# Starting a NEMT Business in New York City: TLC Paratransit, Livery, and Ambulette Rules (2027)

Canonical URL: https://nemtguide.com/states/new-york/new-york-city/ · Updated 2026-09-30

To start a NEMT business in NYC, pick your license by vehicle. Ambulettes need NYSDOT operating authority and Article 19-A drivers. Wheelchair vans run as a TLC paratransit service also need a TLC base license ($1,500 for three years) and TLC licenses for each van and driver. Car service needs a TLC livery or black car base. Then get a MAS letter of support and enroll with Medicaid.

- In New York City the TLC licenses paratransit bases, vans, and drivers on top of NYSDOT authority, and a small paratransit base can run from the owner's home.
- New York Medicaid has not required a TLC license from city ambulette companies with a NYSDOT contract carrier permit since January 28, 2016.
- A new TLC livery base needs 10 affiliated cars (or 5 with one wheelchair van), a $5,000 bond, and letters from the local council member and community board.
- As of September 2026, only wheelchair accessible vehicles can get a new TLC for-hire vehicle license.
- Access-A-Ride supplemental contracts approved by the MTA Board in February 2026 pay about $92.39 per vehicle service hour and use lift-equipped vans only.

## New York City NEMT at a glance

| Fact | Details |
| --- | --- |
| Who licenses ride companies | The NYC Taxi and Limousine Commission (TLC) licenses paratransit and for-hire bases, vehicles, and drivers. NYSDOT grants the operating authority underneath. |
| Medicaid rides | Medical Answering Services (MAS) books them through its Downstate contact center, 844-666-6270, which covers all five boroughs |
| Paratransit base license | $1,500 for three years ($500 a year). Needs a NYSDOT common carrier certificate and at least one van. A base with four or fewer vans may run from the owner's home. |
| Paratransit van license | $550 for two years, plus an $800 Commercial Motor Vehicle Tax if the van is registered outside the city. A first-time van must be this or last model year, under 500 miles. |
| Paratransit driver license | $367.25 in all ($252 for three years). Needs a commercial class A, B, or C license, active Article 19-A status, and no more than 5 points in 15 months. |
| Ambulette exception | Since January 28, 2016, New York Medicaid has not required a TLC license from city ambulette companies holding a NYSDOT contract carrier permit |
| Livery base license | $1,500, a $5,000 surety bond, letters from the council member and community board, and 10 affiliated cars, or 5 with one wheelchair van (checklist of March 27, 2026) |
| City Medicaid base rates | Wheelchair $52.90 plus $3.60 a mile, stretcher $230, livery $22.97 plus $2.93 a mile (eMedNY fee schedule file dated April 5, 2026) |
| Licensed paratransit bases | 24 as of September 29, 2026, 13 of them with Brooklyn addresses, next to 191 livery bases and 546 black car bases |
| Access-A-Ride supplemental pay | An average of $92.39 per vehicle service hour under the four contracts the MTA Board approved on February 25, 2026 |

## Who arranges rides here

- [NYC Taxi and Limousine Commission (TLC), Long Island City](https://www.nyc.gov/site/tlc/businesses/paratransit-bases.page): Licenses paratransit and livery bases, their vehicles, and their drivers. (718) 391-5501
- [TLC Safety and Emissions Inspection Facility, Woodside](https://www.nyc.gov/site/tlc/vehicles/vehicle-inspections.page): Gives paratransit vans their TLC visual inspection after NYSDOT inspects them. (718) 267-4559
- [NYSDOT Passenger Carrier Operating Authority](https://www.dot.ny.gov/divisions/operating/osss/bus/passenger): Grants the carrier authority that ambulettes and TLC paratransit bases need. (518) 457-6512
- [MAS Downstate Contact Center](https://wp2.medanswering.com/contact-center/): Books Medicaid rides for members in all five boroughs. (844) 666-6270
- [MAS Transportation Provider Relations](https://wp2.medanswering.com/transportation-provider-relations-team/): Reviews new ride companies for the Medicaid letter of support. (866) 242-2578
- [MTA New York City Transit Procurement](https://www.mta.info/doing-business-with-us/procurement/new-york-city-transit): Buys Access-A-Ride carrier and supplemental service contracts.

New York City adds its own licensing layer to NEMT. The Taxi and Limousine Commission (TLC) licenses paratransit bases, livery and black car bases, and the vans, cars, and drivers that work from them. Whether a ride company needs any TLC license depends on its vehicles and on the operating authority it holds from NYSDOT, the state Department of Transportation.

