# How to Start a NEMT Business in Connecticut (2027)

Canonical URL: https://nemtguide.com/states/connecticut/ · Updated 2026-09-28

To start a NEMT business in Connecticut, form your company, get a livery permit from the Department of Transportation, register each vehicle on DMV livery plates, and get your drivers a public passenger endorsement. Then apply to MTM Health, the statewide Medicaid broker for the Department of Social Services, which contracts, credentials, and trains new providers where it needs more rides.

- MTM Health books Medicaid rides for the whole state, so an MTM contract is the way into HUSKY Health ride work anywhere in Connecticut.
- Every company that carries riders for pay needs a CTDOT livery permit, and each vehicle needs DMV livery plates before its first paid trip.
- MTM voids Connecticut applications that arrive without a valid DOT permit, so get the CTDOT permit before you apply to the broker.
- Livery vehicles for 14 or fewer passengers must carry at least $1.5 million in liability cover, and CTDOT checks it before it approves a registration.
- Connecticut sets no rate for broker trips. MTM negotiates each rate and does not pay for no-shows.

## Connecticut NEMT at a glance

| Fact | Details |
| --- | --- |
| Medicaid agency | Connecticut Department of Social Services (DSS), which runs HUSKY Health and contracts with one broker to arrange and pay for rides |
| How rides work | One statewide broker books rides for HUSKY A, C, and D and Covered CT members. There are no NEMT regions. |
| Medicaid broker | MTM Health, which bought Veyo, the previous broker, in 2022 and now runs the program |
| How to join | Get your CTDOT livery permit first, then apply on MTM Health's Join Our Network page. MTM voids Connecticut applications without one. |
| State registration | A Department of Transportation livery permit ($200 application), then DMV livery registration ("L" plates) for each vehicle |
| Insurance | At least $1.5 million per accident per livery vehicle for 14 or fewer passengers, $5 million for 15 or more. MTM must be certificate holder and additional insured. |
| Drivers | At least 18, with a Connecticut license carrying the F public passenger endorsement: fingerprint check, medical exam, and no DUI conviction in 5 years |
| Vehicle inspections | CTDOT inspects vans, SUVs, and any vehicle seating 8 to 10 before it is registered. Full-size vans then get a DMV inspection every six months. |
| Pay | MTM sets your rate one provider at a time. It does not pay for no-shows, and state law pays only for riders actually carried. |
| EVV | NEMT is not on the list. Connecticut's EVV covers home care and home health, such as the CT Home Care Program and the PCA and ABI programs. |

Connecticut runs Medicaid rides through one statewide broker. The Department of Social Services contracts with MTM Health, which bought Veyo, the previous broker, in 2022 and now runs the program. To drive those trips you need a Department of Transportation livery permit, DMV livery plates, drivers with a public passenger endorsement, and $1.5 million in liability cover per vehicle. The rules below follow the state statutes, CTDOT's livery forms, and MTM's Connecticut pages as of September 2026.

## How Medicaid rides work in Connecticut

The Connecticut Department of Social Services (DSS) runs Medicaid under the HUSKY Health name. It uses one broker for the whole state, with no NEMT regions, and names MTM Health as that broker. MTM takes each ride request, picks the ride type, books the trip with a company in its network, and pays that company.

Members qualify when they have no other way to reach a Medicaid-covered medical, behavioral health, or dental appointment. DSS lists HUSKY A, C, and D, Covered CT, and other limited benefit members. HUSKY B is not on the list.

MTM picks the ride that fits each member's needs, as of September 2026:

- **Mileage reimbursement** when the member, a friend, or a relative can drive.
- **Bus tickets** when home and the destination are within three quarters of a mile of a bus stop.
- **Sedan, van, or taxi** when the member can walk between the door and the vehicle.
- **Wheelchair vehicles**, for standard and oversized wheelchairs, when the member's health care provider verifies the mobility need.

DSS also lists non-emergency ambulance and air ambulance, both with prior approval. Its list has no stretcher van. MTM says it schedules ambulance trips only for members traveling out of state.

