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

Canonical URL: https://nemtguide.com/states/nebraska/ · Updated 2026-09-29

To start a NEMT business in Nebraska, form your company, insure your vehicles, and get Public Service Commission authority before your first paid ride. From January 1, 2027, Medicaid rides need a one-year PSC Medicaid NEMT license. Then enroll with Nebraska Medicaid through its Maximus portal and apply to MTM Health, the ride broker for all three Heritage Health plans.

- MTM Health arranges rides for all three Heritage Health plans (UnitedHealthcare since January 1, 2026), so an MTM agreement is the way into Medicaid ride work.
- Nebraska Medicaid requires every NEMT provider to enroll with the state, even when a broker pays you, and to get Public Service Commission authority before enrolling.
- From January 1, 2027, Medicaid rides need a one-year PSC Medicaid NEMT license under LB 1126, in place of the Medicaid designation on a carrier authority used through 2026.
- Drivers must be at least 19 with no more than 3 license points in 2 years, and pass sex offender, criminal history, and abuse registry checks before the first ride and every year.
- Nebraska Medicaid does not pay for wait time or no-shows, and its fee schedule base rate already covers the first five loaded miles and all empty miles.

## Nebraska NEMT at a glance

| Fact | Details |
| --- | --- |
| Medicaid agency | Nebraska Department of Health and Human Services, Division of Medicaid and Long-Term Care (MLTC). It contracts with three Heritage Health plans, which buy rides through a broker. |
| How rides work | Each Heritage Health plan hires its own ride broker, and all three use MTM Health. The few fee-for-service members request rides through the Customer Service Center. |
| Medicaid broker | MTM Health, for Molina Healthcare, Nebraska Total Care, and UnitedHealthcare Community Plan (UnitedHealthcare since January 1, 2026) |
| How to join | Get Public Service Commission authority, enroll with Nebraska Medicaid through the Maximus portal, then apply to MTM Health's network. |
| State registration | Public Service Commission: carrier authority with a Medicaid designation through 2026, then a one-year Medicaid NEMT license from January 1, 2027, for a fee of up to $250 |
| Insurance | PSC minimums: $500,000 for vehicles seating 7 or fewer passengers, $1.5 million for 8 to 15, $5 million for 16 or more, plus uninsured and underinsured motorist cover of $100,000 per person |
| Drivers | At least 19 (21 to 70 for PSC carrier drivers), no more than 3 license points in 2 years, no revocation in 3 years, and clear registry and criminal checks before the first ride and every year |
| Vehicle inspections | The PSC inspects each vehicle before it issues plates, and it may inspect carrier vehicles at any time and at least once a year. MTM tracks vehicle inspections during credentialing. |
| Pay | MTM pays under your contract. Fee-for-service trips pay from the July 1, 2026 fee schedule, such as $46.12 per wheelchair van trip, with claims due within six months. |
| EVV | NEMT is not on the list. Nebraska EVV covers personal care services (since January 2021) and home health services (since January 2024). |

Nebraska runs Medicaid rides through Heritage Health, its managed care program, and each of its three health plans hires a ride broker. All three use MTM Health, and UnitedHealthcare moved to MTM on January 1, 2026. Before MTM can use you, you need Public Service Commission authority and a Nebraska Medicaid enrollment. The rules below follow the Nebraska Medicaid Provider Manual dated August 21, 2026, and the state's NEMT regulation, 471 NAC 27, as amended November 12, 2024.

## How Medicaid rides work in Nebraska

The Nebraska Department of Health and Human Services (DHHS) runs Medicaid through its Division of Medicaid and Long-Term Care (MLTC). Nearly all Medicaid and CHIP members get their care through Heritage Health, which has three statewide health plans, each a [managed care organization](https://nemtguide.com/glossary/managed-care-organization/). Each plan picks its own transportation company, and as of September 2026 all three use MTM Health. The provider services lines come from the state's provider manual:

| Health plan | Ride broker | Provider services |
|---|---|---|
| Molina Healthcare of Nebraska | MTM Health | (844) 782-2678 |
| Nebraska Total Care | MTM Health | (844) 385-2192 |
| UnitedHealthcare Community Plan | MTM Health | (866) 331-2243 |

UnitedHealthcare moved its Nebraska rides to MTM on January 1, 2026, and its September 2026 provider manual names MTM. The state's Heritage Health member FAQ, dated May 22, 2026, still lists Modivcare for UnitedHealthcare. Our [MTM Health](https://nemtguide.com/brokers/mtm-health/) guide covers the company in its other states.

