How to Start a NEMT Business in New Jersey (2027)

New Jersey runs Medicaid rides through one broker. Modivcare arranges non-emergency rides for NJ FamilyCare members in all 21 counties, in a program the state has run since 2009. To drive those trips you need a registered company, the right state or town license for your vehicles, and drivers and insurance that pass the broker’s checks. The rules below follow the Medicaid transportation chapter, N.J.A.C. 10:50 (readopted March 3, 2022), and the Department of Health’s MAV and ambulance chapter, N.J.A.C. 8:40 (readopted September 25, 2023).

How Medicaid rides work in New Jersey

The Division of Medical Assistance and Health Services (DMAHS), part of the Department of Human Services, runs NJ FamilyCare, the state’s Medicaid program. State rule N.J.A.C. 10:50-1.4 puts every non-emergency ride with a broker under contract with the department: non-emergency ambulance, mobility assistance vehicle (MAV) service, livery, public transit, and mileage reimbursement. The state pays the broker a fixed monthly rate for each member, a capitation payment, and the broker pays the transportation companies.

Health plans do not arrange these rides. The NJ FamilyCare managed care contract (January 2026 version) leaves all MAV, non-emergency stretcher, and livery trips with the state’s broker, and plans cover only emergency ground and air transportation. In its bid for the next broker contract, the state reports 4,357,216 paid trips in 2022, about 363,101 a month, with an average of 157 transportation companies under contract each month.

Modivcare assigns each rider a level of service. For ambulatory MAV, wheelchair, and stretcher riders, a doctor, physician assistant, nurse practitioner, or registered nurse signs a Medical Necessity Form. The form says how long the level lasts: 90 days, 180 days, a year, or lifetime.

Level	Rider	Vehicle
Ambulatory	Walks to the vehicle alone	Livery sedan or van
Special rate ambulatory	Walks, but rides alone	Livery sedan or van
Ambulatory MAV	Walks, needs help door through door	Ask Modivcare
Wheelchair MAV	Uses a wheelchair	Licensed MAV
Basic life support	Travels on a stretcher	BLS ambulance

Modivcare’s form calls the ambulatory MAV level door-through-door livery service, while the state’s bid calls it ambulatory MAV, so ask Modivcare which license it wants for those riders. Members who can use a bus get a pass instead. Modivcare puts members from skilled nursing facilities at the ambulatory MAV level automatically.

Members book at least two business days ahead: by phone up to a month before the appointment, and online with no limit. Facilities set up standing orders for trips three or more days a week to the same place, such as dialysis, good for three months. Modivcare’s New Jersey facility FAQ gives the transportation provider three hours to pick up a hospital discharge and up to 90 minutes for a will-call return. Its closest provider policy limits rides to 20 miles when an equal provider is available in the community, with exceptions for unique specialists and treatment already under way.

Ridership may shift in 2027. Starting January 1, 2027, certain adults ages 19 to 64 on NJ FamilyCare Plan ABP must work, volunteer, or go to school to keep coverage, and most of them must renew every six months. Members who miss a renewal can lose coverage, and their rides with it. See the federal work requirement rule.

How to join Modivcare, New Jersey’s Medicaid broker

You do not enroll with NJ FamilyCare to give non-emergency rides. The state’s rule sends every NEMT trip through the broker and requires the broker to use only transportation companies that DMAHS approves (N.J.A.C. 10:50-1.3). Modivcare, formerly LogistiCare, holds that contract. It came out of Chapter 11 bankruptcy on December 29, 2025 (see Modivcare exits bankruptcy). Its steps:

1. Get your license first. Wheelchair trips need a Department of Health MAV license, stretcher trips need a BLS ambulance license, and sedan trips need a town license and MVC registration.
2. Send the provider form. Fill out the Become a Transportation Provider form on Modivcare’s Join Our Network page, which also maps the areas where Modivcare needs providers most.
3. Send your documents. For each driver, Modivcare lists a PASS wheelchair certificate, First Aid and CPR, a defensive driving certificate, a drug screen, a motor vehicle report, and a background check. For each vehicle, it wants current registration, a passed state inspection, and proof of insurance.
4. Pass the field visit. Modivcare visits providers to confirm their vehicles meet its contract standards.
5. Complete compliance training. Owners and drivers train when they contract and every year after, and the owner signs an annual attestation.

