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

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

To start a NEMT business in Florida, form your company on Sunbiz, get your local business tax receipts and any county for-hire permit, and insure your vans. Then enroll with Florida Medicaid through AHCA, pass a Level 2 fingerprint check for each owner, and apply to the brokers your county's health plans use: Modivcare, MTM Health, Alivi, or Ride2MD.

- Florida has no single Medicaid broker. Each health plan picks its own, so the brokers you join depend on the plans in your counties.
- Enroll your company with Florida Medicaid first. Plans must confirm that every network provider holds a current agreement with AHCA.
- Every owner of 5 percent or more needs a Level 2 fingerprint screening. Drivers need a Level 1 screening.
- Florida sets no state NEMT license, but Miami-Dade, Broward, and Palm Beach counties regulate wheelchair and stretcher companies.
- Plans hold transportation providers to Rule 14-90: drug testing, driver medical exams, hours limits, and yearly vehicle inspections.

## Florida NEMT at a glance

| Fact | Details |
| --- | --- |
| Medicaid agency | Agency for Health Care Administration (AHCA), which pays health plans and two fee-for-service brokers a monthly rate for each eligible member |
| How rides work | Each Statewide Medicaid Managed Care plan arranges rides through a broker, in nine regions (A to I). Members outside a plan ride with one of two state brokers. |
| Medicaid brokers | Modivcare (Aetna, Community Care Plan, Humana), MTM Health (Molina, UnitedHealthcare since March 1, 2026), Alivi (Sunshine), Ride2MD (Simply, Florida Community Care) |
| How to join | Enroll your company with Florida Medicaid as a non-emergency transportation provider, then apply to each broker that serves the plans in your counties |
| State registration | No state NEMT license. AHCA enrollment, a Level 2 fingerprint check for each owner, local business tax receipts, and permits in Miami-Dade, Broward, and Palm Beach. |
| Insurance | AHCA enrollment asks for $100,000 per person and $200,000 per incident. The state plan contract sets $200,000 per person and $300,000 per incident. |
| Drivers | A valid license and a Level 1 screening. Rule 14-90 adds drug and alcohol tests, a medical exam every two years, and hours limits. Miami-Dade sets a minimum age of 18. |
| Vehicle inspections | At least once a year under the plan contract and Rule 14-90. Miami-Dade inspects at a county station, and Palm Beach wants a yearly ASE mechanic inspection. |
| Pay | Your broker negotiates your rate, and your broker agreement sets when you get paid. The state fee schedule sets rates only for ambulances. |
| EVV | Not required for NEMT. Florida EVV covers home health visits, private duty nursing, and personal care services. |

Florida runs Medicaid rides through its health plans. Under Statewide Medicaid Managed Care, each plan hires its own broker, so there is no single broker to join. Members who are not in a plan ride with one of two brokers the state hires directly. The rules below follow the state's Non-Emergency Transportation Services Coverage Policy (November 2019), its plan contract updated July 1, 2026, and its February 2026 provider enrollment policy.

## How Medicaid rides work in Florida

The Agency for Health Care Administration (AHCA) runs Florida Medicaid. Most members belong to a Statewide Medicaid Managed Care (SMMC) plan, and AHCA pays each plan a monthly rate for each member. Every plan must provide rides around the clock to members with no other way to reach a covered service, including dental care and prescriptions. Every plan hires a broker to arrange its rides.

Since February 2025, the program has nine lettered regions, set by section 409.966 of the Florida Statutes. Members outside a plan ride with one of two fee-for-service brokers, paid a monthly rate per eligible member under the state's NEMT waiver for July 1, 2025 to June 30, 2027:

- **Region A** (Modivcare): Bay, Calhoun, Escambia, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Okaloosa, Santa Rosa, Taylor, Wakulla, Walton, and Washington.
- **Region B** (MTM Health): Alachua, Baker, Bradford, Citrus, Clay, Columbia, Dixie, Duval, Flagler, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Nassau, Putnam, St. Johns, Sumter, Suwannee, Union, and Volusia.
- **Region C** (MTM Health): Pasco and Pinellas.
- **Region D** (MTM Health): Hardee, Highlands, Hillsborough, Manatee, and Polk.
- **Region E** (MTM Health): Brevard, Orange, Osceola, and Seminole.
- **Region F** (MTM Health): Charlotte, Collier, DeSoto, Glades, Hendry, Lee, and Sarasota.
- **Region G** (Modivcare): Indian River, Martin, Okeechobee, Palm Beach, and St. Lucie.
- **Region H** (Modivcare): Broward.
- **Region I** (Modivcare): Miami-Dade and Monroe.