The DSS monthly reporting package shows what the work looks like. Completed trip legs in December 2025, by the report's own mode labels:

| Measure | December 2025 |
|---|---|
| All completed trip legs | 227,156 |
| Cab | 145,372 |
| Bus | 48,076 |
| Wheelchair lift | 25,385 |
| Gas reimbursement | 8,317 |
| Transportation providers | 63 |

Trips are short: the average in December 2025 was 9.85 miles, and 81 percent were 10 miles or less. Apart from return rides, the top reasons were drug rehabilitation (50,431 legs), behavioral health (18,853), specialists (12,610), and [dialysis](https://nemtguide.com/guides/dialysis-transportation/) (11,683).

## How to join MTM Health, Connecticut's Medicaid broker

You do not bill DSS for broker trips. You sign a contract with MTM, and MTM sends and pays your trips. State law requires every company that contracts or subcontracts for these rides to meet state licensure or certification rules and the DSS transportation requirements, and to offer riders every level of service it is licensed for (CGS 17b-276).

MTM's onboarding follows these steps:

1. **Apply.** Fill out the application on MTM's Join Our Network page. For Connecticut, the form says a valid DOT permit is required and applications without one are voided, so the CTDOT permit comes first.
2. **Interview and contract.** A network representative contacts you if your area needs providers. If not, MTM keeps your application on file.
3. **Credentialing.** You send every company, driver, and vehicle document. MTM's system will not assign trips to a provider whose credentials are not current.
4. **Training.** MTM walks you through its trip process. Every employee must complete fraud, waste, and abuse training and HIPAA training each year.

Trips arrive through the MTM Link provider portal, or through an API connection to your own dispatch software. MTM's Connecticut office is at 200 Corporate Place, Suite 210, Rocky Hill. The DSS NEMT unit takes questions at dss.nemt@ct.gov. Our [MTM Health guide](https://nemtguide.com/brokers/mtm-health/) covers the company in other states, and the [broker credentialing guide](https://nemtguide.com/guides/nemt-broker-credentialing/) covers the paperwork.

## Licenses and registrations

### Your company

Form an LLC or corporation with the Secretary of the State on Business.CT.gov. As of September 2026, an LLC costs $120 to form and $80 a year for its annual report, filed between January 1 and March 31, starting the year after you form. A corporation costs $250 to form, then $150 for its first report within 90 days and $150 each year after.

Get your employer identification number (EIN) free from the IRS. CTDOT asks for your organizing documents and any trade name registration. See [LLC for NEMT](https://nemtguide.com/guides/llc-for-nemt/) for choosing an entity.

### Connecticut Department of Transportation

CTDOT's Regulatory and Compliance Unit regulates for-hire passenger companies. Under CGS 13b-101 and 13b-103, any company in the business of carrying passengers for hire needs a CTDOT livery permit before its first trip. Holding yourself out as a livery operator without one is a class B misdemeanor. CTDOT offers these permits:

| Permit | What it covers | Limits |
|---|---|---|
| Restricted, government livery | Trips under a contract with, or a lower tier contract for, a federal, state, or local agency | Only trips under that contract |
| Restricted, elderly and handicapped | Livery service for elderly riders and riders with disabilities | Every vehicle in the fleet must be wheelchair accessible |
| General intrastate livery | All livery service inside Connecticut | CTDOT weighs the public need for your service |
| Interstate registration ("Z" plates) | Trips between Connecticut and another state only | Needs federal FMCSA authority first |

Each application costs $200, by check or money order payable to "Treasurer, State of Connecticut", and the fee is not refunded. The government livery form asks for the company you will contract with, so if you have no contract yet, ask the unit which permit fits before you file. Bring or send:

- The completed application with notarized signatures, and your FEIN.
- A copy of your insurance policy, or a letter on your insurer's letterhead with the proposed limits and cost.
- A photo ID and your company's organizing documents.
- A tariff sheet with your hourly or mileage rates, which must be higher than taxicab meter rates, charged from your headquarters and back.
- Financial statements showing cash on hand, in the company's name, that covers your first six months of expenses.
- A State Police criminal history, based on fingerprints, for every owner, officer, and member, updated every two years. Email the unit for the service code you need to book fingerprints.
- Answers about each owner's accidents and criminal convictions in the last 10 years, and any license suspension.

