How to Start a NEMT Business in Oregon (2027)

Oregon has no single Medicaid ride broker. Each coordinated care organization (CCO) picks a ride service for its members, and the Oregon Health Authority (OHA) contracts regional brokerages for members who are not in a CCO. To get that work, you need a registered company, the right city and state permits, insurance, and vehicles and drivers that meet Oregon’s NEMT rules. This page follows OHA’s Medical Transportation Services Provider Guide, last updated December 22, 2025, OAR 410-136 as amended effective January 1, 2025, and OAR 410-141-3920 to 3965 as last amended effective July 1, 2026.

How Medicaid rides work in Oregon

OHA runs the Oregon Health Plan (OHP). Most members belong to a CCO, which covers their physical, behavioral, and dental care and their non-emergent medical transportation (NEMT). NEMT is part of the budget OHA gives each CCO, and each CCO arranges rides through its own ride service, also called a brokerage. The 2026 CCO contract renews one year at a time and can run through December 31, 2028. Plans can change ride services, as Umpqua Health Alliance did on July 1, 2023, so check each plan’s current one before you apply.

Members who are not in a CCO are “open card” members, Oregon’s name for fee-for-service Medicaid. For them, OHA contracts brokerages that are often local governments, such as transit districts and councils of government. OHA pays each one a fixed rate per ride, based on its projected costs and rides, and settles the rate against actual costs every year. The brokerage then pays the transportation companies it subcontracts.

CCOs and their ride services

As of September 2026, OHA’s CCO contact list and the plans’ own pages name these ride services.

CCO	Area	Ride service
Health Share of Oregon	Clackamas, Multnomah, Washington	Ride to Care
Trillium Tri-County	Clackamas, Multnomah, Washington	MTM Health
Yamhill Community Care	Yamhill, parts of Washington and Polk	WellRide (Transdev)
PacificSource Marion/Polk	Marion, Polk	Modivcare
PacificSource Columbia Gorge	Hood River, Wasco	Modivcare
PacificSource Central Oregon	Crook, Deschutes, Jefferson, part of Klamath	Modivcare
Columbia Pacific CCO	Clatsop, Columbia, Tillamook	NW Rides
InterCommunity Health Network	Benton, Lincoln, Linn	Cascades West Ride Line
Trillium Southwest	Lane, western Linn and Douglas	RideSource
Advanced Health	Coos, Curry	Bay Cities Brokerage
Umpqua Health Alliance	Most of Douglas	Bay Cities Brokerage
AllCare CCO	Curry, Josephine, Jackson, part of Douglas	ReadyRide
Jackson Care Connect	Jackson	TransLink
Cascade Health Alliance	Parts of Klamath	TransLink
Eastern Oregon CCO	12 eastern counties, including Lake	GOBHI Transportation Services

CareOregon administers the NEMT benefit for three of these plans: Health Share of Oregon, Columbia Pacific, and Jackson Care Connect. In Ride to Care, Ride Connection manages the network of transportation companies, ComTrans runs dispatch, and Transdev runs the main call center. Ride to Care worked with about 60 contracted transportation companies as of September 2026. Tillamook County Transportation District runs NW Rides, and Rogue Valley Transportation District runs TransLink.

Open card brokerages

OHA’s ride service list gives these brokerages for open card members.

Counties	Open card brokerage
Clackamas, Multnomah, Washington	Tri-County MedLink
Marion, Polk	Marion-Polk MedLink
Clatsop, Columbia, Tillamook	NW MedLink
Benton, Lincoln, Linn	Cascades West Ride Line
Lane	RideSource (Lane Transit District)
Crook, Deschutes, Jefferson	Cascades East Transit (Central Oregon Intergovernmental Council)
Coos, Curry, Douglas, Jackson, Josephine, Klamath, Lake	TransLink (Rogue Valley Transportation District)
Baker, Gilliam, Grant, Harney, Hood River, Malheur, Morrow, Sherman, Umatilla, Union, Wallowa, Wasco, Wheeler	GOBHI Transportation Services

Yamhill County’s open card members also ride through a MedLink brokerage. OHA’s brokerage form OHP 0729B (September 2023) lists one Transdev contact for all three MedLink brokerages.

Who qualifies and where rides go

OHA’s provider guide lists the benefit packages that include NEMT: OHP Plus (benefit codes BMH, BMD, and BMM), OHP Bridge (BRG), CAWEM Plus (CWX), and rides to an administrative exam (ADM). Members with only the Qualified Medicare Beneficiary package get no NEMT. Rides go to and from services OHP covers, and the ride service must approve gas, meals, or lodging before the trip for the member to be paid back. See mileage reimbursement.