## Which license a New York City NEMT company needs

Match your license to what you drive. As of September 2026, the city and state sort NEMT companies this way:

| You run | You need | Medicaid enrollment |
|---|---|---|
| Ambulettes under a NYSDOT contract carrier permit | The NYSDOT permit, DMV Article 19-A registration for drivers, NYSDOT inspections. No TLC license for Medicaid since January 28, 2016. | Ambulette (0602) |
| Wheelchair vans as a TLC paratransit service | A NYSDOT common carrier certificate, a TLC paratransit base license, and a TLC license for each van and driver | Ambulette (0602) with the NYSDOT certificate and a 19-A letter, or livery (0605) with the base license |
| Sedans and minivans for curb-to-curb trips | A TLC livery, black car, or for-hire base license, with TLC-licensed cars and drivers | Livery (0605), which exists in New York City only |

Every company also needs a letter of support from Medical Answering Services (MAS), the statewide Medicaid broker, before it enrolls with New York Medicaid through eMedNY. The [New York guide](https://nemtguide.com/states/new-york/) covers enrollment, NYSDOT authority, Article 19-A, and insurance, and the [MAS guide](https://nemtguide.com/brokers/medical-answering-services/) covers the broker. For how these layers compare across states, see [NEMT license requirements](https://nemtguide.com/guides/nemt-license-requirements/).

## Do ambulettes in New York City need a TLC license

For Medicaid, not if you hold a contract carrier permit. The state Medicaid transportation manual, effective August 25, 2023, says the Department of Health stopped requiring TLC licenses from city [ambulette](https://nemtguide.com/glossary/ambulette/) companies with a NYSDOT contract carrier permit on January 28, 2016. The same manual lets those companies add sedans and minivans for livery-level trips, which NYSDOT does not inspect, while every ambulette vehicle keeps its NYSDOT inspection every six months.

TLC reads its own role more widely. Its definitions, updated October 17, 2025, describe a paratransit base as the place a paratransit service runs from and say that includes all ambulette services. Its base license also requires a NYSDOT common carrier certificate. If your authority is a common carrier certificate, email TLC at LicensingInquiries@tlc.nyc.gov and get its answer in writing before you run trips in the city.

Three more rules apply to city ambulettes:

- **Enrollment is open.** The state's moratorium on new ambulette companies in New York City, Nassau, and Suffolk lifted on December 1, 2021.
- **Buying a company brings a bond.** A new owner who buys a city ambulette company and enrolls it must post an OMIG surety bond. The [New York guide](https://nemtguide.com/states/new-york/) has the amounts.
- **Stretcher vans answer to TLC too.** The manual holds each [stretcher van](https://nemtguide.com/glossary/stretcher-van/) to NYSDOT rules and to TLC rules when it operates in New York City.

## How to get a TLC paratransit base license

TLC says paratransit bases give pre-arranged rides to passengers with disabilities, most of them to and from health care facilities. On September 29, 2026, the city's list of current TLC bases showed 24 paratransit bases, 13 of them with Brooklyn addresses, next to 191 livery bases and 546 black car bases.

As of September 2026, TLC lays out these steps, and its application form is dated March 27, 2026:

1. **Clear every fine** owed to TLC, DMV, the Department of Finance, or any other city or state agency. TLC will not accept the application until they are paid.
2. **Reserve your business name.** Email the Business Name Reservation Request to Name-Reservation@tlc.nyc.gov. An approved name is held for 45 days.
3. **Fingerprint every owner, stockholder, and member** through IdentoGO, using TLC's ORI code 156GQS.
4. **Collect the documents:** the application, photo ID for every owner, principal, member, and manager, your NYSDOT common carrier certificate, proof of your EIN (IRS notice CP-575 or letter 147-C), formation papers showing who owns what share, a zone rate map or rate book, and the Business Lease Affirmation.
5. **Add workers' compensation proof.** Send a certificate from the New York State Insurance Fund or a Workers' Compensation Board exemption, naming "NYC Taxi and Limousine Commission" as certificate holder, with a name and address that match the application exactly.
6. **Email everything** as PDF or JPG files to NewBusinessApp@tlc.nyc.gov. When TLC finds the file complete, it books you an in-person appointment to pay.
7. **Attach at least one paratransit van.** TLC then mails the base license by certified mail.

The form also asks for a website, a 24-hour phone number, and how you will dispatch, with an FCC radio license number or another method. If a parent company owns any part of your company, list every person or entity holding 10% or more of that parent, or TLC will deny the application.

