT in Los Angeles County: Ambulette Licenses, City of LA Permits, and Who Books Rides (2027)

A wheelchair or gurney van company in Los Angeles County answers to two local regulators on top of Medi-Cal. The County EMS Agency licenses ambulette companies and vans for pickups in unincorporated areas, and the Los Angeles Department of Transportation (LADOT) permits every van, driver, and attendant that picks up inside the City of Los Angeles. Which one you need depends on where each ride starts, and many companies need both.

Who books Medi-Cal rides in Los Angeles County

California has no statewide NEMT broker: each Medi-Cal health plan arranges rides for its members, and every company that drives them enrolls in Medi-Cal with DHCS. The California guide covers enrollment, Title 22 van rules, and fee-for-service rates.

The Medi-Cal provider manual (page updated December 2023) lists three plans in the county: L.A. Care and its plan partners, Health Net and its plan partners, and Kaiser Permanente. L.A. Care partners with Call the Car and wants the signed Physician Certification Statement faxed to its Utilization Management at 213-438-2201 within 24 hours of each NEMT trip. As of September 2026, Call the Car lists 888-839-9909, L.A. Care’s Medi-Cal line, for L.A. Care rides around the clock, and Health Net uses Modivcare for all NEMT and NMT for members of its direct network and shared-risk medical groups.

The County ambulette license

County Code Chapter 7.17 calls every wheelchair van, litter van, and medical transport van an ambulette. An ambulette operator is anyone who, for pay, carries people needing non-emergency medical transportation from any location in the unincorporated areas of the county (Section 7.17.010). Ambulances follow Chapter 7.16, which since July 28, 2011 has required a County license for pickups anywhere in the county, cities included, and a licensed ambulance operator may run ambulettes without a second license (7.17.100). See what an ambulette is.

How to get licensed

1. Call the EMS Agency at 562-378-1500 for the current application, as its forms page asks.
2. File the application with the EMS Agency. Section 7.17.040 asks for your financial status and any unpaid judgments, the areas you will serve, each van’s type, age, condition, and capacity, your base of operations, your insurance, your color scheme and insignia, your experience, and the rates you plan to charge.
3. Attend the public hearing. Section 7.17.050 requires one on every operator application. The EMS Agency’s October 2013 hearing guide says a three-member Ambulance Licensing Hearing Board, drawn from the Department of Health Services, the Fire Department, and the Sheriff’s Department, can grant the license with or without conditions, deny it, continue the hearing, or take up to 30 days to decide. Bring six copies of any document you submit that day. If neither you nor an authorized representative appears, the application is denied for nonappearance.
4. License each van. Every ambulette that picks up in an unincorporated area displays a County seal on its left rear and carries a copy of its vehicle license (7.17.071).

The director decides whether public convenience, necessity, and safety call for the license, weighing whether you are financially responsible, efficiently managed, and fit to hold one (7.17.060). The EMS Agency’s pending list, revised July 2026, showed one ambulette applicant waiting and says no company may operate until it is approved and licensed. The licensed ambulette operators list, revised January 26, 2026, names three ambulette-only companies, in Glendale, Arcadia, and downtown Los Angeles.

What you pay (Section 7.14.010, as of September 2026)	First year	Each renewal
Ambulette operator license	$4,846.17	$2,923.43
Each ambulette van	$361.72	$327.41

A van license moves to a replacement van, but an added van needs its own (7.14.040). To sell or transfer the company, notify the director in writing at least 30 days before the transfer, and expect a possible new application, full fee, and hearing (7.14.050).

Vans, drivers, and insurance

• Van standards. Every litter and wheelchair van must meet the state standards set under Welfare and Institutions Code 14136, whether or not it carries Medi-Cal riders (7.17.070). The stretcher van requirements guide covers the Title 22 equipment.
• Odometers. A company that charges by the mile has each van’s odometer tested and certified every year by the County Weights and Measures Bureau, and sends the paid device registration certificate with each renewal (7.17.090).
• Staffing. A litter van carries a licensed and certified driver and attendant on every gurney trip. A van carrying wheelchair or semiambulatory riders needs at least one driver (7.17.109).
• Drivers and attendants. Each needs a Class B or C license or a California ambulance driver’s license, a DL-51 medical report with a Class A or B license, a Red Cross first aid certificate or equivalent, and a County ambulette ID card with photo, good for two years. EMT-1 or higher skips the card (7.17.151, 7.17.170).
• Insurance. General liability and auto liability of at least $1,000,000 combined single limit per occurrence each, naming the County as additional insured, with 30 days’ notice to the EMS Agency before any change. A deductible over $5,000 needs the County risk manager’s approval (7.17.110). Workers compensation is required before the license issues (7.17.130).

City of Los Angeles permits from LADOT

Inside city limits, LAMC 71.02 bars picking up or trying to pick up a passenger in a non-ambulatory passenger vehicle without a Board of Transportation Commissioners permit for that van. Section 71.00 covers any van built or equipped to carry riders in litters or wheelchairs, whether or not a fee is charged. Drivers need a non-ambulatory driver permit (71.03(b)), and attendants an attendant permit (71.04.1, added by Ordinance 154,996 effective April 26, 1981).