A ride may stop at a pharmacy on the way home when the medicine is for the visit, it is needed right away, and the pharmacy is on or near the return route. Rides to covered care in California, Idaho, or Washington within 75 miles of the Oregon border are not treated as out-of-state travel. Under the CCO rules, NEMT does not cover unscheduled trips to an emergency room, including from urgent care, or trips for health-related social needs services.

Booking and ride types

Members can book up to 90 days ahead, book recurring rides all at once, and ask for same-day rides, and each call center must be open at least Monday through Friday, 9 a.m. to 5 p.m. Children 12 and under ride with an adult attendant, the parent provides any safety seat state law requires, and no one may bill extra for an attendant.

PacificSource lists a standard car or van, a bus pass, a taxi, a wheelchair-accessible vehicle, a stretcher vehicle, and a non-emergency ambulance, plus mileage reimbursement. CCO drivers give at least the level of help the ride service approved: curb to curb, door to door, or hand to hand, where the driver stays with the member until the care team takes over. Secure transport, the involuntary transport of a person in crisis, is a separate service with its own OHA approval.

Which brokers to join

You contract with ride services one agreement at a time, for the plans and counties you want to serve. Open card brokerages assign rides by cost, the member’s needs, and each company’s capabilities, availability, and past performance. A CCO does not have to contract with every company that applies, but if it declines you, it must tell you why in writing.

1. List your ride services. Pick your counties, then find every CCO ride service and open card brokerage there in the two tables above.
2. Contact each provider team. Ask whether they are adding companies, and which service levels and areas are short.
3. Apply. Send the application and your company documents.
4. Pass credentialing. The brokerage checks your drivers, vehicles, insurance, and policies before it sends trips. The CCO contract requires every NEMT provider to pass the plan’s provider credentialing before its first ride.
5. Sign the agreement and get enrolled with OHA. Oregon’s CCO billing rule requires every provider to be enrolled with OHA, as a fee-for-service or encounter-only provider, before its encounter data is accepted. Plans enroll their providers on form OHP 3108 (January 2025), which lists “Transportation Provider” as provider type 1 and asks for an NPI. See how to get an NPI number.

Where to start with each ride service:

• Ride to Care. Ride Connection runs provider support at 503-528-1751 and providersupport@rideconnection.org. See our Ride to Care guide.
• WellRide and the MedLink brokerages. Transdev takes an online initial application and answers within a week. If you move on, you send compliance forms, staff information, and fleet information, and its review team replies within two weeks of getting everything. Its Oregon provider line is 866-336-2906. See Transdev Health Solutions.
• GOBHI. Email nemtcredentialing@gobhi.org. GOBHI runs NEMT for Eastern Oregon CCO members and OHA’s open card members, and its program covers 14 eastern Oregon counties. See GOBHI Transportation Services.
• Bay Cities Brokerage. Fill out its vendor application, which asks for your Medicaid provider number, service area, vehicle counts by type, hours, and insurance, and email support@bca-ride.com with questions. See Bay Cities Brokerage.
• MTM Health and Modivcare. Our MTM Health and Modivcare guides cover how each one adds transportation companies.
• Local ride services. RideSource, TransLink, Cascades West Ride Line, Cascades East Transit, and NW Rides are run by transit districts or councils of government, and ReadyRide serves AllCare CCO. Ask each one how it adds transportation companies.

Transdev’s January 2024 provider FAQ shows what an application can ask for: proof of good standing from the Secretary of State, a certificate of insurance, a signed statement that your company never uses restraints or seclusion, a written fleet maintenance plan, a drug-free workplace and testing policy, an ownership and control disclosure under 42 CFR 455, a fraud, waste, and abuse education form, and a W-9 for payment.

No open card brokerage may contract with or pay a company or driver who is excluded from Medicaid, Medicare, or CHIP, or who has a conviction tied to those programs. A company whose owner or managing employee is excluded cannot enroll unless OHA finds good cause. Transdev asks you to check the OIG, SAM, and OFAC lists every month and keep proof of each search. See the OIG exclusion list.

Licenses and registrations

Your company

Form an LLC or corporation with the Oregon Secretary of State’s Corporation Division. Articles of organization for an LLC, and articles of incorporation for a business corporation, each cost $100 under the Business Registry fee schedule. Both renew every year on the anniversary of the original filing, for $100, and the state mails a notice about 45 days before. An assumed business name costs $50 and renews every two years. Your registered agent needs an Oregon street address.

Get your employer identification number (EIN) from the IRS, which never charges for one. Then get the business license your city requires. Portland asks for its City of Portland business license before it permits a private for-hire company.

