# Nassau County Medicaid Transportation: Town Licenses, the County TLC Decal, and Rates

Canonical URL: https://nemtguide.com/states/new-york/nassau-county/ · Updated 2026-10-02

Nassau County Medicaid members book rides through Medical Answering Services (MAS) at 844-666-6270, and MAS hands each trip to an enrolled company. To get that work, a company needs a license from its town, city, or village where one is required, a Nassau County Taxi and Limousine Commission registration for every vehicle that picks up or drops off in Nassau, and Medicaid enrollment backed by a MAS letter of support.

- Nassau Medicaid rides come through MAS, which took over the county on December 1, 2023.
- A Nassau ride company stacks a local license, a county TLC decal on each vehicle, and Medicaid enrollment with a MAS letter of support.
- The county TLC registers ambulettes and paratransit vans too, and its rules charge vehicles under NYSDOT authority the in-county fee.
- New ambulette companies may enroll in Nassau again, but they post an OMIG surety bond unless OMIG grants an exception.
- Medicaid pays $64.00 plus $3.00 a mile for a Nassau wheelchair trip and $7.38 plus $3.62 a mile for a taxi trip.

## Nassau County NEMT at a glance

| Fact | Details |
| --- | --- |
| Who books Medicaid rides | MAS, on its Downstate line, 844-666-6270. Nassau and Suffolk were the last counties to move to MAS, on December 1, 2023. |
| County TLC registration | $550 per vehicle new, $500 per vehicle to renew for two years, $25 for county plates. $5 for a vehicle with a town, city, or village license (as of October 2026). |
| Town license example | Town of Hempstead taxicab owner: $50 filing fee plus $500 per vehicle, then $100 a year. Livery: $50 plus $100 per vehicle, then $75. The year runs October 1 to September 30. |
| County driver license | $100 for two years. Age 19 or older, 7 or fewer DMV points in 18 months, a 6-hour defensive driving course, and a drug test every year. |
| Medicaid taxi enrollment | eMedNY asks for proof from the Nassau TLC for taxi trips in Nassau. A New York City livery license can stand in for the Nassau decal. |
| Ambulette enrollment | Open since December 1, 2021. New Nassau applicants post an OMIG surety bond of $25,000 a year per ambulette, up to $100,000. |
| Wheelchair rate | $64.00 a trip plus $3.00 a mile (A0130 and S0209, effective May 20, 2024), tied with Suffolk for the highest county base in the state |
| Taxi rate | $7.38 a trip plus $3.62 a mile (A0100 and S0215, effective April 1, 2022) |

## Who arranges rides here

- [Nassau County Taxi and Limousine Commission, Mineola](https://www.nassaucountyny.gov/3786/Taxi-Limousine-Commission): Registers every for-hire vehicle that picks up or drops off in Nassau. (516) 571-2600
- [Town of Hempstead Office of the Town Clerk](https://hempsteadny.gov/452/Limousine-Taxicab-Livery-Driver): Licenses taxicab and livery owners and drivers in the Town of Hempstead. (516) 812-3025
- [MAS Downstate Contact Center](https://wp2.medanswering.com/contact-center/): Books Medicaid rides for Nassau County members. (844) 666-6270
- [MAS Transportation Provider Relations](https://wp2.medanswering.com/transportation-provider-relations-team/): Decides on the letter of support a new ride company needs to enroll. (866) 242-2578
- [NYSDOT Passenger Carrier Operating Authority](https://www.dot.ny.gov/divisions/operating/osss/bus/passenger): Grants the operating authority ambulettes show before the county TLC registers them. (518) 457-6512

Nassau County regulates paid rides at two levels. Its cities, towns, and villages can license drivers and companies inside their own borders, and the county Taxi and Limousine Commission registers every for-hire vehicle that picks up or drops off a passenger anywhere in Nassau. New York Medicaid looks for the county layer before it enrolls a taxi company here.

## Who sends Medicaid trips in Nassau County

Across New York, Medical Answering Services (MAS) books Medicaid rides and assigns them to enrolled companies, and eMedNY has turned away new transportation applications without a MAS letter of support since April 15, 2024. The [New York guide](https://nemtguide.com/states/new-york/) and the [MAS guide](https://nemtguide.com/brokers/medical-answering-services/) cover enrollment and the network contract.

Nassau was one of the last two counties to switch. The state policy manual, effective August 25, 2023, moved Nassau and Suffolk to MAS on December 1, 2023, four months after the other 60 counties. Nassau members book on the MAS Downstate line, 844-666-6270.