Fee-for-service members include people in the Medically Needy program and presumptively eligible pregnant women.

### Which broker each health plan uses

AHCA's report of plan subcontractors, cumulative through the second quarter of 2026, names these brokers:

| Health plan | Broker for its rides |
|---|---|
| Aetna Better Health of Florida | Modivcare |
| Community Care Plan | Modivcare |
| Humana Medical Plan | Modivcare |
| Molina Healthcare of Florida | MTM Health |
| UnitedHealthcare Community Plan | MTM Health, since March 1, 2026 |
| Sunshine Health, its specialty plans, and its long-term care plans | Alivi |
| Children's Medical Services Health Plan | MTM Health (plan run by Sunshine through September 30, 2026) |
| Simply Healthcare and Clear Health Alliance | Ride2MD |
| Florida Community Care | Ride2MD |

UnitedHealthcare moved its rides to MTM Health on March 1, 2026 (see the UnitedHealthcare switch). The Children's Medical Services Plan moves to Molina on October 1, 2026, so ask Molina which broker handles it. Not every plan serves every region, so check the state's plan comparison tool at flmedicaidmanagedcare.com.

### Who qualifies and which ride fits

A member qualifies when they have no other way to reach a Medicaid service. The policy covers the most cost-effective ride that is medically right for the member: airline, ambulance, public transit, wheelchair or stretcher van, multi-load van, private vehicle, nonprofit agency, taxi, or rideshare. Sunshine describes stretcher service as a reclining ride with no lights, sirens, or emergency equipment required.

The policy also sets these rules:

- **Copay.** Members owe $1 per trip unless exempt or waived by the plan. When it applies, the plan pays you the contracted amount less the copay.
- **Escorts.** Carry an escort at no charge when the member is under 21, is blind or deaf, has a mental illness or intellectual disability, or needs help because of a medical condition. The escort cannot be your driver or employee. Plans must also carry up to three of the member's children under 13 at no extra cost.
- **No caps.** You may not limit a member's trips, set trip zones, or refuse a ride because the doctor is far away.
- **Not covered.** Waiting time during the appointment, trips a home and community-based waiver already provides, Baker Act transfers to a behavioral health facility, and visits to hospitalized family.

Overnight trips include lodging and meals at the state travel rate. Some groups get no rides, such as members covered only as Qualified Medicare Beneficiaries and Family Planning Waiver members.

Providers may not require booking more than three business days ahead, and urgent trips need no reservation. Plans set at least a 24-hour notice policy. Sunshine books routine rides one business day ahead and must approve trips of more than 100 miles one way.

## Which brokers to join

Joining has two parts: enrolling with the state, then contracting with brokers.

1. **Find the plans in your counties** with the state's comparison tool, then list their brokers from the table above.
2. **Enroll with Florida Medicaid** on the Florida Medicaid Web Portal as provider type 41, Transportation, Non-emergency (specialty 941). Limited Enrollment is for providers who serve only plan members. Full Enrollment adds fee-for-service members.
3. **Send the documents.** The February 2026 policy asks for the application, proof of your tax ID (IRS letter 147C, Form SS-4, or a W-9), fingerprint screening for everyone on the application, a local business license or business tax receipt, and liability insurance of $100,000 per person and $200,000 per incident.
4. **Apply to each broker.** Modivcare, MTM Health, and Alivi have forms on their provider pages, and Alivi says it calls back within 2 business days. For Ride2MD, ask Simply's or Florida Community Care's provider services.
5. **Pass credentialing** with each plan or the broker working for it.

AHCA processes a complete application in 60 days or less, and you have 21 days to fix anything missing. You renew every five years. The policy also lists a surety bond (AHCA Form 5000-1064) for non-emergency, multi-load, and taxi providers, except those contracted through the transportation coordinator.