CTDOT gives you 10 business days to send any document it asks for, or it can withdraw the application and keep the fee. A complete application goes to the Administrative Law Unit for a public hearing, with notice to town officials and other livery companies in your area. There you show the need for your service and answer any opposition. The statutes let CTDOT issue government and elderly and disabled permits with or without a hearing, but its information sheet describes one, so plan for it. A denial can be appealed to Superior Court within 45 days.

After one year, you can add up to two vehicles per $200 application, twice a year, without a hearing, if all your vehicles are in use and you have no open violations (CGS 13b-103). Ads must show your CTDOT permit number and any FMCSA number (CGS 13b-109). The unit's info line is 860-594-2865. See [NEMT license requirements](https://nemtguide.com/guides/nemt-license-requirements/) for how these layers work in other states.

### Department of Motor Vehicles

The DMV will not register a livery vehicle without CTDOT's approval. After the final decision, give CTDOT your permit number, DMV form H-13, the title or bill of sale, proof of the $1.5 million insurance minimum, and your inspection form if one was required. As of September 2026, the unit handles these livery registration requests by email. A livery registration ("L" plates) costs $266 every two years for a vehicle with seven or fewer seats, plus $4 for each seat above seven (CGS 14-49).

State law also uses "invalid coach" for a vehicle used only for riders who cannot walk and are not on stretchers. Invalid coaches run by licensed ambulance organizations follow Department of Public Health standards and rates (CGS 19a-177 and 19a-181). The DSS transportation policy treats a wheelchair accessible livery vehicle, run under a CTDOT permit, the same as an invalid coach.

## Vehicle rules

CTDOT inspects before a vehicle is registered:

- **Inspected:** vans, SUVs, crossovers, wagons, modified vehicles, and any vehicle seating 8 to 10. Sedans seating seven or fewer are not.
- **Timing:** within 30 days of the final decision. An inspection is good for 30 days, so register within that time.
- **Full-size vans** built for eight or more passengers, vehicles over 10,000 pounds, and buses get a CTDOT reciprocity sticker good for six months, then a DMV inspection every six months.
- **Stretched or modified vehicles** go back to CTDOT every 24 months.

Once you hold a permit, email a CTDOT Public Transit Inspector for a free pre-purchase inspection before you buy a wheelchair van or modified vehicle. It checks whether the vehicle as built and equipped can be used in livery service, not its mechanical condition. Run through our [vehicle inspection checklist](https://nemtguide.com/templates/nemt-vehicle-inspection-checklist/) before each inspection.

CTDOT's instructions for new permit holders list this equipment for vehicles whose cargo area opens into the passenger area, such as SUVs, crossovers, and wagons:

- A floor to ceiling luggage barrier, secured at the side and floor.
- Three reflective triangles and a mounted fire extinguisher of at least 2.5 pounds.
- A first aid kit, mounted or in a labeled compartment.
- An emergency hammer and seat belt cutter. CTDOT's safety equipment guide says every vehicle should have one that riders can see and reach.

CTDOT's inspection page adds that federal rules require a USDOT number on the side of van-type vehicles, buses, modified vehicles, and any vehicle built for eight or more people, driver included.

Children under 8 must ride in a child restraint or booster seat (CGS 14-100a). DSS says MTM does not supply wheelchairs or child car seats, so the member brings them.

CTDOT's Mobility Aid Vehicle Inspection Guide, issued April 4, 2018, sets the wheelchair rules. It follows the federal ADA vehicle standards in 49 CFR part 38:

- A modifier's certification label, and wheelchair signs of at least 4 by 4 inches on the side and back.
- A securement area with a clear floor space of 30 by 48 inches near the accessible door.
- A slip resistant lift platform at least 28.5 inches wide and 48 inches long.
- Ramps 30 inches or longer that hold 600 pounds, and shorter ramps that hold 300 pounds.
- At least 56 inches of door height over the raised lift or ramp on vehicles 22 feet long or less, and 68 inches on longer ones.
- A seat belt and shoulder harness at each wheelchair position, used with the wheelchair tiedown, never in place of it.
- A lift interlock so the vehicle cannot move while the lift is out, and a way to lower and stow the lift if the power fails.
- Rear-loading vans may not load or unload riders in the public right of way.