Once you contract, Modivcare’s provider page links to its provider portal, billing and claims help, ride reservations, and driver safety courses. Our Modivcare guide covers the company in its other states.

New Jersey is choosing its next broker

The Division of Purchase and Property took bids for the next broker contract, bid T2503, until March 4, 2026. Until DMAHS names a winner, Modivcare arranges the rides. The winner must sign every provider’s service agreement and inspect every vehicle within 120 days of the award, and the state will hand it a list of the companies that drive trips today. Three parts of the bid matter to small companies:

• Small business subcontracting. The winner must make a good faith effort to subcontract with certified New Jersey Small Business Enterprises and Disabled Veterans’ Businesses. Certification through the Division of Revenue and Enterprise Services is free, because the state has waived its $100 fee.
• No ride-hail apps. The bid does not allow transportation network companies in the network.
• Exclusion checks. The broker must confirm no one working for your company is on a federal or state exclusion list.

A bill pre-filed for the 2026 session, A985, would put vehicle, staffing, and on-time standards for broker providers into law. It is a proposal, not law.

Licenses and registrations

Your company

Get your employer identification number (EIN) from the IRS, free and issued online. Form an LLC or corporation with the Division of Revenue and Enterprise Services: the certificate of formation costs $100 under the fee schedule updated July 1, 2026. Then file Form NJ-REG to register for state taxes and as an employer. Those two filings let you get a Business Registration Certificate, which you need to contract with any New Jersey public agency, counties and towns included.

File an annual report by the last day of the month you formed in, every year, for $75. The state can revoke a business that fails to file, even if it never received a reminder.

New Jersey Department of Health, Office of Emergency Medical Services

The Office of EMS licenses every company that provides MAV or basic life support service on a trip that starts in New Jersey, whoever pays for the ride (N.J.A.C. 8:40-2.4). It licenses the company and each vehicle. Running without a license can bring a cease and desist order and penalties of $1,000 a day, plus $1,000 a day for each unlicensed vehicle (N.J.A.C. 8:40-7.4).

If you carry	You need
Wheelchair riders	A MAV provider license and a license for each vehicle
Riders on a stretcher	A BLS ambulance license, because a MAV may not carry a stretcher
Walking riders, curb to curb	No health license: a town license and MVC registration
Walking riders who need help door through door	A MAV or a livery license, as Modivcare directs

A BLS ambulance normally needs two EMTs. Under a Department of Health waiver revised December 9, 2025, a company that files the waiver paperwork may staff non-emergency BLS runs with one EMT and one emergency medical responder.

A MAV license application needs:

• The Office of EMS application, listing every owner and all of the ownership.
• A street address for your principal place of business. A post office box or mail drop is rejected.
• A standard operating procedures manual covering the topics in N.J.A.C. 8:40-3.5.
• Personnel files for your crew, and at least one licensable vehicle.
• A certificate of insurance sent by your insurer or agent.
• A fingerprint background check for each owner of 5 percent or more, plus your incorporation papers and a government photo ID.

The department also reviews each owner’s track record, including licenses in other states and any fraud or criminal convictions. Pay by certified bank check or money order to “Treasurer, State of New Jersey”. Fees under N.J.A.C. 8:40-2.5:

Fee	Amount
New MAV provider	$1,500 plus $100 per vehicle
New provider, second year of the cycle	$1,250 plus $50 per vehicle
Renewal	$500 plus $100 per vehicle
Late renewal	$500 more
Ownership change, same controlling owner	$250

Licenses last up to 24 months. Trade names starting with A through L expire December 31 of even-numbered years, and M through Z on December 31 of odd-numbered years. A renewal filed 10 or more days late is refused, and you apply again as a new provider. Report any ownership change at least 30 days ahead, and a new controlling owner needs a new license before running trips (see how to sell a NEMT business). Licensing questions go to the Office of EMS at 609-633-7777 or OEMSAgencyLic@doh.nj.gov.