Plans must confirm every provider holds a current AHCA agreement and finish onboarding within 60 days. If your onboarding is not done in 60 days and the plan did not cause the delay, it may take back what it paid you. They also check transportation providers against chapter 427 of the Florida Statutes and Rules 41-2 and 14-90, which cover drug testing, safety, and driver conduct. Screen your people against the [OIG exclusion list](https://nemtguide.com/glossary/oig-exclusion-list/) too. See our pages on [Modivcare](https://nemtguide.com/brokers/modivcare/), [MTM Health](https://nemtguide.com/brokers/mtm-health/), and [Alivi](https://nemtguide.com/brokers/alivi/).

### Level 2 screening for owners

Section 409.907 of the 2026 Florida Statutes requires a Level 2 screening through AHCA for each principal: officers, directors, managing employees, billing agents, and anyone owning 5 percent or more. It is a fingerprint check against state and FBI records, requested through the Care Provider Background Screening Clearinghouse. As of September 2026, it costs $60 plus the vendor's fee, keeps prints on file for 5 years, and usually takes 5 to 7 business days. Renewal costs $42. See the Level 2 background check.

## Licenses and registrations

### Your company

Form an LLC or corporation with the Division of Corporations on Sunbiz. As of September 2026, an LLC costs $125 ($100 to file plus $25 for the registered agent) and a corporation costs $70. File the annual report between January 1 and May 1: $138.75 for an LLC and $150 for a corporation, with a $400 late fee after May 1. A company that has not filed by the third Friday in September is administratively dissolved.

Get your EIN free from the IRS, and a Type 2 NPI for your company, which AHCA checks against the national registry. See [how to get an NPI number](https://nemtguide.com/guides/how-to-get-an-npi-number-for-nemt/). Then get a local business tax receipt from your county and, where required, your city.

### AHCA and your county

Florida has no state NEMT license. AHCA asks for a state license only from ambulances, and other transportation companies show a local license. Some counties add a permit. See [NEMT license requirements](https://nemtguide.com/guides/nemt-license-requirements/).

| If you | You need |
|---|---|
| Serve any Medicaid member | Florida Medicaid enrollment with AHCA, provider type 41 |
| Own 5 percent or more, or manage the company | A Level 2 fingerprint screening through AHCA |
| Run wheelchair or stretcher trips in Miami-Dade | A county Non-Emergency Certificate and a chauffeur registration for each driver |
| Run wheelchair or stretcher trips in Palm Beach County | A vehicle for hire permit, vehicle decals, and driver ID badges |
| Run medical transport in Broward | A license from Broward County Consumer Protection |
| Drive a vehicle built for 16 or more people, counting the driver | A commercial driver's license |

**Miami-Dade.** Chapter 4, Article III of the county code covers rides for people on stretchers or in wheelchairs who need no medical care on the way. Apply to the Department of Transportation and Public Works for a Non-Emergency Certificate (wheelchair, stretcher, combo, or specialty sedan). The county checks your finances and criminal record, and the Board of County Commissioners must approve, which takes three to six months. Vehicles need county inspection decals before they start. Each driver must be at least 18 and needs a county chauffeur registration, with a Florida driver's license, a defensive driving certificate, and wheelchair Passenger Assistance Techniques training where it applies.

**Palm Beach County.** Consumer Affairs licenses every non-medical wheelchair and stretcher company operating in the county, and each driver needs a permit and ID badge. Its application, revised in January 2020, requires at least two vehicles for a new company and a yearly inspection of each vehicle. Vehicles more than two model years old need that inspection from an ASE certified mechanic.

**Broward County.** The Consumer Protection Division licenses emergency and non-emergency medical transport services. Call 954-765-1700 before you run trips there. In other counties, ask the tax collector and consumer protection office whether a vehicle for hire permit applies.

**Registration and heavier vans.** Florida registers a van that carries people for pay as a for-hire vehicle. A vehicle rated at 10,000 pounds or more is a Florida commercial motor vehicle, and section 316.302 applies certain federal driving, equipment, and inspection rules to it. A vehicle built for more than 15 people, counting the driver, needs a driver with a CDL. See do NEMT drivers need a CDL.

