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

New Mexico has no statewide Medicaid broker. Each of the four Turquoise Care health plans arranges rides for its own members through a vendor it picks, and the Health Care Authority pays enrolled companies directly for fee-for-service members. To do either kind of work, you need a certificate and tariff from the New Mexico Department of Transportation first. The rules below follow 8.324.7 NMAC, HCA’s transportation fee schedule effective January 1, 2025, and the NMDOT motor carrier rules effective July 1, 2024, with the safety rule replaced on June 24, 2025.

How Medicaid rides work in New Mexico

The New Mexico Health Care Authority (HCA) runs Medicaid through its Medical Assistance Division. Since July 1, 2024, members in Turquoise Care, the managed care program, choose one of four health plans. Each plan covers rides for its members and hires its own ride vendor, which books each trip with a transportation company in its network. New Mexico is one of the states where each health plan picks a broker, so one contract reaches only one plan’s members.

As of September 2026, the plans use these ride vendors. The last column is how far ahead members must book a routine ride.

Health plan	Ride vendor	Member notice
Presbyterian Health Plan	Modivcare	48 hours
Blue Cross and Blue Shield of New Mexico	Modivcare, then MTM Health from November 1, 2026	3 working days
Molina Healthcare	Superior Medical Transportation	3 business days
UnitedHealthcare Community Plan	Its own member services line	3 business days

The Blue Cross switch matters most right now. The plan’s notice of July 15, 2026, updated September 9, 2026, says MTM Health takes over rides already booked for after November 1, including standing rides. See Blue Cross and Blue Shield of New Mexico’s move to MTM Health and the broker transition checklist.

Members outside a plan are in fee-for-service. HCA says Native American members can choose a plan or fee-for-service. There is no broker for fee-for-service rides: you enroll with HCA and bill it directly. See fee-for-service Medicaid.

Who qualifies and what is covered

Under 8.324.7 NMAC, Medicaid covers a ride for a member who has no transportation of their own and cannot use a less costly option such as public transit. Free options come first: volunteers, relatives, or a nursing facility’s own vans. Medicaid pays for the least costly ride that suits the member’s condition.

• Covered trips. Rides to covered medical and behavioral health care, plus meals and lodging when care is far from home. Lodging is covered when a member must travel more than four hours one way and stay overnight. Meals are covered when a member is away from home for eight hours or more.
• Pharmacy trips. Not covered, except for members released from a correctional facility, who may ride to a pharmacy within their first seven days out (8.310.2 NMAC). Molina’s 2026 to 2027 member handbook lists pharmacy rides as an extra Molina benefit.
• Waiver members. A ride to a waiver service provider is covered only for physical, occupational, or speech therapy or behavioral health.
• Attendants. Medicaid covers one attendant when a provider certifies in writing that one is medically necessary, or when the member is under 18. Children who simply come along with an adult member are not covered.
• Riders you cannot carry. NMDOT’s rule bars NEMT carriers from carrying riders who need medical monitoring or care to keep their breathing, circulation, or responsiveness stable. Self-administered oxygen up to six liters per minute through a nasal cannula is allowed.

Rural and tribal areas

Long trips are common, and New Mexico has two rules for them. When a member travels more than 120 miles from home for care, you must keep a written referral from the referring or treating provider. It names the service and the provider, and says why the care is not available locally. Medicaid raised the limit from 65 miles and set a 12-month renewal in Supplement 23-09, effective July 1, 2023, and HCA told the health plans to do the same in Letter of Direction 40 on November 16, 2024. The posted rule text still says 65 miles and six months, so ask each plan vendor which limit it applies.

Trips to cities within 100 miles of the New Mexico border count as in-state, except in Mexico. Other out-of-state trips need prior authorization from HCA. For the economics of long empty drives, see rural NEMT.

Tribal communities are part of the market too. NMDOT’s certificate application lists governmental and tribal entities as applicant types, and its list of approved NEMT tariffs includes the Pueblo of Picuris. For working with tribal health programs, see tribal NEMT.

Which brokers to join

Work in this order:

1. Get your NMDOT certificate and tariff. HCA’s enrollment matrix lists NMDOT certification for non-emergency medical transportation as a required document, and every paid ride needs it.
2. Enroll with HCA. Create an account at YES.NM.GOV and apply in the Provider and PED Enrollment System. HCA’s matrix of September 11, 2026 lists two transportation provider types: handivan, which covers non-emergency medical transport vans and secured medical transport vans, and taxi. Each enrolls as a group biller and uploads the NMDOT certification, a city or county business license, proof of malpractice, professional, or medical liability insurance, a federal tax ID letter, and a W-9. HCA lists both as atypical provider types, so the system lets you apply without an NPI. If you have one, it allows one workspace per NPI. HCA’s customer service center for enrollment help is 1-800-299-7304.
3. Apply to Modivcare for Presbyterian members, and for Blue Cross members through October 31, 2026. Use the Become a Transportation Provider form. As of September 2026, Modivcare lists driver requirements of a PASS wheelchair certificate, First Aid and CPR, defensive driving, a drug screen, a motor vehicle report, and a background check. See our Modivcare guide.
4. Apply to MTM Health for Blue Cross members from November 1, 2026. MTM’s steps are an application, an interview, a contract, credentialing, training, and a first trip. See our MTM Health guide.
5. Ask Superior Medical Transportation about Molina members. It is the ride service of Superior Ambulance Service in Albuquerque, whose office line is (505) 247-8840.
6. Ask UnitedHealthcare Provider Services at 1-888-702-2202 how transportation companies join the network behind its member ride line.

HCA enrollment is required even if you only work for a plan’s vendor. Federal rule 42 CFR 438.602(b) makes the state screen and enroll every network provider of a Medicaid health plan, and a plan may sign you for up to 120 days while enrollment is pending. Blue Cross and Blue Shield of New Mexico told providers in April 2026 that HCA requires enrollment for Medicaid payment. HCA revalidates each provider every three years.

The state plan puts the federal driver checks on the state’s transportation regulator, now NMDOT. Each company and driver must be clear of the federal OIG exclusion list, each driver must hold a valid license, and each company needs a process for drug law violations and for reporting drivers’ driving histories to Medicaid. For how brokers check your files, see NEMT broker credentialing.

Licenses and registrations

Your company

Form an LLC or corporation online with the New Mexico Secretary of State at enterprise.sos.nm.gov. The office no longer accepts paper filings. Articles of organization for an LLC cost $50 under NMSA 53-19-63, and the LLC Act sets no annual report for LLCs. See LLC for NEMT.

Register with the Taxation and Revenue Department for a Business Tax Identification Number, the number NMDOT’s rules and form call a CRS number. There is no fee, and you apply online at tap.state.nm.us. Get your employer identification number (EIN) from the IRS, which issues it free. Get a city or county business license, because HCA enrollment asks for one.

NMDOT Transportation Regulation Bureau

Since July 1, 2024, NMDOT’s Transportation Regulation Bureau (TRB) regulates motor carriers. The work moved from the Public Regulation Commission under Senate Bill 160 of 2023. Certificates the commission issued before then stay in force with the same number.

Everyone who provides paid transportation in New Mexico needs operating authority from NMDOT. Under 18.3.2 NMAC, non-emergency medical transport is a specialized passenger service that needs a certificate. The rule defines it as scheduled rides to or from medical or therapeutic appointments for passengers who need no medical monitoring or treatment on the way. These are the fees in 18.3.5 NMAC, effective July 1, 2024:

Filing	Fee	When
New certificate	$300	Before your first paid ride
Tariff change	$200	To change rates or terms
Lease or transfer of certificate	$100	Selling or leasing your authority
Change of control	$50	New owners of the certificate holder
Reinstatement, insurance lapse	$100	After a suspension for no insurance on file

The certificate application goes to the TRB at P.O. Box 1149, Santa Fe, NM 87504, with the $300 check or money order. Your insurance company sends proof of coverage directly. The application needs:

• Your business names, physical and mailing addresses, and the address of every office and vehicle lot, called stationing points.
• Your Business Tax ID (CRS number), and your articles and good standing from the Secretary of State for an LLC or corporation.
• A workers’ compensation certificate or a certificate of exemption.
• A Form E filed by your insurer, and a proposed tariff with your rates, terms, and dispatch process.
• The territory you want: statewide, or within or between named counties.
• A vehicle list with plate, VIN, and seating, each vehicle’s annual inspection report from the last 12 months, and the mechanic’s qualification form.
• A written preventive maintenance program and a drug and alcohol testing policy.
• A driver list with copies of each driver’s license, motor vehicle record, and DOT medical card.
• A notarized oath that the facts are true.

NMDOT posts a notice of each complete application and cannot act on it for at least 20 days. During that period, anyone may object, and a full-service carrier may protest for $150, which leads to a hearing. NMDOT issues the certificate if you are fit and able, meet the safety and insurance rules, serve a useful public purpose, and have filed a tariff. If your application is still incomplete 60 days after you first submit it, you lose the fee.

After approval, keep the certificate at your office and a copy in every vehicle. File NMDOT’s annual report by March 1 each year, with your vehicle and driver lists, to TRB.AnnualReport@dot.nm.gov. The form asks for an agent for legal papers who is a New Mexico resident, over 18, and not the owner. The TRB’s main line is (505) 827-4519.

Trips across a state line, such as to a border city, can bring federal registration rules too. See DOT number for NEMT and, for licensing in every state, NEMT license requirements.