A small group of members is not in a Heritage Health plan, such as members whose Medicaid only pays Medicare coinsurance and deductibles and noncitizens covered for emergencies only. Under 471 NAC 27, [fee-for-service](https://nemtguide.com/glossary/fee-for-service-medicaid/) members request rides through the Customer Service Center, and Nebraska Medicaid pays enrolled providers from its [fee schedule](https://nemtguide.com/glossary/fee-schedule/).

### Who qualifies and where rides go

Medicaid covers the most appropriate ride to a Nebraska Medicaid service when the member has no working vehicle or valid license, cannot drive or cannot travel or wait alone because of a documented physical, cognitive, or developmental limitation, or cannot get a free ride. Rides go to the nearest Medicaid provider within 20 miles of home that can meet the member's needs, unless DHHS approves a longer trip. Medicaid may also cover rides to a pharmacy.

Nebraska Total Care's 2026 provider manual lets its rides go farther, measured one way by car. Beyond these limits, MTM needs the plan's prior approval:

| County type | One-way limit | Counties |
|---|---|---|
| Urban | 30 miles | Adams, Buffalo, Cass, Dodge, Douglas, Gage, Hall, Lancaster, Lincoln, Madison, Platte, Sarpy, Saunders, Scotts Bluff, Washington |
| Rural and frontier | 75 miles | The other 78 counties |

A child under 13 may not ride without a parent, guardian, or an adult they name, and one such adult may ride with a child under 19. One extra passenger may ride with an aged or disabled member. Long trips cover much of Nebraska's map, so read [rural NEMT](https://nemtguide.com/guides/rural-nemt/) before you set your service area.

471 NAC 27 does not cover trips to an emergency room, family visits to a hospitalized member, trips for services given at home, or pharmacy and equipment trips when free delivery is available. Nursing facility and ICF/DD residents get rides only for a discharge to a private home in Nebraska. Since May 1, 2026, Nebraska also enforces Medicaid work requirements for expansion adults aged 19 to 64 (Provider Bulletin 26-02), so a member who loses coverage loses the ride benefit. See [the federal work requirement rule](https://nemtguide.com/news/medicaid-work-requirement-rule/).

### How members book

The state rule says members request a scheduled trip at least three business days ahead. Urgent trips are the exception: an appointment the provider grants within 48 hours, and every hospital discharge. Nebraska Total Care asks for two business days and books up to 60 days ahead. UnitedHealthcare asks for three business days for routine trips and books up to 30 days ahead.

The ride types in 471 NAC 27 are fixed route public transit, ambulatory sedans, vans, and handi-buses, wheelchair-accessible vans, commercial airlines, and a personal vehicle driven by an individual provider the member picks. Nebraska Total Care also buys extra rides through MTM, such as trips to WIC appointments and Alcoholics Anonymous meetings.

## How to join MTM Health in Nebraska

The provider manual says every provider must enroll with Nebraska Medicaid before billing for covered services, whether the member is in fee-for-service, a Heritage Health plan, or a waiver. It tells NEMT providers to contact the Public Service Commission first. The order that works:

1. **Get PSC authority.** Through December 31, 2026, that means common or contract carrier authority with a Medicaid designation. From January 1, 2027, it means a PSC Medicaid NEMT license. Both are explained below.
2. **Get an NPI.** Nebraska Medicaid requires a National Provider Identifier before you enroll, and a company gets a Type 2 NPI. See [how to get an NPI number](https://nemtguide.com/guides/how-to-get-an-npi-number-for-nemt/).
3. **Enroll with Nebraska Medicaid.** Apply through the Provider Data Management System, run with the state's contractor, Maximus. PSC-certified commercial NEMT carriers are provider type 61, specialty 95, in the limited risk screening category (list updated March 22, 2024). That means federal database checks of the company, its owners, and its managers, including the [OIG exclusion list](https://nemtguide.com/glossary/oig-exclusion-list/) and SAM.
4. **Sign the enrollment documents.** Every provider accepts the Service Provider Agreement (MC-19), an Ownership Disclosure Acknowledgement, the Felony/Misdemeanor Statement (MC-199), a United States Citizenship Attestation, and the MS-84 ACH/EFT form. Enroll every business location, allow site visits, and revalidate every five years.
5. **Apply to MTM Health.** Fill out MTM's network application. Its steps are an interview, a contract, credentialing, training, and your first trip. MTM says providers in areas with a need hear back quickly, and it keeps other applications on file.

Nebraska Medicaid Provider Relations is at (402) 471-9018 and DHHS.MedicaidProviderEnrollment@nebraska.gov. For what brokers check, see [NEMT broker credentialing](https://nemtguide.com/guides/nemt-broker-credentialing/) and [how to contract with Medicaid health plans](https://nemtguide.com/guides/contract-with-medicaid-health-plans/).

## Licenses and registrations

### Your company

Form an LLC or corporation with the Nebraska Secretary of State. A certificate of organization for an LLC, or articles of incorporation, costs $100 online or $110 in the office, as of September 2026. You need a registered agent with an office in Nebraska.

An LLC must also publish a notice of organization for three weeks in a row in a legal newspaper near its designated office, under Neb. Rev. Stat. 21-193, and file the proof of publication for $25 online or $30 in the office. LLC biennial reports are due by April 1 of each odd-numbered year, starting the odd-numbered year after you form, and become delinquent on June 16. Corporations report by March 1 of even-numbered years. A missed report leads to administrative dissolution.

Nebraska has no general state business license. Get your employer identification number (EIN) from the IRS, which never charges for one. For the choice of entity, see [an LLC for a NEMT business](https://nemtguide.com/guides/llc-for-nemt/).

### Nebraska Public Service Commission

The PSC regulates the rates, routes, and service of every intrastate for-hire passenger carrier, under Title 291 NAC chapter 3 (effective June 23, 2025). Which authority you need depends on the rides you give:

| If you | You need |
|---|---|
| Carry Medicaid NEMT riders through December 31, 2026 | Common or contract carrier authority with specific authorization to carry DHHS clients |
| Carry Medicaid NEMT riders from January 1, 2027 | A PSC Medicaid NEMT license, renewed every year |
| Carry private pay, facility, or other for-hire riders | Common or contract carrier authority, such as open class service for prearranged rides |
| Drive a vehicle built for 16 or more people, driver included | A commercial driver's license (49 CFR 383.5) |

**The 2026 path.** Rule 003.02(C) bars any carrier from carrying passengers under contract with DHHS or its subcontractors without specific PSC authorization, and a limousine-only authority never qualifies. File the common or contract carrier application with a $300 nonrefundable fee, your formation papers, and a fingerprint-based background check from the Nebraska State Patrol. The August 2025 form asks about your management experience, driver screening, vehicle maintenance, and insurance. It also asks for a balance sheet, a pro forma, at least three people who would testify for you, and why your area needs another Medicaid NEMT carrier.

The PSC's own guide lays out the steps:

1. Staff review the application for one to two weeks.
2. The PSC publishes it in The Daily Record for 30 days, when other carriers can protest.
3. With no protest, you and a supporter each file an affidavit, staff review them in one to three weeks, and the PSC decides at a Tuesday Commission meeting. A contract carrier needs an affidavit from each entity it will serve.
4. With a protest, a hearing follows about six to eight weeks after a planning conference, and a decision four to six weeks after that.
5. Within 45 days of approval, file your proposed rates, your insurance, and your annual vehicle fees, or the grant becomes void. Rates carry their own 30-day publication period.
6. PSC investigators inspect every vehicle, then hand over the plates, cab cards, and your authority.