**Where the base can be.** A base with four or fewer vehicles may run from the owner's home. A larger one must be on commercial or suitably zoned property. Either way it needs outside signage with its business name and phone number that marks it as a paratransit base. TLC checks the address against the Department of Buildings certificate of occupancy and may ask for a Buildings letter of no objection.

**Fees and renewal.** The license costs $1,500 for three years, which matches the $500 a year in TLC Rule 60B-06. The rules have you file renewals at least 60 days before the license expires, and TLC will not renew a base license after it expires. Renewals are paid online through TLC's LARS system, with documents, including a recent phone bill showing the base's name and address, emailed to BusinessMR@tlc.nyc.gov.

## TLC licenses for paratransit vans

Each van needs its own TLC paratransit vehicle license, applied for online through LARS after your base files a Base Affirmation for it. As of September 2026, TLC sets these terms:

| Item | Rule |
|---|---|
| Authority | A NYSDOT certificate of operating authority for the City of New York, and affiliation with one licensed base |
| First-time van | This or last model year, fewer than 500 miles, shown on a NYSDOT form MC300 dated within one month |
| Documents | Photo ID, Social Security card, proof of ownership in your name (registration, bill of sale, lease, or title), a for-hire insurance certificate (FH-1), and a liability certificate showing the state's paratransit coverage levels |
| Cost | $550 for a two-year license, plus $800 Commercial Motor Vehicle Tax for a van registered outside the city. Cards carry a 2% fee, e-checks none. |
| Plates | TLC posts a DMV plate letter on TLC UP, and DMV issues "TC" for-hire plates |
| Inspection | NYSDOT inspects the van and issues an MC300 sticker, then TLC gives it a visual inspection in Woodside, Queens |
| Deadline | Every step within 45 days of applying, or TLC denies the application |
| Retirement | Seven years after the van is first licensed, or sooner if it fails a NYSDOT inspection |

The license goes live within 48 hours of passing the Woodside inspection. Renew at least 30 days before it expires. A late renewal up to 60 days after expiry costs $25 more, and after that the license cannot be renewed. To keep a van past its retirement date, ask at least two months ahead and show that its replacement is ordered and will arrive within 60 days of that date.

Each van also carries an electronic trip record system that logs the driver's license number, the plate, and each pickup and drop-off time and place. Owners send proof of insurance to TLC by January 15 every year and may not charge extra for a wheelchair, a disability, or a service animal. See [wheelchair accessible vehicle](https://nemtguide.com/glossary/wheelchair-accessible-vehicle/) for how these vans are built.

## TLC paratransit driver license

Every driver of a TLC paratransit van needs a TLC paratransit driver license. As of September 2026:

| Requirement | Detail |
|---|---|
| Age and license | 18 or older, with a commercial class A, B, or C license |
| Driving record | No more than 5 DMV points in the 15 months before the latest conviction |
| Article 19-A | Active status, which the employer keeps current with DMV |
| Course | A DMV 6-hour defensive driving course within 90 days of applying, unless one was taken in the last three years |
| Other steps | Fingerprints and photo at IdentoGO (service code 15425Y), a 10-minute sex trafficking awareness video, and all tickets paid |
| Cost | $367.25 in all: $252 for a three-year license, $90.25 for fingerprints and photo, and about $25 for the course |
| Renewal | $252, online only, up to 90 days before expiry |

Applicants have 90 days from the application date to finish every step. Once a driver works for you, the base may not require them to drive more than 12 hours in a row, and the owner must train every driver to help riders in and out and to use the ramp and securement straps. See [wheelchair securement](https://nemtguide.com/guides/wheelchair-securement/).

## Livery car service for Medicaid in New York City

Medicaid livery (category 0605) is curb-to-curb car service in New York City only, and each ride needs an order from the member's practitioner. eMedNY accepts a TLC livery, for-hire, paratransit, or black car base license for it. Livery companies may use drivers who own their cars, as long as those drivers and cars meet TLC and DMV rules. See [livery vehicle](https://nemtguide.com/glossary/livery-vehicle/).

A new livery base costs more to open than a paratransit base. Here is how TLC's livery checklist, dated March 27, 2026, compares with the paratransit base rules:

| Item | Livery base | Paratransit base |
|---|---|---|
| License fee | $1,500 | $1,500 for three years |
| Surety bond | $5,000 for the City of New York | None |
| Vehicles to start | 10 affiliated, or 5 with one wheelchair van | 1 |
| Local sign-off | Letters of no objection from the City Council member and community board, or proof you asked by certified mail | None |

The livery base also files an Environmental Assessment Statement and a Comprehensive Operating Plan, a certificate of occupancy or Buildings letter of no objection dated within two years, an off-street parking lease or contract, and resumes showing the owners can run a base. Finding cars is harder too: as of September 2026, TLC takes new for-hire vehicle license applications only from owners of wheelchair accessible vehicles, after a court order stopped new electric vehicle applications on November 13, 2023.