## Vehicle rules

The plan contract requires a safety inspection of every vehicle at least once a year. Under Rule 14-90, the inspector needs at least a year of experience as a mechanic or inspector, and the check covers brakes, lights, tires, steering, suspension, exhaust, mirrors, doors, seat belts, safety equipment, wheelchair equipment, and the speedometer. Keep inspection and maintenance records for four years, and daily driver inspection reports for two weeks. Use our [vehicle inspection checklist](https://nemtguide.com/templates/nemt-vehicle-inspection-checklist/).

Every vehicle needs:

- Two-way communication with your base, audible to the driver at all times.
- Working air conditioning and heat.
- The plan's toll-free complaint number posted inside.
- A charged fire extinguisher rated at least 1A:BC, mounted within reach.
- Two outside rear view mirrors and a driver seat belt.
- A seat for every rider, escort, and attendant, within the registered seating capacity.
- Room for the member's wheelchair, child seat, stretcher, secured oxygen, or IV equipment. Belongings that can be stowed safely ride free.

No smoking, eating, or drinking unless medically needed. Take out of service any vehicle that fails state licensing or safety standards, ADA rules, or the contract, and have it inspected again before it carries members.

Lift and ramp vans must meet ADA rules. Under Rule 14-90, a lift or ramp cannot push the van past its weight ratings, the controls must give the operator a full view of the platform and rider, and every vehicle carries normal and emergency lift instructions. Train each driver on [wheelchair securement](https://nemtguide.com/guides/wheelchair-securement/).

## Driver rules and training

Under section 409.907, drivers who work for a transportation company, a rideshare company, or a broker need a Level 1 screening, not Level 2. Level 1 covers employment history, a statewide criminal check through the Florida Department of Law Enforcement (FDLE), and the national sex offender website. As of September 2026, an FDLE search costs $24 plus a $1 card fee.

A guilty finding, or a guilty or no contest plea, for any offense on the list in section 435.04 disqualifies a driver. The list includes:

- Violent crimes such as murder, manslaughter, vehicular homicide, kidnapping, and aggravated assault or battery.
- Sexual offenses, including sexual battery and lewd or lascivious offenses.
- Abuse, neglect, or exploitation of a child, an elderly person, or a disabled adult.
- Felony theft or robbery, burglary, arson, and felony drug offenses.

A domestic violence offense, or a pending arrest for a listed offense, also disqualifies a driver.

Rule 14-90 adds these standards, which the plan contract applies to transportation providers:

- **License.** No one drives on a suspended, cancelled, or revoked license, and a driver must report a suspension notice by the end of the next business day.
- **Medical exam.** Before hire, at least every two years, and after 30 or more days off sick or injured, on FDOT Form 725-030-11 or a stricter standard.
- **Drug and alcohol testing.** A drug-free workplace policy and a testing program under 49 CFR parts 40 and 655. See NEMT driver drug testing.
- **Hours.** No more than 12 hours of driving in 24 hours, no driving after 16 hours on duty, 8 hours off before driving again, and no more than 72 hours on duty in 7 days.

Training covers boarding, wheelchair lifts, defensive driving, passenger securement, and emergencies. Under Rule 41-2.006, drivers give their name and company at pickup and wear photo ID the rider can see. The plan contract also requires help boarding when a rider needs it.

Keep background checks, training records, medical certificates, and daily duty logs for four years. The plan also needs a trip database with the driver's name and license number for every trip. Our [driver file checklist](https://nemtguide.com/templates/nemt-driver-file-checklist/) covers what to collect.

## Trip rules and how you get paid

Plans must meet these on-time targets for AHCA, measured each month:

| Standard | Plan target |
|---|---|
| Arrival for the appointment | On time for at least 90% of trips |
| Missed trips | No more than 0.2% of requests |
| Unscheduled trips | 85% served within 3 hours of the request |
| Pickup to the appointment (Leg A) | 90% within 15 minutes of the scheduled time |
| Return pickup (Leg B) | 90% within 30 minutes of the scheduled time |
| Members with standing orders | No missed appointments caused by the transporter |

Standing orders include dialysis, cancer treatment, and methadone. AHCA can charge a plan $2,500 for each appointment missed because of a late or missed ride. Sunshine expects a response of up to 60 minutes on a [will-call trip](https://nemtguide.com/glossary/will-call-trip/). Record pickup and drop-off times and places on a [trip log](https://nemtguide.com/templates/nemt-trip-log-template/) so each claim matches the trip.