**The 2027 license.** LB 1126 (2026) amended Neb. Rev. Stat. 75-311, effective July 18, 2026. Beginning January 1, 2027, no one may give Medicaid NEMT rides for DHHS, a Heritage Health plan, or any agent of DHHS without a PSC license. The PSC approves an applicant it finds fit, willing, and able, may hold a hearing but does not have to, and sets a fee of no more than $250. The license lasts one year and renews every year. Transportation network companies can apply too, and the PSC does not regulate license holders' rates. Carriers with a Medicaid designation today should ask the PSC how they move to the license.

The PSC released draft rules for the license on August 4, 2026, in Rule and Regulation No. 215, and set a hearing on them for September 21, 2026. As proposed, the application would ask for a USDOT number, your Secretary of State filing, a designated agent, a vehicle list, and a State Patrol fingerprint check. The license would cover the whole state unless you limit it to certain counties, and the per-vehicle fee would not apply to vehicles used only under the license. These stay proposals until the PSC adopts them, and the PSC's fee schedule (effective July 1, 2026) does not yet list a license fee. Under the amended definitions in Neb. Rev. Stat. 75-302, the license is only for Medicaid rides, so private pay and facility work still needs carrier authority. See [DOT numbers for NEMT](https://nemtguide.com/guides/dot-number-for-nemt/) and [NEMT license requirements](https://nemtguide.com/guides/nemt-license-requirements/).

## Vehicle rules

The PSC inspects each vehicle before it issues your plates, and it may inspect any carrier vehicle at any time and at least once a year, under rule 005.07. A vehicle it finds unsafe stays out of service until it is repaired and reinspected. Under the draft license rules, a licensee could instead attest that a certified mechanic inspected each vehicle in the past year. MTM tracks inspections, insurance, and licenses during credentialing, and its system will not send trips to a provider whose documents lapse.

Every PSC carrier vehicle needs:

- A PSC plate on the front or rear, and the PSC identification card in the driver's area.
- Your company name and PSC application number on both doors or sides, readable from 50 feet in daylight, in a contrasting color.
- The PSC complaint notice posted where passengers can read it.
- A title and registration in your company's name, or a written lease that meets PSC rules. Personal vehicles not owned by or leased to the company cannot be used.
- Working seat belts, turn signals, lights, and horn, comfortable heat and ventilation, and child restraints as the law requires. This is the PSC's equipment standard for DHHS contractors that hold no PSC authority.
- Child seats that meet federal standard 213 for children under 8, in a back seat when one is equipped, with children under 2 rear facing, under Neb. Rev. Stat. 60-6,267. Riders aged 8 to 17 wear seat belts.

Register each vehicle with the DMV first, since the PSC registers only vehicles that already have state plates. Then file the PSC vehicle registration form, revised July 2026, and pay the PSC's per-vehicle fee, currently $50. The same fee is due again each year at renewal.

471 NAC 27 lists wheelchair-accessible vans as a ride type. It lists no stretcher van, and the state fee schedule carries no stretcher code, so ask your broker before you buy one. See [ADA rules for NEMT](https://nemtguide.com/guides/ada-requirements-for-nemt/) and run our [vehicle inspection checklist](https://nemtguide.com/templates/nemt-vehicle-inspection-checklist/) before each inspection.

## Driver rules and training

Nebraska sets driver rules in two places: 471 NAC 27 for every Medicaid NEMT driver, and the PSC rules for drivers of carrier vehicles. A driver is disqualified by:

- Being under 19. PSC carrier drivers must be 21 to 70, and the PSC can waive the upper limit each year for an insurable driver with a medical certificate and a satisfactory driving record.
- More than three points on a Nebraska license in the past two years, or failing a comparable standard in the state that licensed them.
- A driver's or chauffeur's license revocation in the past three years.
- A "record found" on the Nebraska Adult and Child Abuse and Neglect Central Registry, or a listing on the State Patrol Sex Offender Registry.
- A criminal history showing the driver was the respondent in a protection order, a crime against a child or vulnerable adult, a drug-related crime, or any crime that could harm a Medicaid client if repeated.
- Illegal drug use, vision worse than 20/40 in either eye even with glasses, or hearing below the PSC's standard.