Motor Vehicle Commission and your town

The Motor Vehicle Commission (MVC) registers licensed MAVs as passenger vehicle transportation, with plates that start with “OM”.

Sedans and minivans that carry walking riders are livery work. New Jersey law defines livery service as carrying passengers for hire by limousine (N.J.S.A. 48:16-13). A limousine company:

• Files a $1.5 million liability policy with the clerk of the town where it has its principal place of business (N.J.S.A. 48:16-14).
• Gets a license to operate from that town, for no more than $50 per company plus $10 per vehicle, and files the duplicate with the MVC (N.J.S.A. 48:16-17).
• Registers each vehicle with MVC limousine plates, with an insurance certificate naming the MVC as certificate holder and a power of attorney for service of process.

Only your home town can license a limousine company that runs trips between towns (N.J.S.A. 48:16-22.3). A town may charge up to $50 for its own license if you run trips that start and end inside it (N.J.S.A. 48:16-18.1). Taxis follow a separate law, but they also need town approval and a $1.5 million policy (N.J.S.A. 48:16-3). Ask Modivcare which registration it accepts for ambulatory trips. For licensing in every state, see NEMT license requirements and livery vehicle.

Vehicle rules

The Office of EMS inspects each MAV before it licenses it, on its EMS-16 survey report, and holds annual licensing inspections plus random, unannounced ones. The MVC inspects MAVs every year for safety and emissions. Modivcare makes its own field visits, and the bid for the next contract adds a yearly broker inspection of every MAV and livery vehicle.

Every MAV needs (N.J.A.C. 8:40-4 and 8:40-5, and the EMS-16 survey):

• A seat belt for every occupant, and a child restraint for children under 8 who weigh 80 pounds or less, kept on board or at your office.
• A mounted fire extinguisher rated 2A 10BC or 3A 40BC with a current tag, a flashlight with two D cells, and three reflective triangles or battery flashers. Flares are not allowed.
• A CPR mask or other barrier device, and exam gloves.
• A working heater and air conditioner, two-way communications, and “No smoking” signs in the rider and driver areas.
• Your trade name on both sides in letters at least 4 inches high, the vehicle number on both sides and the rear at least 3 inches high, and the wheelchair access symbol at least 8 inches high.

A MAV may not look like an ambulance: no Star of Life, no lights or sirens, no words like “Paramedic”, and “Ambulance” or “Emergency” only as part of your legal company name. It carries no more than nine passengers and never a stretcher.

Each wheelchair position needs a four-point, forward-facing tiedown that holds the chair frame to within one inch of movement, plus a seat belt fixed to the wheelchair. The ramp or automatic lift must hold at least 500 pounds, with a manual backup that works within five minutes. The rider compartment must measure at least:

Measurement	Minimum
Height above each wheelchair position	58 inches
Width at 42 inches above the floor	56 inches
Length, one or two wheelchair positions	82 inches
Length, three or four positions	92 inches

The compartment needs two doorways that are not side by side, such as a curbside door in the front half and a rear door, each at least 28 inches wide and one at least 56 inches high. Vehicles first licensed after February 17, 1998 need a roll cage or roll bar. The bid for the next contract lists 56 inches of headroom, but the Department of Health rule requires 58, so buy to the higher number.

Livery vehicles need a two-way communication system (a mobile phone counts), a first aid kit, and a fire extinguisher (N.J.S.A. 48:16-22.1). Before the first pickup each day, the driver checks tires, wipers, horn, windows, lights, fluids, and brakes on a checklist you supply (N.J.S.A. 48:16-22.2).