LADOT’s application procedure, revised September 20, 2022, sets the path:

1. Send the packet to the Board of Transportation Commissioners: a cover letter, one vehicle permit form per van with its DMV registration, the fees, a balance sheet and full bank statement, your articles and Statement of Information or fictitious business name, a Business Tax Registration Certificate with class L194 from the Office of Finance, and a manager’s resume. LADOT recommends a meeting with its staff first.
2. Wait for the hearing. The Board decides at a public hearing, and a first-time medical transportation applicant may wait three months.
3. Put the van in service within 120 days. It needs commercial registration, a LADOT inspection and decal, and, if you charge mileage, an odometer certificate issued within 30 days of that inspection. Proof of insurance goes in after the grant.
4. Permit your drivers. Driver permits issue only after the Board grants the van permit. Your company files each application online, and the driver brings original documents, a Live Scan form, and first aid and CPR cards.

LADOT’s fees, from LAMC 71.06.1 (amended effective March 5, 2022) and the procedure letter revised September 20, 2022:

LADOT fee	Amount
New company application	$4,463
Company permit, initial and each July	$1,081
Technology fee, each July	$100 per van
Van permit	$542 if the CHP inspects it, $567 if not
Decal	$45
Driver or attendant permit	$98 new, $104 renewal, plus $107 fingerprinting

The Board’s guidelines, approved August 11, 2005, limit a company that holds no unrestricted permits to three new ones. You must show one year running a non-ambulatory service in California, two years managing a fleet, or two years in medical transportation administration. You also need $20,000 in liquid assets plus $5,000 for each van you do not yet own, a business plan with your Medi-Cal provider number, and a Department of Justice background check on every majority owner, manager, and supervisor. A company serving a facility or public agency under contract can instead get restricted permits that cover only that contract’s riders, for as long as it runs.

Board Order 598, as amended July 7, 2023, adds rules beyond the state’s:

• A van getting its first permit is no more than 10 years old, and may stay five more years with a yearly inspection by a state-certified mechanic.
• Its lift or ramp holds at least 600 pounds, each wheelchair gets a 30 by 48 inch floor space, and interior height is at least 56 inches in a van 22 feet long or less.
• It carries GPS navigation, a 10-unit first aid kit, a two-way radio or phone, and your unit number on the right rear and left front fenders.
• A gurney trip has two crew members and a dispatcher on duty. LADOT’s driver permit brochure also asks litter van drivers and attendants for a state EMT-1 card or higher.
• You keep every call record for two years and file a profit and loss statement, balance sheet, and trip statistics within 45 days after your fiscal year ends.

LAMC 71.14 sets insurance for a van seating 1 to 7 at $100,000 per person, $300,000 per accident, and $50,000 property damage, and 8 to 12 seats at $100,000, $350,000, and $100,000.

What the County and City let you charge

Both governments set the most a company may charge. The City’s schedule covers trips that start in Los Angeles unless a higher authority sets the rate, and the County’s does not apply to a contract with the County.

Charge	County, 7.17.080 (1996)	City of LA, Ordinance 187,587 (September 16, 2022)
One seated or wheelchair rider	$36.50	$46.00
Each rider when two ride	$22.75	$25.75
Gurney patient	$70.25	$116.50
Each mile	$3.50 per patient	$4.00, shared among a group
Waiting, each 15 minutes after the first 15	$8.00	$12.00
Night, 7 p.m. to 7 a.m.	$16.75	$19.75
Wheelchair use	$5.50	$10.25

The City also allows $25.50 for an extra attendant and $27.00 for oxygen, and every bill must tell riders they can take complaints to LADOT at 213-928-9600. See private pay NEMT for setting cash rates.

County overflow contracts

The Department of Health Services ran 22 BLS ambulances and 8 medical transport vans of its own in December 2024, and it buys the rides that fleet cannot cover, for itself and three other County departments, through Transportation Overflow Services master agreements. On December 3, 2024, the Board of Supervisors approved successor agreements from January 1, 2025 to December 31, 2030, with options to 2035, at an estimated $8.821 million a year. The Board letter says the qualification process stays continuously open to new companies.

To qualify, hold a County ambulance or ambulette operator license in good standing, with no upheld violations in the prior six months, plus business licenses in each city you respond in. Ambulette insurance is $1 million general liability per occurrence and aggregate, $1 million auto, and workers compensation with $1 million employer’s liability. Ambulette-only contractors are exempt from the 24-hour access requirement.

What to do first

1. Map your pickups. Unincorporated pickups need the County license, and City of Los Angeles pickups need LADOT permits.
2. Enroll in Medi-Cal through PAVE, as the California guide explains, and gather what the NEMT license requirements guide lists.
3. Call the EMS Agency at 562-378-1500 and LADOT at 213-928-9600 before you buy vans, since LADOT’s age, lift, and GPS rules go beyond the state’s.
4. Apply to Call the Car and Modivcare once your Medi-Cal application is in.
5. Ask the EMS Agency about the overflow qualification once your County license is granted.

For the other Southern California county pages, see San Diego County and Riverside County.