Run the registry and criminal history checks before a driver's first Medicaid ride and every year after, for employees and independent contractors alike, and keep the results on file for DHHS. PSC carriers also keep an exam certificate from a physician or physician assistant for each driver, renewed at least every two years.

471 NAC 27 and the PSC rules set no training course for NEMT drivers, so MTM's contract sets the training. MTM walks new providers through its trip process, and every employee of an MTM provider must complete fraud, waste, and abuse training and HIPAA training each year. See [NEMT driver training](https://nemtguide.com/guides/nemt-driver-training/).

On the job, drivers do not smoke in the vehicle. Under PSC rule 005.05, no driver drives more than 12 hours after 10 hours off duty, or at all after 16 hours on duty. A driver who goes more than 100 air miles from base keeps a logbook, and you keep each day's sheet for a year. Track each driver on our [driver file checklist](https://nemtguide.com/templates/nemt-driver-file-checklist/).

## Trip rules and how you get paid

The state's NEMT chapter sets no pickup window or on-time standard, so your broker contract carries those rules. Nebraska Total Care's provider page says drivers wait five minutes, and members are asked to be ready an hour before the appointment. When a ride runs late, the member or facility calls MTM, which can send another vehicle. For UnitedHealthcare members, MTM expects you to pick up a hospital discharge within 180 minutes and a will-call return ride within 60 minutes.

PSC carriers keep a trip log for two years, signed by the driver, with who hired the vehicle, the pickup and destination addresses and times, and the amount charged. Our [trip log template](https://nemtguide.com/templates/nemt-trip-log-template/) covers those fields.

For Heritage Health members, MTM pays you under your contract. For fee-for-service members, Nebraska Medicaid pays from fee schedule 471-000-503. DHHS notes the July 1, 2026 rates did not rise because no rate increase was funded for the state fiscal year. The main codes, in dollars:

| Code | What it pays | July 1, 2026 |
|---|---|---|
| [T2003](https://nemtguide.com/glossary/t2003/) | Trip (encounter) | 19.69 |
| T2003 with modifier 52 | Trip, modifier 52 rate | 9.41 |
| [A0130](https://nemtguide.com/glossary/a0130/) | Wheelchair van trip | 46.12 |
| [S0209](https://nemtguide.com/glossary/s0209/) | Wheelchair van mileage, per mile | 1.85 |
| [S0215](https://nemtguide.com/glossary/s0215/) | Other mileage, per mile | 1.85 |
| [T2001](https://nemtguide.com/glossary/t2001/) | Attendant or escort | 2.87, or 6.05 with modifier 52 |
| [A0090](https://nemtguide.com/glossary/a0090/) | Mileage by a person with a vested interest | 0.76 |

The base rate covers vehicle costs, staff, the first five [loaded miles](https://nemtguide.com/glossary/loaded-miles/), all unloaded miles, and usual waiting time, so loaded miles are paid from the sixth mile on. 471 NAC 27 lists wait time and [no-shows](https://nemtguide.com/glossary/no-show/) as services Medicaid does not cover. You can bill only when the rider was in the vehicle and your company is enrolled with Nebraska Medicaid.

Fee-for-service claims are due within six months of the date of service, on the professional claim forms: the CMS-1500 on paper or the 837P electronically. Approved claims are usually paid the Tuesday after they are submitted. If Nebraska Medicaid takes an action against you, such as denying payment, 471 NAC 2-007.01 gives you 90 days from the date of the action to send a written hearing request to the Medicaid Director. Sanctions and refund requests must be appealed within 30 days.

## Insurance requirements

The PSC sets the minimum liability cover for every carrier by the vehicle's rated seating, under rule 003.03:

| Seats | Liability minimum |
|---|---|
| 7 or fewer passengers | $500,000 |
| 8 to 15 passengers | $1,500,000 |
| 16 or more passengers | $5,000,000 |

Passenger carriers also carry uninsured and underinsured motorist cover of at least $100,000 per person and $300,000 per accident. Your insurance company files proof with the PSC on Form E, in your company's full, correct name. The PSC accepts only continuous policies that last until cancelled on 30 days' written notice, not a policy for a fixed term. The insurer must be authorized in Nebraska, with narrow exceptions, and the PSC application warns that a personal auto policy does not count.

