Medicaid Transportation in Mecklenburg County, NC: How Private Companies Get MTS Work

Mecklenburg County does not hand its NC Medicaid Direct rides to a broker. It runs its own transit service, the Mecklenburg Transportation System (MTS), inside the Child, Family and Adult Services department (the county’s social services agency), and it fills the gaps with contract vendors. For a small company in Charlotte, that gap is the opening: trips after 5 p.m., weekends, and days when MTS is closed but a sponsoring agency is open.

The statewide rules (NCTracks enrollment, the county manual MA-2910, driver screening, and how county trips are paid) are on the North Carolina guide. This page covers what is different here.

Who arranges Medicaid rides in Mecklenburg County

MTS books rides for Medicaid members who are not in a health plan, plus several senior and disability programs. Riders call scheduling at 704-336-4547, book at least 3 business days and up to 30 days ahead, and pay no fare on Medicaid trips. Health plan members ride through Modivcare or MTM Health instead, so those trips never reach MTS.

The MTS page lists MTS and its contract vendors as the main way Medicaid riders travel, and the county’s February 2026 announcement adds monthly Charlotte Area Transit System (CATS) bus passes in some cases. A rider who needs door-to-door service, or a trip outside the county, needs an approved Medicaid Transportation Exception Verification Form first.

Volume is large. The county’s April 16, 2024 presentation to the Board of County Commissioners counted 190,142 Medicaid trips for 2,460 riders in fiscal year 2023, and 144,610 trips from July 2023 through February 2024. On February 27, 2026, the county announced that MTS was taking new riders again in its senior and disability programs, which adds non-Medicaid trips to the same schedule.

Where contract vendors fit

MTS runs from 5 a.m. to 6:30 p.m., seven days a week except December 25, and the last pickup a rider can book is 5:30 p.m. County-certified drivers and contract vendors share trips until 5 p.m. After 5 p.m., only contract vendors drive, finishing the day’s drop-offs and trips delayed by traffic. The 2024 Title VI plan puts the county’s own direct service at Monday through Friday, 6 a.m. to 5 p.m., with no service on county holidays. When MTS is closed but a sponsoring agency is open, the county says its contract vendors provide the rides.

The April 2024 presentation described the whole system like this:

Part of the system	April 2024
MTS staff	46
MTS vehicles	25 light transit vehicles and three 15-passenger vans
Contract vendors	6
Vendor vehicles	179, with 28 wheelchair accessible

Wheelchair capacity is the thin part. One vendor supplied 10 of the 28 accessible vehicles, and two vendors had one each. A company with even two ramp or lift vans adds real capacity here. See after-hours NEMT for how to staff the late shift that these trips need.

Vendors already carry most fare-paying trips. In its April 2026 notice of a non-Medicaid fare increase from $1.50 to $2.25 starting July 1, 2026, the county projected $161,583.75 of about $181,998 in fiscal 2027 fares from vendor trips and $20,414.25 from MTS direct trips.

Rules your drivers work under

These come from the MTS rider page and the 2024 Title VI plan:

• Pickup window. Riders must be ready one hour before their pickup time, and the driver may arrive at any point in that hour.
• Wait time. Drivers wait 5 minutes, then the trip is a no-show and no second vehicle is sent.
• No-show reports. Vendors report no-shows to the DSS contract administrators every week, and the county sends the rider warning or suspension letters.
• Will-call returns. Once a rider calls to activate a will-call trip, the assigned vendor arrives within one hour.
• Cancellations. Riders cancel at least two hours before the appointment, or the trip counts as a no-show.
• Door to door. Drivers do not enter a rider’s home.

What the county contract requires

The county buys vendor service through formal bids. Its last one was RFP #487-DL-DSS004022, Non-Emergency Medical Transportation Services, due at 2 p.m. on March 11, 2024. Responses went only through MeckProcure, the county’s vendor portal, and the county asked vendors to list NIGP code 95294 (transportation services for the elderly, disabled, and incapable) in their profile so they get notices of the next one. The Procurement Division says you can answer a bid before sending your W-9, ACH, and IAT forms, but the county cannot award you a contract until it has them. It handles questions about closed bids through public records requests.

On top of the county’s own terms, the state manual makes every county NEMT contract carry certain things: a written contract you sign, NCTracks enrollment before your first ride, a random drug and alcohol testing program that meets Federal Transit Administration rules at your own cost, and an annual review. The North Carolina guide lists the rest.

What it pays

The county sets vendor rates in each contract. Two figures from the April 2024 presentation show the scale. MTS raised vendor rates in fiscal 2024, which lifted the average cost per trip from $18.96 to $32.26 in the trip budget it funds with transit grants and county money. The same presentation put total fiscal 2025 vendor costs at $3.4 million. For Medicaid Direct trips, the county authorizes each payment in NCTracks, and the 2025 state rate cut and its reversal are covered in North Carolina reverses its NEMT rate cut.

Charlotte’s for-hire permit

Inside Charlotte city limits, the Charlotte-Mecklenburg Police Department’s Passenger Vehicles for Hire (PVH) office enforces Chapter 22 of the City Code. Its page lists special needs vehicles, transportation vehicles, and contract vehicles among the types it regulates, and its 2026 company list includes wheelchair transport companies. You need three licenses:

License	Fee from July 1, 2026
Company operating certificate, new or renewal	$400 a year, plus $100 a day if late
Vehicle operating permit, new or renewal	$15 per vehicle
Driver application, new	$65
Driver permit	$15
Driver permit renewal, permit fee included	$80

The company application (revised July 2026) asks for your articles or operating agreement, a driver roster and vehicle list, drug test results, a rate sheet, a driver training manual, and fingerprints for each new owner and employee, repeated at least every three years. Each vehicle permit needs a certificate of insurance naming the PVH office as certificate holder, no more than 30 days old, and it renews every year.

Non-metered companies need for-hire “Z” plates. The forms exempt companies contracted directly with DSS from that plate rule if they attach the contract, and they accept no third-party contracts, so a broker subcontract does not qualify. The office works by appointment only and takes company checks or money orders.

What to do first

1. Enroll in NCTracks as a NEMT provider. The county cannot use you until you do.
2. Register on MeckProcure and add NIGP code 95294, so the next MTS bid reaches your inbox.
3. Call MTS and ask for the contract administrator. Ask whether the county is adding vendors between bids and which hours and service levels it is short on.
4. Book a PVH appointment if you will pick up riders in Charlotte, and get the company certificate before you permit vehicles and drivers.
5. Apply to Modivcare and MTM Health for health plan trips in the same area, since most North Carolina Medicaid members are in a health plan.

In October 2025, the county also asked for quotes on a study of whether to add microtransit to MTS, paid for by a fiscal 2026 grant from the City of Charlotte through the Charlotte Regional Transportation Planning Organization. Watch the commissioners’ agendas for what the county decides, since a change to how MTS runs would reach its vendors too.