Vehicle rules

You are responsible for inspections. Under 18.3.4 NMAC, as replaced on June 24, 2025, your company has every vehicle inspected before a driver uses it to carry riders and at least once a year after. The inspector must be qualified under 49 CFR 396.19, and brake inspections need an inspector qualified under 49 CFR 396.25. NMDOT’s application asks for each vehicle’s annual inspection report and the brake inspector’s qualification form. Drivers inspect their vehicle daily and file inspection reports. NMDOT can inspect your vehicles and records at any time without notice. It sends a written report within 30 days, and it can issue a red tag on the spot to stop a practice that endangers public safety.

Every vehicle needs:

• Working heat, cooling, and air filtration, and a clean cabin.
• A separate seat belt for each passenger in vehicles built for 15 or fewer people, and child restraints that meet state and federal rules.
• At least four doors, and a design that carries no more than eight people including the driver. The 2025 rule sets these limits for every certificated passenger vehicle, with a door exception only for shuttles, so ask the TRB before you buy a larger van.
• Your company name and your NMDOT number, shown as “NM” and the number, on both sides, in letters at least two and a half inches high. A carrier that shows a federal operating authority number or an MVD safety number instead is exempt.
• A copy of your certificate, your tariff rates posted in the passenger area, and a posted notice with your operating authority number, your management phone line, and NMDOT’s complaint line, 505-795-1401.
• Warning devices required by state law, and bags secured so they cannot hurt riders or block the driver’s view.

For wheelchair work, HCA’s fee-for-service schedule pays a wheelchair van code (A0130) and has no stretcher van code. Ambulance rides are covered when a provider certifies that no other ride is safe. Use our wheelchair securement guide and vehicle inspection checklist, and see NEMT vehicle requirements.

Driver rules and training

NMDOT’s rule 18.3.4.12 NMAC, as replaced on June 24, 2025, bars a driver who:

• Is under 18 or has no valid license.
• Has more than three moving violations in the last three years, or one in that time for fleeing police, reckless driving, or driving on a suspended or revoked license.
• Was convicted in the last seven years of a felony, or of a misdemeanor for DUI, reckless driving, leaving the scene of an accident, another driving offense, violence, or a sexual offense.
• Has more than three misdemeanors of any kind.
• Is listed on a national sex offender registry.

Before you hire, and every five years after, get a local and national fingerprint-based background check that searches a multistate records database and the national sex offender registry, and a nationwide driving history report. The state also adopts parts of the federal commercial driver rules for all your drivers, even in a sedan:

• Medical card. Each driver passes a DOT medical exam and carries the certificate. Most drivers renew it every 24 months (49 CFR 391.45).
• Drug and alcohol testing. Your program must meet 49 CFR Parts 40 and 382, which include pre-employment, random, post-accident, and reasonable suspicion tests. See NEMT driver drug testing and our drug and alcohol policy.
• Road test and yearly review. Give a road test or accept its equivalent, and review each driver’s record every year.
• Hours. A NEMT driver may not drive more than 12 hours in any 24-hour period.
• On the job. Drivers wear seat belts, never drive ill, fatigued, or after drinking, and never carry a radar detector.

The state sets no training course of its own. The vendors do: Modivcare asks for the certificates listed above, and MTM Health requires fraud, waste, and abuse training and HIPAA training for every employee each year. See NEMT driver training.

Keep a file for each driver with the employment contract, hire and separation dates, qualifications, duty status, and drug and alcohol test records. Keep driver files for three full calendar years after the driver leaves. Our driver file checklist tracks them.

Trip rules and how you get paid

NMDOT’s records rule, 18.3.7 NMAC, applies to every ride, whoever pays. Keep passenger lists, trip sheets, and daily dispatch records for three full calendar years, and log every complaint. Report any accident that kills someone or injures someone who needs medical treatment to law enforcement right away and to NMDOT promptly. Charge only what your approved tariff says. Charge mileage by the least expensive route, measured by odometer, GPS, or NMDOT’s official road map, with half a mile or more rounded up.

For health plan members, your vendor agreement sets the rate, trip standards, no-show pay, and dispute steps. Members book with the vendor, and plans such as Presbyterian and Molina limit same-day rides to urgent care. As of September 2026, the ride pages for Molina and Blue Cross members promise these standards. Molina’s ride service gives members a 30-minute pickup window and says the driver waits up to 10 minutes after arriving. Blue Cross says a shared ride should add no more than 45 minutes to a member’s travel time. Molina’s ride service also lets children 12 to 17 ride alone only with a signed parent waiver, and children 11 and under always ride with a parent or guardian.