TLC also sets its own insurance floor for livery and black cars, in a chart updated March 3, 2026. A car seating up to 7 passengers needs $100,000 per person, $300,000 per occurrence, $10,000 for property damage, and $100,000 in personal injury protection. For paratransit vans, TLC uses the state's levels.

## Medicaid rides and rates in the five boroughs

Members in all five boroughs book through the MAS Downstate contact center at 844-666-6270, which also serves Nassau, Putnam, Suffolk, and Westchester. MAS negotiates rates with each company, and negotiated rates replace the fee schedule. The eMedNY fee schedule file dated April 5, 2026 lists these New York City base rates:

| Service | Code | Rate | Effective |
|---|---|---|---|
| Wheelchair ambulette | A0130 | $52.90 a trip | May 30, 2024 |
| Wheelchair mileage | S0209 | $3.60 a mile | April 1, 2022 |
| Stretcher | T2005 | $230.00 a trip | May 20, 2024 |
| Taxi and livery | A0100 | $22.97 a trip | April 1, 2022 |
| Taxi and livery mileage | S0215 | $2.93 a mile | April 1, 2022 |

At those rates, a 4-mile livery trip pays $22.97 plus $11.72, or $34.69.

Manhattan's congestion zone adds a step for car service. The state manual of August 25, 2023 says the surcharge that began January 1, 2019, $2.75 for a single passenger and $0.75 per passenger in a shared ride, applies to Medicaid taxi, livery, black car, and app-based trips, while ambulettes are exempt. You file and pay a monthly return online with the Department of Taxation and Finance within 20 days after each month, and bill the surcharge back to Medicaid under code A0170 with modifier TU for a single trip or TK per pooled rider. Tax and Finance dropped its separate $1.50 registration on May 3, 2023.

## Access-A-Ride work from the MTA

MTA New York City Transit runs Access-A-Ride, New York City's ADA [paratransit](https://nemtguide.com/glossary/paratransit/) service, through primary carriers that drive MTA-owned vans and through contractors that use their own vehicles, such as broker car services, taxis, e-hail services, and supplemental carriers.

On February 25, 2026, the MTA Board approved four supplemental service contracts, worth an estimated $469,277,852 through March 31, 2033, for ABBA Local Transportation, Corporate Transportation Group, D&J Service, and VGM GOV BIZ. All four already served Access-A-Ride. The new contracts pay an average of $92.39 per vehicle service hour for the service hours actually run, down from $101.36 on a guaranteed 10-hour shift, and they no longer accept TLC-regulated wheelchair vehicles, only lift-equipped vans.

The scope of work from May 1, 2025 shows what a carrier takes on: at least 20 owned or leased wheelchair vehicles at the start, drivers with a commercial license and passenger endorsement under Article 19-A for cutaway vans or a TLC license for other vehicles, federal transit drug and alcohol testing, and GPS positions sent every 30 seconds. The contracts carry participation goals of 15% for minority-owned, 15% for women-owned, and 6% for service-disabled veteran-owned businesses, and each carrier filed a plan to meet them. The scope also lets a carrier's drivers work for a subcontractor. See [ADA paratransit contractor](https://nemtguide.com/guides/ada-paratransit-contractor/), [government NEMT contracts](https://nemtguide.com/guides/government-nemt-contracts/), and [subcontracting NEMT trips](https://nemtguide.com/guides/subcontract-nemt-trips/).

## TLC penalties that can close a small base

TLC's Chapter 60 rules set mandatory penalties for running an unlicensed van, using a driver without a TLC paratransit license, using a driver without a state license or Article 19-A qualification, and, for bases, letting drivers take street hails:

| Violation within 24 months | Penalty |
|---|---|
| First | $100 to $350 |
| Second, in any combination | $350 to $500 |
| Third, in any combination | License revoked |

A licensee with five or more open summonses within 12 months also loses the license. Missing the monthly trip record upload costs $500 if you plead guilty before the hearing or $1,000 after it, with a suspension until you send the data. Keep financial and trip records for three years, keep a phone TLC can reach around the clock, and answer any TLC contact within 48 hours.