## Layer one: a license from your town, city, or village

New York lets Nassau's cities, towns, and villages license drivers and for-hire businesses inside their borders, and the county names the City of Long Beach, the Town of Hempstead, and the Village of Rockville Centre as examples. A local license can cover owning a for-hire vehicle, regular safety checks, and running the base station that takes trip requests. The county does not replace it: its forms say a county registration and driver authorization do not let you run point-to-point trips inside a municipality that regulates for-hire vehicles.

The Town of Hempstead, whose Office of the Town Clerk sits at One Washington Street, shows what a local license costs. As of October 2026 it charges:

| License | First time | Renewal |
|---|---|---|
| Taxicab owner | $50 filing fee, then $500 per vehicle | $100 per vehicle |
| Limousine or private livery van owner | $50 filing fee, then $100 per vehicle | $75 per vehicle |
| Taxi driver | $20 | $20 a year |

Owners pay the per-vehicle fee once the town Building Department approves the application. Every Hempstead license runs from October 1 to September 30. Owners file a notarized application with vehicle registrations, workers' compensation and disability proof, an insurance certificate naming the town as holder, and corporate disclosure statements, and taxicab owners add rate sheets or zone maps. Drivers need at least a Class E license, first-time drivers are fingerprinted, and new applicants list two Nassau County residents, not relatives, who have known them for a year or more. Other towns, cities, and villages set their own fees, so ask the clerk where your base sits.

## Layer two: the Nassau County TLC registration

The Nassau County Taxi and Limousine Commission (NCTLC) is part of the county Department of Consumer Affairs, at 240 Old Country Road, 3rd Floor, Mineola, open weekdays 9:00 am to 4:30 pm. It registers taxis, limousines, and other prearranged paid rides, and a vehicle counts as operating in Nassau the moment it picks up or drops off a passenger there. Each registered vehicle shows the NCTLC decal on the passenger side of the windshield and keeps its registration card on board. Police and NCTLC investigators can stop and impound an unregistered vehicle. State law (Vehicle and Traffic Law 498) also lets a vehicle licensed by New York City, Suffolk, or another qualifying jurisdiction carry its own riders into Nassau and back without a second license. Ask the commission which rule covers a vehicle based outside the county.

The fee turns on whether a Nassau municipality licenses the vehicle. One with a town, city, or village license registers as exempt for a token fee. One with no local license, because its municipality issues none or because it is licensed outside the county, pays the full fee. As of October 2026, the county's applications charge:

| Registration | Fee |
|---|---|
| New registration | $550 per vehicle |
| Renewal | $500 per vehicle for two years |
| Exempt, with a local license | $5 per vehicle for one year |
| NCTLC license plates | $25 per vehicle |
| Replacement after a plate, vehicle, or base change | $25 per vehicle |

A renewal filed after the expiration date costs $25 more. You file in person, with every document sorted by vehicle, and the county denies any application left incomplete after 90 days. The new-registration instructions ask for:

- **Your local license** for each vehicle, or a clear letter or "taxi legend" from the municipality.
- **DMV papers:** the registration, title, or bill of sale with the VIN, and a current FH-1 insurance card.
- **A liability certificate** on ACORD form 25-S naming Nassau County Consumer Affairs TLC, 240 Old Country Road, Mineola, NY 11501, as holder, with at least 10 days' notice of cancellation.
- **Workers' compensation proof** on form U-26.3 or C-105.2, or a CE-200 exemption if you have no employees.
- **Business filings:** your corporate filing receipt, plus an assumed name certificate or a business certificate from the Nassau County Clerk if you trade under another name.
- **Owner papers:** a DMV license and proof of residence for every owner, partner, officer, and manager, and proof of your business location and parking.
- **A state safety inspection receipt** and a notarized affidavit.

Owners must also owe no child support, fines, or debts to any government agency. You cannot register with a post office box, and a vehicle licensed by a Nassau municipality must get its plates within 10 days of preliminary approval.

## Ambulettes and paratransit vans in Nassau

Nassau's commission covers wheelchair and stretcher vans as well. Its rules, dated March 4, 2009, define an [ambulette](https://nemtguide.com/glossary/ambulette/) or paratransit vehicle as a special-purpose for-hire vehicle built for non-emergency trips to and from medical care, with room for a wheelchair, a stretcher, or riders with disabilities. The registration form lists paratransit beside taxi, limousine, and commuter van, and asks whether each vehicle is handicapped accessible.

Under those rules, a vehicle running on NYSDOT authority is charged the in-county fee, not the full one. Before the commission registers it, you show your NYSDOT operating authority and a current NYSDOT inspection sheet, and the renewal form names the MC300 inspection. Its drivers need Article 19-A certification, covered below.