For fee-for-service members, HCA pays the lesser of your usual charge, your tariff, or its fee schedule, and its payment includes gross receipts tax. It pays only for the miles the member is in the vehicle, so deadhead miles earn nothing. When two or more members ride from the same place to the same provider, HCA pays for one. The schedule effective January 1, 2025 pays these amounts:

Code	Service	Rate
A0100	Taxi, per loaded mile	$2.06, up to $300 per one-way trip
A0130	Wheelchair van, per loaded mile	$1.78, up to $300 per one-way trip
T2001	Attendant or escort, per mile	$0.71, up to $150 per one-way trip
A0180	Member lodging, per night	$60.80
A0190	Member meal	$7.64

At those rates, a 150-mile one-way taxi trip reaches the $300 cap, and the same trip by wheelchair van pays $267. The mileage codes carry a two-letter origin and destination modifier, such as RD for residence to a diagnostic or treatment site.

Bill on the CMS-1500 claim form within 90 calendar days of the ride. If a claim is denied or paid wrong, you get one extra 90 days from that notice to fix it, and HCA pays by electronic funds transfer only. See CMS-1500 for NEMT and the timely filing limit.

Records decide audits. HCA’s Supplement 26-05 of September 3, 2026 reported federal payment error audit findings: an attendant trip whose log left the attendant section blank, and a taxi claim whose billed miles did not match the record. HCA then required management and billing staff of NEMT providers to attend a training on September 15, 2026. See New Mexico’s NEMT provider training, NEMT trip documentation, and our trip log template.

Insurance requirements

NMDOT adopts the federal passenger carrier minimums in 49 CFR 387.33. The limits depend on seating, counting the driver:

Vehicle seats	Minimum liability
15 or fewer	$1,500,000
16 or more	$5,000,000

Your insurance company files a Form E directly with NMDOT, by email to TRB.InsFiling@dot.nm.gov. Copies you send yourself do not count. The insurer must be authorized in New Mexico. The policy must name your exact legal and business names and run until canceled. No deductible may exceed $5,000 unless you post a surety bond for the difference or show self-insurance. If coverage is not on file, NMDOT can suspend your authority at once.

HCA enrollment asks for proof of malpractice, professional, or medical liability insurance. Modivcare’s join page lists general liability, sexual abuse and molestation coverage, auto liability, and workers’ compensation, and says limits vary by state. Ask each vendor for its New Mexico limits in writing before you buy. For what brokers ask for elsewhere, see NEMT insurance requirements.

New Mexico requires workers’ compensation once you have three or more workers, part-time workers included. In an LLC or corporation, owners with 10 percent or more count toward the three, even if they opt out of coverage themselves. Employers also file a workers’ compensation fee with each quarterly wage report, Form TRD-41431. From July 1, 2025 to June 30, 2028, it is $2.55 for the employer and $2.25 for the employee.

What it costs and how long it takes

These are the fees New Mexico sets as of September 2026. Vehicles, insurance, and equipment depend on your quotes. See what it costs to start a NEMT business.

Item	Cost	Paid to
LLC articles of organization	$50	Secretary of State
Business Tax ID	Free	Taxation and Revenue
EIN	Free	IRS
NEMT certificate	$300	NMDOT
Tariff change	$200	NMDOT

A workable order, from first call to first trip:

1. Call each plan’s ride vendor. Ask Modivcare, MTM Health, Superior Medical Transportation, and UnitedHealthcare where they need providers and which service levels are short.
2. Form your company online and get your EIN and Business Tax ID.
3. Get your city or county business license and your NPI.
4. Buy insurance and have your insurer file Form E with NMDOT. Line up workers’ compensation or its exemption.
5. Build your vehicle and driver files. Get each vehicle’s annual inspection, each driver’s fingerprint background check, driving record, medical card, and drug test, and write your maintenance and drug testing programs.
6. Write your tariff with your rates and terms. Read a few approved NEMT tariffs on NMDOT’s site first, and see our rate sheet template.
7. File the NMDOT certificate application. Allow at least 20 days of notice after it is complete.
8. Enroll with HCA at YES.NM.GOV once your certificate arrives.
9. Finish each vendor’s credentialing and training, then take your first trips.

The NMDOT notice period and each vendor’s credentialing set the pace. For the same steps in any state, see how to start a NEMT business.

Work beyond Medicaid

Three other sources of rides are worth a call.

• Transit and human services programs. NMDOT’s Transit and Rail Division guides transit providers through applying for federal transit grant programs and offers technical help. Ask it which transit systems and agencies near you contract rides out.
• Veterans. The VA pays for special mode transportation, an ambulance or specially equipped vehicle, when a VA provider decides a veteran’s condition requires it and VA approves the trip in advance. Ask your nearest VA health facility how it books these rides. See VA special mode transportation.
• 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 plan. Your NMDOT tariff sets your prices for this work too. Hospital discharges for health plan members still go through the plan’s ride vendor. See how to get NEMT facility contracts and private pay NEMT.