State law adds a device that secures the rider in the wheelchair while moving between the ground and the vehicle. Livery vehicles first registered in Connecticut on or after October 1, 2007 also need one that secures the wheelchair to the lift or keeps the rider from falling off it (CGS 14-100a). See [wheelchair securement](https://nemtguide.com/guides/wheelchair-securement/) for the steps drivers follow.

## Driver rules and training

Every driver of a livery vehicle needs a Connecticut operator's license with the F public passenger endorsement (CGS 14-44). A vehicle built for 16 or more people, driver included, also needs a CDL with a passenger endorsement. To get the F endorsement, as of September 2026, a driver:

1. Is at least 18, or 21 for a commercial motor vehicle, with a valid Connecticut license and an acceptable driving record.
2. Passes a medical exam by a National Registry examiner, form MCSA-5876, within 90 days before applying, and uploads it to the DMV medical portal.
3. Mails form R-7, a national sex offender registry search printed within five days of applying, the signed FBI privacy statements, and a license copy to the DMV. Drivers new to Connecticut in the last five years add certified records from each prior state.
4. Books fingerprints with the service code the DMV emails, paying an $88.25 processing fee.
5. Waits about 6 to 8 weeks for approval, then adds the endorsement at a DMV hub office within 90 days.

Since January 1, 2024, the DMV also requires each applicant to watch its video on interacting with riders with disabilities before it issues or renews the endorsement (CGS 14-44).

The DMV withholds or withdraws the endorsement for these convictions, as of September 2026:

- **Five years:** driving under the influence, refusing or failing a chemical test, evading responsibility, and manslaughter or second-degree assault with a motor vehicle. The statute also bars anyone with a DUI conviction in the five years before applying.
- **Three years:** driving while suspended, reckless driving, and negligent homicide with a motor vehicle.
- **Two years:** moving violations such as speeding, a hand-held phone or distracted driving, failure to yield, and passing a stopped school bus.
- **Criminal records:** the DMV can deny or withdraw the endorsement for a conviction or arrest it considers a serious criminal offense, or a record that questions the driver's moral character.

A new driver can start for up to 90 days after applying, before the endorsement arrives. First, run a local, state, and national criminal and sex offender registry check, yourself or through a consumer reporting agency, and review a DMV driving record no more than seven days old. While driving, the driver carries a copy of the endorsement application and the criminal check (CGS 14-44).

MTM adds its own standards for driving records and for CPR, defensive driving, and passenger assistance training. CTDOT's livery rules make you instruct each driver on Connecticut motor vehicle and livery laws. Keep each driver's endorsement, medical certificate, driving record, and training certificates in one file. Our [driver file checklist](https://nemtguide.com/templates/nemt-driver-file-checklist/) tracks them.

## Trip rules and how you get paid

MTM's Connecticut pages set these standards, as of September 2026:

- **Booking.** Members book at least two business days ahead, up to 30 days out, and recurring trips up to 90 days out. Urgent trips, such as dialysis and [hospital discharges](https://nemtguide.com/guides/hospital-discharge-transportation/), are booked 24 hours a day.
- **Pickup.** Members are ready an hour before the appointment and call MTM once a driver is more than 15 minutes past the scheduled pickup.
- **Returns.** A scheduled return driver should arrive within 30 minutes after the visit ends. A [will-call trip](https://nemtguide.com/glossary/will-call-trip/) should be picked up within one hour of the call.
- **Shared rides.** Members may share a vehicle with other Medicaid members.
- **Minors.** Children under 16 ride with an adult, unless a rider aged 12 to 15 has a signed consent form. No rides to after-school treatment programs when local schools close.

The state's transportation policy, in chapter 7 of the Medicaid provider manual (October 1, 2020 edition), asks transportation companies to keep daily driver logs recording each rider's name, the vehicle's license number, the pickup and drop-off times and places, and any attendant's name. CTDOT's livery rules require you to keep your business records for at least two years. Record every leg on a [trip log](https://nemtguide.com/templates/nemt-trip-log-template/). NEMT is not part of Connecticut's electronic visit verification (EVV) program, which covers home care and home health.