MTM also monitors each provider's insurance as part of credentialing. Ask MTM's network representative for its Nebraska insurance limits in writing before you buy a policy, and compare them with [NEMT insurance requirements](https://nemtguide.com/guides/nemt-insurance-requirements/).

Nebraska's workers' compensation law covers every employer with one or more employees in its regular business, under Neb. Rev. Stat. 48-106. Under 48-145, you insure with a company licensed to write workers' compensation in Nebraska, or self-insure with the approval of the Nebraska Workers' Compensation Court.

## What it costs and how long it takes

These are the fees Nebraska sets as of September 2026. Vehicles, insurance premiums, newspaper publication, and equipment depend on your quotes. See [what it costs to start a NEMT business](https://nemtguide.com/guides/how-much-does-it-cost-to-start-a-nemt-business/) for those.

| Item | Cost | Paid to |
|---|---|---|
| EIN | Free | IRS |
| LLC certificate of organization | $100 online, $110 in office | Secretary of State |
| LLC proof of publication filing | $25 online, $30 in office | Secretary of State |
| Carrier authority application (2026 path) | $300 | PSC |
| Rate filing application | $100 | PSC |
| Vehicle fee and plate | $50 per vehicle a year | PSC |
| Medicaid NEMT license (from 2027) | Up to $250 a year, set by the PSC | PSC |

The PSC fees come from its schedule effective July 1, 2026. State law caps the vehicle fee at $80. It is due each January 1, becomes delinquent on March 1, and is half in the first year if your authority is first issued on or after July 1. A workable order, from first call to first trip:

1. **Apply to MTM's network** and ask where it needs providers and which ride types it is short on.
2. **Form your company,** publish your notice, and get your EIN and NPI.
3. **Buy insurance** that meets the PSC minimums and MTM's requirements, and have your insurer ready to file Form E.
4. **Get PSC authority.** Through 2026, file the carrier application and a State Patrol fingerprint check. From January 1, 2027, apply for the Medicaid NEMT license.
5. **Register your vehicles** with the DMV and then the PSC, and pass the PSC inspection.
6. **Hire drivers** who meet the state rules, and run the registry and criminal history checks.
7. **Enroll with Nebraska Medicaid** through the Maximus portal.
8. **Finish MTM's steps:** interview, contract, credentialing, and training.

Two steps set the pace through 2026. The PSC's own step times add up to about two months before a decision on an unprotested application, and a protest adds months more. MTM adds providers only where it has a need. 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

Four other sources of rides are worth a call.

- **Waiver rides.** The Aged and Disabled and Traumatic Brain Injury waivers pay for non-medical transportation from their own fee schedule. Effective July 1, 2026, a commercial wheelchair van earns $46.12 per base rate plus $1.85 per additional mile. A commercial carrier earns $19.69 for a one-way trip wholly inside Omaha or Lincoln city limits, or a $9.41 base rate plus $1.85 per additional mile elsewhere. To become an Aged and Disabled waiver agency provider, work with DHHS or a resource developer at the Area Office on Aging, then enroll with Nebraska Medicaid.
- **Public transit and aging services.** The Nebraska Department of Transportation funds rural public transit under Section 5311 and vehicles for senior and disability rides under Section 5310. As of September 2026, NDOT lists a 5310 application window of October 31 to November 30 for areas outside Omaha. DHHS and agencies under the Nebraska Community Aging Services Act also contract for client rides.
- **Veterans.** The VA pays for special mode transportation, such as a specially equipped vehicle, when a VA provider decides the veteran's condition needs it and the VA approves the trip in advance. Ask the beneficiary travel office at your nearest VA facility how it books these rides.
- **Facilities and private pay.** Dialysis centers, hospitals, and senior living communities, along with riders who pay for themselves, add work that does not depend on one broker. In Nebraska these rides need carrier authority, and a carrier may charge only the rates the PSC has approved and keeps on file. 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/).