Florida does not set rates for van trips. The policy says non-ambulance trips are paid at a rate you negotiate with the broker, and the 2026 fee schedule sets rates only for ambulances, such as $137.96 for a non-emergency basic life support ambulance (A0428).

When a plan pays a provider directly, it must pay or answer an electronic claim within 15 days, or a paper claim within 20 days. When you bill a broker, your broker agreement sets when you get paid and what you get for [no-shows](https://nemtguide.com/glossary/no-show/), so read those sections before you sign.

You can take a dispute past the broker. Each plan runs its own provider complaint system and cannot hand it to a subcontractor. File a non-claim complaint within 45 days of the issue, and the plan must resolve it within 90 days.

## Insurance requirements

Meet the highest liability minimum that applies to your work:

| Who asks | Minimum liability |
|---|---|
| AHCA enrollment | $100,000 per person and $200,000 per incident |
| Health plan contract | $200,000 per person and $300,000 per incident |
| Transportation Disadvantaged work | $200,000 per person and $300,000 per incident |
| Miami-Dade certificate | $100,000 per person, $300,000 per incident, and $50,000 property damage |
| Palm Beach County | $125,000, $250,000, and $50,000, or $300,000 combined single limit |

Brokers can set higher limits, so ask each one before you buy. See [NEMT insurance requirements](https://nemtguide.com/guides/nemt-insurance-requirements/).

Florida requires workers' compensation once a non-construction business has four or more employees, counting corporate officers and LLC members. Officers, and LLC members who own at least 10 percent, can file an exemption with the Division of Workers' Compensation. See workers' comp for NEMT drivers.

## What it costs and how long it takes

These are the government fees, as of September 2026. For vans, 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 |
|---|---|
| EIN from the IRS | Free |
| LLC formation on Sunbiz | $125 |
| LLC annual report | $138.75, or $538.75 after May 1 |
| Corporation formation on Sunbiz | $70 |
| Level 2 screening for each owner | $60 plus the fingerprint vendor's fee |
| FDLE criminal history search for each driver | $24 plus a $1 card fee |
| Miami-Dade certificate application | $300 per certificate, plus $25 per person screened |
| Miami-Dade annual certificate fee | $625 |
| Miami-Dade chauffeur registration | $55 to register or renew |
| Miami-Dade vehicle inspection | $70 for a new vehicle, $38 after that |
| Palm Beach new vehicle for hire business | $10,000 initial fee, $100 business fee, $50 per vehicle decal (2020 application) |

A workable order, from first call to first trip:

1. **Check your market.** Find the plans and brokers in your counties.
2. **Form your company** on Sunbiz and get your EIN.
3. **Get local permits.** In Miami-Dade, apply early, since the certificate takes three to six months.
4. **Get your NPI** and book Level 2 screenings for every owner and manager.
5. **Buy insurance** at the highest limit you face, and register each van as for-hire.
6. **Equip and inspect** each vehicle.
7. **Hire drivers.** Run Level 1 screenings, driving records, drug tests, and medical exams, then train them.
8. **Enroll with Florida Medicaid.** Allow up to 60 days.
9. **Apply to each broker** and finish credentialing, which plans must complete within 60 days.

## Work beyond Medicaid

Medicaid is not the only source of rides in Florida. Three others are worth a call.

- **Transportation Disadvantaged program.** This state program serves people who cannot drive or buy rides because of disability, income, or age. Each county's Community Transportation Coordinator contracts with local operators, who follow Rule 14-90 and must be paid within 7 working days after the coordinator is paid.
- **Veterans.** The VA pays for special mode transportation when a VA provider decides a veteran's condition requires it. Ask your nearest VA medical center how it books these rides, and see VA transportation contracts.
- **Facilities and private pay.** Dialysis centers, hospitals, senior living communities, and riders who pay for themselves add work that does not depend on one broker. See [NEMT facility contracts](https://nemtguide.com/guides/how-to-get-nemt-facility-contracts/) and [private pay NEMT](https://nemtguide.com/guides/private-pay-nemt/).