Use our vehicle inspection checklist before each inspection, and see NEMT vehicle requirements.

Driver rules and training

For MAV crews, the Department of Health sets these rules (N.J.A.C. 8:40-4.1 and 8:40-5.3):

• At least 18 years old, with a valid driver’s license.
• A current CPR card, and a PAT (Passenger Assistance Techniques) technician card, a MAV technician card, or a course the department approves.
• Pediatric basic life support if you routinely carry children under 8.
• EMT certification if the vehicle carries oxygen equipment, unless the rider supplies it.
• A second crew member when a wheelchair rider is moved up or down five or more steps, or weighs 200 pounds or more and is moved two or more steps.

Crew members wear ID with their name and your company name and carry no weapons, pepper spray included. Keep a file for each one with a copy of the driver’s license, a photo ID, the PAT, MAV, or EMT card, and the CPR card. Our driver file checklist tracks them.

Livery drivers must be at least 21 and cleared by the MVC through a fingerprint background check before they drive (N.J.S.A. 48:16-22.3a). You send the MVC an employer certification application for each driver. Each applicant also takes a drug test at their own cost (N.J.S.A. 48:16-22.3b). A conviction for crimes such as aggravated assault, arson, robbery, sexual assault, or endangering the welfare of a child disqualifies a driver unless they hold a certificate of rehabilitation. Letting an uncleared driver work carries a $500 penalty for each day.

The bid for the next contract adds broker rules for every driver:

• No more than three chargeable accidents or moving violations in three years. No DWI or DUI conviction, and no license suspension for driving offenses, in five years.
• No sexual abuse conviction ever, and no substance abuse or violent crime conviction in seven years.
• 20 hours of classroom and behind-the-wheel training, including wheelchair securement and first aid, within 45 days of hire, with a refresher every two years.

See NEMT driver training and wheelchair securement.

Trip rules and how you get paid

The Department of Health requires a patient care report for every rider on every leg, signed by the crew. It lists the rider, their condition and any help given, pickup and drop-off times and places, the vehicle, and the crew. Give a copy to the receiving facility within 24 hours, and keep reports for 10 years. Report any death or injury in your vehicle, or a crash that must be reported to police, to the Office of EMS by the end of the next business day, then in writing within 14 days. Our trip log template covers the trip times.

The bid for the next contract sets these standards for the broker’s network:

Standard	Next contract bid
Pickups	95 percent within 30 minutes of the scheduled time
Will-call returns	Within 60 minutes of the rider’s call
Shared rides	90 percent no more than 45 minutes longer than a direct trip
Riders per vehicle	Up to 4 adults or 9 children
No-shows	Wait at least 10 minutes past the pickup time

The bid also requires a daily log of actual pickup and drop-off times for each rider, and electronic trip tracking in 90 percent of vehicles. See no-shows. NEMT is not on New Jersey’s electronic visit verification (EVV) list, which covers personal care, MLTSS home-based supportive care, and three DDD services since January 1, 2021, and home health since January 1, 2023.

New Jersey sets no MAV or livery rate. The state’s transportation fee schedule, in N.J.A.C. 10:50-2.2, covers only ambulance and air ambulance codes, which ambulance companies bill directly. Modivcare negotiates your rate. In the bid for the next contract, the broker negotiates rates by service level, including bariatric stretcher and two-person wheelchair trips. It must pay within 30 calendar days of a clean claim and settle incomplete claims within 60 days, and you must bill within one year of the trip. It may drop a provider without cause, but must offer an appeal. See how to bill NEMT brokers.