Connecticut sets no provider rate for broker trips. State law makes DSS the only agency that sets Medicaid transportation fees, and it lets the broker contract set the rates paid under it (CGS 17b-276). MTM's Connecticut page says rates are settled with each provider individually. Three more rules shape your pay:

- **No-shows.** MTM does not pay for them, and state law has paid only for riders actually transported since October 1, 1991. Confirm each pickup the day before. See [no-shows](https://nemtguide.com/glossary/no-show/).
- **Level of service.** DSS pays only for the mode of transportation that is medically necessary (CGS 17b-276c). Run the trip at the level MTM assigned.
- **Claims.** MTM's June 12, 2024 presentation to a state oversight council notes that claims can be submitted up to 90 days after the appointment. Check the deadline in your contract.

## Insurance requirements

Connecticut law sets the minimum cover for livery vehicles (CGS 14-29):

| Vehicle | Minimum per accident |
|---|---|
| Livery, 14 or fewer passengers | $1.5 million |
| Livery, 15 or more passengers | $5 million |

CTDOT wants a current ACORD certificate of insurance from your insurer before it handles a transaction, and a new one at each policy renewal. It will not approve a DMV registration without proof of the $1.5 million minimum.

MTM's Connecticut checklist, as of September 2026:

| Item | What MTM asks for |
|---|---|
| General and auto liability | Limits that match Connecticut's NEMT requirements |
| Both policies | MTM listed as certificate holder and additional insured |
| Workers' compensation | Coverage that meets state requirements |

Ask your MTM network representative to confirm each limit in writing before you buy. See [NEMT insurance requirements](https://nemtguide.com/guides/nemt-insurance-requirements/) for what brokers ask for elsewhere.

The Workers' Compensation Commission says that, with few exceptions, every Connecticut employer must carry workers' compensation. Sole proprietors must accept the Act to be treated as an employer, and corporate officers, LLC members, and partners may opt out on the commission's forms 6B, 6B-1, and 75.

## What it costs and how long it takes

These are the fees Connecticut sets, as of September 2026. For vehicles, insurance, and equipment, see [what it costs to start a NEMT business](https://nemtguide.com/guides/how-much-does-it-cost-to-start-a-nemt-business/).

| Item | Cost | Paid to |
|---|---|---|
| EIN | Free | IRS |
| LLC certificate of organization | $120 | Secretary of the State |
| LLC annual report | $80 a year | Secretary of the State |
| Livery permit application | $200 | CTDOT |
| Livery plates, seven seats or fewer | $266 every two years | DMV |
| Each seat above seven | $4 | DMV |
| Driver fingerprint processing | $88.25 | Fingerprint booking |
| Pre-purchase wheelchair van inspection | Free | CTDOT |

A workable order, from first call to first trip:

1. **Form your company** and get your EIN.
2. **Get an insurance quote letter** for $1.5 million per vehicle, and open a company bank account holding six months of expenses.
3. **Ask CTDOT which livery permit fits**, email it for a fingerprint service code, and get your criminal history.
4. **File the livery application** with the tariff, the financial statements, and the $200 fee.
5. **Start your drivers' F endorsements.** The DMV takes about 6 to 8 weeks.
6. **Go to your hearing.** After the final decision, get each vehicle inspected within 30 days and registered within 30 days of the inspection.
7. **Send MTM's provider application** with your permit, then finish the interview, contract, credentialing, and training before your first trip.

CTDOT's hearing, the DMV's background checks, and MTM's need for providers set the pace. For the same steps in any state, see [how to start a NEMT business](https://nemtguide.com/guides/how-to-start-a-nemt-business/).

## Work beyond Medicaid

Three other sources of rides are worth a call.

- **Private pay and facilities.** Dialysis centers, hospitals, senior living communities, and riders who pay for themselves spread your work beyond one broker. A government livery permit covers only contract trips, so this work needs a general permit, or an elderly and handicapped permit for those riders. See [how to get NEMT facility contracts](https://nemtguide.com/guides/how-to-get-nemt-facility-contracts/) and [private pay NEMT](https://nemtguide.com/guides/private-pay-nemt/).
- **Town dial-a-ride programs.** CTDOT gives towns matching grants for demand responsive rides for people aged 60 or older (CGS 13b-38bb). Towns apply through their regional planning organization or transit district, so ask both how their rides are run.
- **Veterans.** The VA pays for special mode transportation, such as a wheelchair van, when a VA provider decides a veteran's condition requires it and the VA approves the trip in advance. Ask your nearest VA health facility how it books these rides.