## Frequently asked questions

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

Yes. The Nebraska Public Service Commission (PSC) regulates for-hire passenger carriers, and the Medicaid provider manual says transportation providers must get PSC certification or an exemption before they enroll. Through December 31, 2026, Medicaid rides need common or contract carrier authority with a Medicaid designation. From January 1, 2027, they need a PSC Medicaid NEMT license, valid for one year. Nebraska has no general state business license.

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

MTM Health, for all three Heritage Health plans as of September 2026. MTM arranges rides for Molina Healthcare of Nebraska and Nebraska Total Care, and it became the broker for UnitedHealthcare Community Plan of Nebraska on January 1, 2026. The state's member FAQ dated May 22, 2026 still lists Modivcare for UnitedHealthcare, but UnitedHealthcare's provider notice and its 2026 provider manual name MTM.

### Do I have to enroll with Nebraska Medicaid if a broker pays me?

Yes. The Nebraska Medicaid Provider Manual (August 21, 2026) says every provider must enroll before billing for covered services, whether the member is fee-for-service or in a Heritage Health plan. You enroll through the Provider Data Management System, run with the state's contractor Maximus, and you need an NPI first. Commercial NEMT carriers fall in the limited risk screening category.

### What changes for Nebraska NEMT on January 1, 2027?

LB 1126 (2026) moves Medicaid NEMT from a designation on a carrier authority to its own PSC license. From January 1, 2027, no one may give Medicaid NEMT rides for DHHS, a Heritage Health plan, or anyone working on DHHS's behalf without it. The license lasts one year, costs up to $250, and the PSC may hold a hearing but does not have to. The PSC's draft rules, released August 4, 2026, would make the license statewide. As of September 2026, the PSC has not posted the license fee or the application form.

### How much does Nebraska Medicaid pay for NEMT trips?

For Heritage Health members, MTM pays you under your contract. For fee-for-service members, the fee schedule effective July 1, 2026 pays $46.12 for a wheelchair van trip (A0130) and $19.69 per trip under T2003, plus $1.85 per loaded mile after the first five. DHHS says rates did not rise for this state fiscal year, and Medicaid does not pay for wait time or no-shows.

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

Through 2026, mostly as long as the PSC takes. Its guide gives one to two weeks for review, a 30-day publication period for protests, and one to three weeks to review affidavits before a decision at a Tuesday Commission meeting, about two months in all. A protested application goes to a hearing and takes months longer. Rates, plates, and your insurance filing come after approval, and MTM adds providers only where it needs them.

### Can I start a Nebraska NEMT business with one van?

Yes. The Medicaid chapter lists ambulatory sedans and vans and wheelchair-accessible vans as ride types, and the PSC's $50 vehicle fee is charged per vehicle. One van still needs a PSC plate, an inspection, the insurer's Form E filing, and drivers who pass the state checks. Through 2026 the PSC weighs whether existing carriers already meet the need where you apply. From 2027, the license test is being fit, willing, and able to do the work and follow PSC rules.

## Official resources

- [Nebraska Medicaid Provider Manual](https://dhhs.ne.gov/Documents/Medicaid%20Provider%20Manual.pdf)
- [Nebraska Medicaid provider enrollment portal (Maximus)](https://www.nebraskamedicaidproviderenrollment.com/)
- [Nebraska DHHS: Medicaid fee schedules](https://dhhs.ne.gov/Pages/Medicaid-Provider-Rates-and-Fee-Schedules.aspx)
- [Nebraska PSC: Passenger carrier application steps](https://psc.nebraska.gov/transportation/passenger-carriers)
- [Nebraska PSC: Passenger carrier forms](https://psc.nebraska.gov/transportation/transportation-forms)
- [Nebraska PSC: Rulemaking for the Medicaid NEMT license (R&R 215)](https://psc.nebraska.gov/administration/proposed-rules-regulations)
- [MTM Health: Apply to join the network](https://www.mtm-inc.net/driverswanted/)
- [Nebraska Total Care: Transportation for providers](https://www.nebraskatotalcare.com/providers/transportation-.html)
- [Nebraska Secretary of State: Business forms and fees](https://sos.nebraska.gov/business-services/forms-and-fee-information)
- [IRS: Get an employer identification number](https://www.irs.gov/businesses/small-businesses-self-employed/get-an-employer-identification-number)