Insurance requirements

The Department of Health will not license a MAV company until an original certificate of insurance arrives from your insurer or agent, naming the department as certificate holder and your trade name as an insured. Minimums under N.J.A.C. 8:40-3.3, with auto limits per vehicle and per occurrence:

Coverage	MAV	BLS
Auto liability	$500,000	$500,000
General liability	$300,000	$300,000
Professional liability	None	$300,000

Stop all service the moment any required coverage lapses. Livery and taxi companies need a $1.5 million liability policy filed with their town (N.J.S.A. 48:16-14 and 48:16-3). Modivcare asks for general liability, sexual abuse and molestation coverage, auto liability, and workers’ compensation, with limits that vary by state, so ask for New Jersey’s limits in writing.

The bid for the next contract sets higher floors, in dollars:

Coverage	Minimum
General liability	1 million per occurrence, 2 million aggregate
Business auto, with hired and non-owned	2 million combined single limit
Employer’s liability	1 million per accident and per employee

The State of New Jersey must be an additional insured on the general and auto policies. See NEMT insurance requirements.

New Jersey requires workers’ compensation as soon as one person works for you for pay. Corporate officers count, while LLC members, partners, and a sole owner do not. Going without is a disorderly persons offense, with penalties of up to $5,000 for each 10 days. See workers’ comp for NEMT drivers.

What it costs and how long it takes

These are the fees New Jersey sets as of September 2026. Vehicles and insurance premiums depend on your quotes; see what it costs to start a NEMT business.

Item	Cost	Paid to
EIN	Free	IRS
LLC certificate of formation	$100	Division of Revenue
Annual report	$75 a year	Division of Revenue
Small business certification	Free, fee waived	Division of Revenue
MAV provider license	$1,500 plus $100 per vehicle	Department of Health
MAV renewal	$500 plus $100 per vehicle	Department of Health
Limousine license to operate	Up to $50 plus $10 per vehicle	Your town

A workable order, from first call to first trip:

1. Choose your service levels: MAV work, sedan work, or both.
2. Form your company, get your EIN, file NJ-REG, and rent a street address.
3. Buy insurance, and have your agent send certificates to the Department of Health or your town clerk.
4. Buy and equip vehicles to N.J.A.C. 8:40, measuring the compartment before you sign.
5. Hire and train crews, with CPR, a PAT or MAV technician card, and background checks.
6. Apply to the Office of EMS, pass the vehicle inspection, and register each vehicle with the MVC.
7. Send Modivcare’s provider form and your documents, and pass its field visit.

The Department of Health sets the pace. It returns incomplete applications, and you have six months to complete one without a second fee. Once it calls your application complete, you have six months to request the initial audit and vehicle inspections. A new vehicle can run for up to 30 days on a certificate of inspection while its license arrives. For the same steps in any state, see how to start a NEMT business.

Work beyond Medicaid

• MLTSS non-medical rides. NJ FamilyCare health plans buy non-medical trips, such as shopping and religious services, for members in Managed Long Term Services and Supports, billed per trip with T2003. The managed care contract asks these providers for a valid inspection sticker, liability insurance, background checks, and a fee schedule.
• Developmental disability waivers. Under its Supports Program manual of September 2025, the Division of Developmental Disabilities pays approved providers $0.77 a mile for each rider when they carry two or more people, billed as A0090HI22 (see A0090). Drivers must be 18, with a license abstract of 5 points or less and background checks. Apply with an NPI and DDD’s combined Medicaid and DDD application.
• County transportation. Counties run their own rides for seniors and people with disabilities, listed on NJ TRANSIT’s community transportation page. For fiscal year 2027, NJ TRANSIT budgeted $56.9 million from the Casino Revenue Fund for the statewide Senior Citizen and Disabled Resident Transportation Assistance Program. Ask your county whether it hires private operators.
• Veterans. The VA pays for special mode transportation when a VA provider decides a veteran’s condition requires it and the trip is approved in advance (see VA special mode transportation).
• Facilities and private pay. Dialysis centers, hospitals, and nursing homes pay for rides Medicaid does not cover, and your MAV license covers those trips too. See how to get NEMT facility contracts.