## Frequently asked questions

### Do I need a license to run a NEMT business in Connecticut?

Yes. Connecticut General Statutes 13b-103 bars anyone from running a vehicle in livery service, which means carrying passengers for hire, without a Department of Transportation permit. Each vehicle then needs a DMV livery registration, and each driver needs the F public passenger endorsement on a Connecticut license. MTM's application says Connecticut applications without a valid DOT permit are voided.

### Who is the Medicaid NEMT broker in Connecticut?

MTM Health, also called Medical Transportation Management. It arranges non-emergency rides statewide for HUSKY A, C, and D and Covered CT members under contract with the Department of Social Services. MTM bought Veyo, the broker before it, in 2022, and says the program is now operated by MTM with the same member phone number.

### How much does MTM pay per trip in Connecticut?

Connecticut posts no provider rate for broker trips. State law makes the Department of Social Services the only agency that sets Medicaid transportation fees and lets the broker contract set the rates it pays. MTM's Connecticut page says rates are set with each provider individually, as of September 2026, and that MTM does not pay for no-shows.

### How much insurance do I need for NEMT in Connecticut?

State law requires at least $1.5 million per accident for each livery vehicle designed or used for 14 or fewer passengers, and $5 million for 15 or more (CGS 14-29). CTDOT asks for proof of the $1.5 million minimum before it approves a DMV registration. MTM also wants general liability, MTM named as certificate holder and additional insured, and workers' compensation.

### How long does it take to start a NEMT business in Connecticut?

The longest steps are the CTDOT permit and the broker. A livery application waits for your fingerprint-based criminal history, then goes to a public hearing before a final decision. Vehicles must pass inspection within 30 days of that decision and be registered within 30 days of the inspection. Driver endorsements take about 6 to 8 weeks. MTM takes Connecticut applications only with a DOT permit, and adds providers where it needs them.

### Can I start a Connecticut NEMT business with one wheelchair van?

Yes, if MTM needs wheelchair rides where you are. CTDOT offers a restricted livery permit for elderly riders and riders with disabilities, and every vehicle under it must be wheelchair accessible. You still have to show cash on hand to cover your first six months of expenses, pass the CTDOT mobility aid inspection, and insure the van for $1.5 million.

### Does Connecticut Medicaid pay for stretcher van rides?

The Department of Social Services lists public transit, mileage reimbursement, livery, wheelchair and bariatric wheelchair rides, non-emergency ambulance, and air ambulance as its ride types, as of September 2026. There is no stretcher van on the list. The two ambulance modes need prior approval, and MTM says it schedules ambulance trips only for members traveling out of state.

## Official resources

- [Connecticut DSS: Non-Emergency Medical Transportation](https://portal.ct.gov/dss/health-and-home-care/non-emergency-medical-transportation)
- [MTM Health: Connecticut transportation providers](https://www.mtm-inc.net/connecticut/providers/)
- [MTM Health: Join the provider network](https://www.mtm-inc.net/driverswanted/)
- [CTDOT: Livery permit applications and contacts](https://portal.ct.gov/dot/publictrans/bureau-of-public-transportation/regulatory-compliance-unit)
- [CTDOT: Mobility Aid Vehicle Inspection Guide](https://portal.ct.gov/dot/-/media/dot/public-transportation/mobilityaidvehicleinspectionguidesignedpdf.pdf)
- [Connecticut DMV: Public passenger endorsement](https://portal.ct.gov/dmv/licenses-permits-ids/driver-license-endorsements/apply-public-passenger-endorsement)
- [Business.CT.gov: LLC forms and fees](https://business.ct.gov/knowledge-base/articles/domestic-limited-liability-companies-forms-and-fees)
- [Connecticut Workers' Compensation Commission: Workers' compensation insurance](https://portal.ct.gov/wcc/knowledge-base/articles/employers/workers-compensation-insurance)
- [IRS: Get an employer identification number](https://www.irs.gov/businesses/small-businesses-self-employed/get-an-employer-identification-number)