On the Medicaid side, Nassau reopened to new ambulette companies on December 1, 2021. Before then, eMedNY denied new ambulette applicants in Nassau, Suffolk, and New York City because the Department of Health judged those areas already had enough of them.

Nassau is also one of six counties, with Suffolk, Westchester, Monroe, Erie, and Orange, where OMIG requires a surety bond before a new ambulette company enrolls. The bond runs $25,000 a year per ambulette you own or use, capped at $100,000. You post it within 90 days of OMIG saying you are otherwise eligible and renew it every year. A company that expects less than $500,000 in ambulette billing in its first full year can ask OMIG for an exception in a letter filed with its application. See Medicaid surety bond and the [ambulette business guide](https://nemtguide.com/guides/ambulette-business/).

## Driver licenses in Nassau County

A Nassau driver carries one local license. Where a town, city, or village issues hack licenses, that license covers driving there. Where none does, the county issues a for-hire driver authorization, and it also licenses Nassau-based drivers who carry passengers in New York City, Westchester, and Suffolk.

As of October 2026, the county application requires:

- **Age and experience:** 19 or older, with a DMV license held for at least 6 months.
- **License class:** Class A, B, or E, or a commercial Class C with a passenger endorsement for DOT vans, ambulettes, paratransit, and buses. Ambulette, paratransit, and DOT van drivers must be [Article 19-A](https://nemtguide.com/guides/new-york-article-19-a/) certified.
- **Driving record:** no more than 7 DMV points in the 18 months before the application.
- **Course:** an original certificate from a 6-hour DMV defensive driving course that stays valid for the whole license term.
- **Papers:** a Social Security card and a second proof of address, such as a utility bill or lease. Cell phone bills do not count.
- **Checks within 5 business days of applying:** fingerprints at IdentoGO with NCTLC service code 158K5Z, and a drug test at an approved lab. The county's Labcorp form sets the test at $32, and it repeats every year.
- **Fee:** $100 for a two-year license, plus $25 for a renewal filed within 30 days after it expires.

See [NEMT driver drug testing](https://nemtguide.com/guides/nemt-driver-drug-testing/) for how a yearly test fits a wider testing program.

## Medicaid taxi enrollment needs Nassau TLC proof

eMedNY's enrollment chart, which lists what each category of service must send, names Nassau twice. A taxi company (category 0603) carrying riders in Nassau needs proof from the Nassau TLC, and a New York City livery license can substitute for the Nassau decal. The same chart has you keep records that every driver holds a valid Class E license and every vehicle carries livery plates. See [livery vehicle](https://nemtguide.com/glossary/livery-vehicle/) for what the plates mean.

An ambulette company can take curb-to-curb trips at taxi rates without a separate taxi license, the state manual says, but where a local TLC applies, its proof is a condition of enrollment. The manual tells new companies to ask the area's prior authorization official, now MAS, which local papers they need, and it warns that breaking local rules can end Medicaid enrollment.

## What Medicaid pays in Nassau County

Nassau's base rates on the eMedNY fee schedule file dated April 5, 2026 differ sharply from New York City's, which matters if you run trips on both sides of the Queens line. MAS negotiates each company's rates, and the state manual says those replace the schedule.

| Service | Nassau | New York City |
|---|---|---|
| Wheelchair van trip ([A0130](https://nemtguide.com/glossary/a0130/)) | $64.00 | $52.90 |
| Wheelchair van loaded mile (S0209) | $3.00 | $3.60 |
| Stretcher van trip ([T2005](https://nemtguide.com/glossary/t2005/)) | $230.00 | $230.00 |
| Taxi or livery trip ([A0100](https://nemtguide.com/glossary/a0100/)) | $7.38 | $22.97 |
| Taxi or livery loaded mile (S0215) | $3.62 | $2.93 |

Nassau's wheelchair and stretcher rates took effect May 20, 2024 and its taxi rates April 1, 2022. The city's took effect between April 1, 2022 and May 30, 2024. Nassau's $64.00 wheelchair base ties Suffolk as the highest county base in the state.

A 6-mile Nassau wheelchair trip pays $64.00 plus $18.00, or $82.00. A 6-mile Nassau taxi trip pays $7.38 plus $21.72, or $29.10, while the same trip as New York City livery pays $22.97 plus $17.58, or $40.55.