## What to do first

1. **Choose your model:** ambulette under a contract carrier permit, TLC paratransit base, or livery base. The tables above show what each costs.
2. **Apply to NYSDOT for authority first.** TLC's base and van licenses both require it, and NYSDOT says the process usually takes 6 to 16 weeks.
3. **Reserve your name with TLC** and book fingerprints for every owner while NYSDOT reviews.
4. **Pick the base address.** Your home works for four vans or fewer. Otherwise confirm the certificate of occupancy before you sign a lease.
5. **Buy a van that qualifies:** this or last model year, under 500 miles, with an MC300 no more than a month old when you apply.
6. **Start driver licenses early.** Register drivers under Article 19-A, then give each the 90 days TLC allows for the paratransit driver license.
7. **Ask MAS for a letter of support,** then enroll with eMedNY, as the [New York guide](https://nemtguide.com/states/new-york/) explains.
8. **Set up trip records** so each van logs every ride and your base uploads them to TLC every month.

## Frequently asked questions

### Do I need a TLC license to run an ambulette in New York City?

It depends on your NYSDOT authority. New York Medicaid stopped requiring a TLC license from city ambulette companies that hold a NYSDOT contract carrier permit on January 28, 2016, and eMedNY enrolls ambulettes with NYSDOT authority and a DMV Article 19-A letter. TLC's own definitions, updated October 17, 2025, count every ambulette service as paratransit, so a company with a common carrier certificate should ask TLC in writing before it runs city trips.

### How much does a TLC paratransit base license cost?

As of September 2026, TLC charges $1,500 for a three-year paratransit base license, the same $500 a year its Chapter 60 rules set, paid in person once TLC confirms your application is complete. Each van then needs its own license at $550 for two years, and each driver a paratransit driver license at $252 for three years, or $367.25 with fingerprints and the defensive driving course.

### Can I run a NYC paratransit base from my home?

Yes, if the base runs four or fewer vehicles. TLC Rule 60B-14 lets that base sit at the owner's residence. A larger base must be on commercial property or other suitably zoned land. Either way the base needs outside signage with its business name and phone number that marks it as a paratransit base, and TLC checks the address against the Department of Buildings certificate of occupancy.

### What license does a NEMT driver need in New York City?

A driver of a TLC-licensed paratransit van needs a TLC paratransit driver license: 18 or older, a commercial class A, B, or C license, active Article 19-A status through the employer, no more than 5 DMV points in 15 months, and a 6-hour defensive driving course. All steps must be done within 90 days of applying. Car service drivers need a TLC driver license instead.

### Can I get TLC plates for a sedan to do Medicaid livery trips?

Not for a new vehicle license. As of September 2026, TLC takes new for-hire vehicle license applications only from owners of wheelchair accessible vehicles. Medicaid livery companies (category 0605) may still use drivers who own cars already licensed by TLC, as long as those drivers and cars meet TLC and DMV rules and work through your TLC base.

### How do I get Access-A-Ride work in New York City?

Through MTA New York City Transit contracts. Register in the MTA Vendor Portal, because NYC Transit bid documents cannot be downloaded without a bidder number, and watch its procurement page. The supplemental service contracts the Board approved in February 2026 run through March 31, 2033 and use lift-equipped vans only. The 2025 scope set a 20-vehicle minimum for each carrier and lets carriers use subcontractors, so a smaller company can take part as a subcontractor.

## Official resources

- [NYC TLC: Paratransit base license application and forms](https://www.nyc.gov/site/tlc/businesses/paratransit-bases.page)
- [NYC TLC: Paratransit vehicle license](https://www.nyc.gov/site/tlc/vehicles/get-a-paratransit-license.page)
- [NYC TLC: Paratransit driver license](https://www.nyc.gov/site/tlc/drivers/get-a-paratransit-drivers-license.page)
- [NYC TLC: Chapter 60 rules for paratransit vehicles and bases](https://www.nyc.gov/assets/tlc/downloads/pdf/rule_book_current_chapter_60.pdf)
- [NYC TLC: For-hire vehicle base licenses](https://www.nyc.gov/site/tlc/businesses/for-hire-vehicle-bases.page)
- [NYSDOT: Passenger operating authority](https://www.dot.ny.gov/divisions/operating/osss/bus/passenger)
- [eMedNY: Licenses needed for each transportation category of service](https://www.emedny.org/info/ProviderEnrollment/ProviderMaintForms/Additional_Requirements_for_Transportation_Enrollment.pdf)
- [MAS: Become a transportation provider](https://wp2.medanswering.com/transportation-providers/become-a-provider/)
- [MTA: New York City Transit procurement opportunities](https://www.mta.info/doing-business-with-us/procurement/new-york-city-transit)