## Frequently asked questions

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

Florida has no state NEMT license. You enroll your company with Florida Medicaid through AHCA, each owner passes a Level 2 fingerprint screening, and you get your city and county business tax receipts. Some counties add their own permit. Miami-Dade requires a Non-Emergency Certificate that takes three to six months, and Palm Beach County licenses non-medical wheelchair and stretcher companies. A vehicle built for more than 15 people, counting the driver, needs a driver with a CDL.

### Who are the Medicaid NEMT brokers in Florida?

Each health plan picks its own. As of the state's second quarter 2026 report, Modivcare works for Aetna, Community Care Plan, and Humana, and MTM Health works for Molina and the Children's Medical Services Plan, which moves from Sunshine to Molina on October 1, 2026. UnitedHealthcare moved to MTM Health on March 1, 2026. Alivi works for Sunshine Health, and Ride2MD for Simply, Clear Health Alliance, and Florida Community Care. Members outside a plan ride with Modivcare or MTM Health, depending on the region.

### Do I have to enroll with Florida Medicaid if I only drive for a broker?

Yes. The state contract requires each health plan to confirm that all its providers hold a current agreement with AHCA. Limited Enrollment is the type for providers who only serve plan members. Plans must finish onboarding a provider within 60 days. If you do not complete onboarding in that time and the plan did not cause the delay, it may take back what it paid you.

### Do NEMT drivers in Florida need a Level 2 background check?

Florida law requires a Level 2 fingerprint screening for the owners, officers, and managing employees of a Medicaid provider. Drivers who work for a transportation company, a rideshare company, or a broker need a Level 1 screening instead, under section 409.907 of the 2026 Florida Statutes. A broker or a county permit may ask for more, so check each agreement.

### How much do Florida Medicaid brokers pay per trip?

Florida does not set a per-trip rate for wheelchair, stretcher, or ambulatory vans. The state NET policy says those trips are paid at a rate you negotiate with the broker. The state fee schedule sets rates only for ambulances. Time spent waiting for a rider during an appointment is not a covered service, so ask how your broker handles long waits before you sign.

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

The state steps set the pace. AHCA processes a complete Medicaid application in 60 days or less, and you have 21 days to fix anything missing. Plans then have up to 60 days to onboard you. A Level 2 screening usually takes 5 to 7 business days. A Miami-Dade Non-Emergency Certificate takes three to six months because the county commission must approve it.

### Can I get NEMT work in Florida outside Medicaid?

Yes. Each county has a Community Transportation Coordinator that arranges rides for the state's Transportation Disadvantaged program and contracts with local operators. The VA pays for special mode transportation when a VA provider decides a veteran needs it. Dialysis centers, hospitals, senior living communities, and private pay riders add work that does not depend on one broker.

## Official resources

- [AHCA: Fee-for-service NEMT brokers and provider contacts](https://ahca.myflorida.com/medicaid/medicaid-policy-quality-and-operations/medicaid-policy-and-quality/medicaid-policy/federal-authorities/federal-waivers/fl-1915-b-managed-care-waiver.html)
- [AHCA: Non-Emergency Transportation Services Coverage Policy](https://ahca.myflorida.com/content/download/5967/file/59G-4.330.pdf)
- [AHCA: Florida Medicaid provider enrollment readiness tool](https://ahca.myflorida.com/provider/readiness.html)
- [AHCA: Background Screening Clearinghouse](https://info.flclearinghouse.com/screening-information.html)
- [Florida Medicaid: Compare health plans by county](https://www.flmedicaidmanagedcare.com/health/comparehealthplans)
- [Modivcare: Become a transportation provider](https://www.modivcare.com/transportation-providers-contact-us/)
- [MTM Health: Join the transportation network](https://www.mtm-inc.net/service-providers/)
- [Alivi: Become a transportation provider](https://alivi.com/become-a-transportation-provider/)
- [Miami-Dade County: Non-Emergency Transportation Certificate](https://www.miamidade.gov/global/license.page?Mduid_license=lic1500577699583202)
- [Florida Division of Corporations: Filing fees](https://dos.fl.gov/sunbiz/forms/fees/)