## Steps to start Medicaid trips in Nassau

1. **Choose the service.** Taxi (category 0603) pays $7.38 plus $3.62 a mile. Ambulette (0602) carries wheelchair and stretcher riders at $64.00 plus $3.00 a mile.
2. **Get the local license first.** Apply where your base sits. In Hempstead, that means the Town Clerk and a Building Department review.
3. **Register every vehicle with NCTLC** in person in Mineola, with the local license in hand, so each locally licensed vehicle registers as exempt for $5 rather than $550.
4. **License each driver** with the town or the county, and certify ambulette drivers under Article 19-A.
5. **For ambulettes, get NYSDOT authority** and an MC300 inspection, then plan for the OMIG bond or its exception letter.
6. **Ask MAS for a letter of support,** then enroll with eMedNY and sign the MAS contract. The [New York guide](https://nemtguide.com/states/new-york/) has those steps, and the [New York City page](https://nemtguide.com/states/new-york/new-york-city/) and [Suffolk County page](https://nemtguide.com/states/new-york/suffolk-county/) cover trips across the county lines.

## Frequently asked questions

### Who arranges Medicaid transportation in Nassau County?

Medical Answering Services (MAS), New York's Medicaid broker. Members call its Downstate contact center at 844-666-6270, and MAS approves each trip and assigns it to a company in its network. MAS took over Nassau and Suffolk on December 1, 2023, four months after the rest of the state. Companies reach MAS Transportation Provider Relations at 866-242-2578.

### Does every Medicaid ride vehicle need a Nassau County TLC decal?

The county says every for-hire vehicle that picks up or drops off a passenger in Nassau must be registered with the Nassau County Taxi and Limousine Commission, with its decal on the passenger side of the windshield and the registration card inside. eMedNY also asks for Nassau TLC proof when a taxi company enrolls to carry Medicaid riders there, though a New York City livery license can stand in for the decal. Unregistered vehicles can be impounded.

### How much does Nassau County TLC registration cost?

As of October 2026, a new registration costs $550 per vehicle and county plates cost $25. A renewal is $500 per vehicle for a two-year registration. A vehicle that already holds a license from a Nassau town, city, or village registers as exempt for $5. Payment goes to the County of Nassau, and you file in person at 240 Old Country Road in Mineola.

### Do ambulettes register with the Nassau County TLC?

Yes. Nassau's TLC rules, dated March 4, 2009, define an ambulette or paratransit vehicle as a special-purpose for-hire vehicle for non-emergency medical trips that carries wheelchairs, stretchers, or riders with disabilities, and the registration form lists paratransit as a vehicle type. A vehicle under NYSDOT authority registers at the in-county fee after it shows its NYSDOT operating authority and a current NYSDOT inspection sheet.

### Can a new ambulette company enroll with Medicaid in Nassau County?

Yes, since December 1, 2021, when the state lifted the moratorium that kept new ambulette companies out of Nassau, Suffolk, and New York City. A new Nassau applicant must still post an OMIG surety bond within 90 days of being found otherwise eligible: $25,000 a year per ambulette or $100,000, whichever is lower. You can ask for an exception if you expect under $500,000 in ambulette billing in your first full year.

### What license does a Medicaid driver need in Nassau County?

A town, city, or village hack license where the municipality issues one, such as the Town of Hempstead's $20 yearly taxi driver license. Elsewhere the county issues a for-hire driver license for $100 for two years: 19 or older, licensed at least 6 months, 7 or fewer DMV points in 18 months, a 6-hour defensive driving course, fingerprints, and a yearly drug test. Ambulette and paratransit drivers also need Article 19-A certification.

## Official resources

- [Nassau County TLC: Vehicle registration applications](https://www.nassaucountyny.gov/3793/Registration-for-vehicles)
- [Nassau County TLC: Driver license applications](https://www.nassaucountyny.gov/3791/Licenses-For-Taxi-Drivers)
- [Nassau County TLC: Rules and regulations](https://www.nassaucountyny.gov/DocumentCenter/View/12858)
- [Town of Hempstead: Taxicab owner license](https://hempsteadny.gov/464/Taxicab-Owner)
- [Town of Hempstead: Limousine and taxicab livery driver license](https://hempsteadny.gov/452/Limousine-Taxicab-Livery-Driver)
- [MAS: Become a transportation provider](https://wp2.medanswering.com/transportation-providers/become-a-provider/)
- [eMedNY: Licenses needed for each transportation category of service](https://www.emedny.org/info/ProviderEnrollment/ProviderMaintForms/Additional_Requirements_for_Transportation_Enrollment.pdf)
- [eMedNY: Medicaid transportation fee schedule](https://www.emedny.org/ProviderManuals/Transportation/PDFS/Transportation_Fee_Schedule.xls)