ODOT Commerce and Compliance Division

Oregon’s NEMT rules work through the brokerages, which must hold every company and driver to the state’s vehicle, driver, and training standards. The state and city registrations below sit on top of that.

If you	You need
Carry riders for hire, outside ODOT’s exemptions	ODOT Class 1R permit, form 735-9751
Run vehicles over 26,000 pounds	$750,000 liability on file with ODOT
Pick up riders in Portland	PBOT company, vehicle, and driver permits
Offer secure transport	OHA certificate, renewed every 2 years
Run an ambulance	An OHA ambulance license

The Class 1R permit covers for-hire passenger work other than regular scheduled routes, and ODOT’s form (January 2023 version) carries a $300 application fee. ORS 825.017 and 825.020 exempt some operations: taxis seating five or fewer passengers, limousine service on irregular routes in vehicles seating eight or fewer, and vehicles seating more than five that run only within a city and three air miles of it, which the city regulates instead. Those terms are narrow, so call ODOT at 503-378-6699 before you decide you are exempt. PBOT’s checklist says vehicles designed to carry 8 or more passengers must register with ODOT.

ODOT’s form asks an LLC to attach its articles of organization, and a corporation or assumed business name must be registered with the Secretary of State. Under ORS 825.402, most new Oregon carriers take ODOT’s Motor Carrier Education Program, at least eight hours of instruction, within 90 days of their first permit. For interstate trips, see DOT numbers for NEMT.

Secure transport companies apply to OHA by letter under OAR 309-033-0432, with letters from the county, and renew every two years. Their vehicles need a secured rear seat behind a safety shield.

Portland Bureau of Transportation

PBOT permits private for-hire companies, vehicles, and drivers in the city of Portland, and it lists non-emergency medical transport among them. It also says new NEMT companies must first secure a contract with the local brokerage. Its requirements, updated July 1, 2026:

• Company. A City of Portland business license, Secretary of State registration, and insurance from a company rated A- or better by A.M. Best, with the city named as an additional insured.
• Vehicles. Current registration, a vehicle under 15 years old unless PBOT grants an age exemption, and a mechanical inspection on PBOT’s form by an ASE Master Mechanic or Blue Seal shop, no older than six months. Wheelchair vehicles also need an ADA certificate of compliance every year.
• Drivers. Each driver applies through PBOT’s online portal, passes the background check, and passes PBOT’s NEMT driver training before a permit is issued. PBOT’s fee schedule, effective July 1, 2024, sets the NEMT driver permit at $105 a year.

For the layers of licensing NEMT companies deal with in every state, see NEMT license requirements.

Vehicle rules

Start with inspections. The state rules require every company to keep records of its vehicle inspections and preventive maintenance and to follow at least the manufacturer’s maintenance schedule. The brokerages set the inspection itself. CareOregon’s template asks for a safety inspection by an ASE-certified mechanic within the last year, a yearly ADA compliance check for each wheelchair vehicle, and an ASE mechanic’s review after any crash before the vehicle returns to service. GOBHI wants an inspection every year. Transdev accepts an ASE inspection less than a year old or inspects the vehicle itself, and it can inspect again at any time.

Under OAR 410-141-3925, every CCO vehicle needs:

• A clean interior, free of debris, with no smoking or vaping in the vehicle at any time.
• Seat belts for every passenger where the vehicle is required to have them.
• A first aid kit, a fire extinguisher, reflective roadside warning devices, a flashlight, and disposable gloves.
• Tire traction devices when conditions call for them.
• Working side and rearview mirrors, horn, heat, air conditioning, ventilation, turn signals, headlights, taillights, and windshield wipers.
• All the equipment needed to carry wheelchairs or stretchers securely under the ADA, Section 504, and ORS 659A.103.

Brokerages add to that list. CareOregon’s template adds a seat belt extender, a bloodborne pathogens spill kit, a spare tire or repair kit, a jack, a seat belt cutter, and non-latex gloves, and it strongly recommends inward and outward facing dash cameras. Transdev asks for a two-way radio or phone link to your office, a GPS device that can report the vehicle’s location, and your company name and vehicle number on the outside.

Wheelchair and stretcher rules:

• A reclining wheelchair is paid at the wheelchair rate, because a wheelchair is not a stretcher.
• An ambulance used as a stretcher car is paid at the stretcher rate, unless the trip runs over two hours and needs a health care professional on board.
• A brokerage must record its reasons when it approves more than one attendant in a wheelchair van, or more than two on a stretcher or ambulance trip.

Run through our vehicle inspection checklist before each brokerage inspection, and see wheelchair securement for the tiedown steps.

Driver rules and training

Oregon’s CCO rule sets these requirements before you hire a driver:

• A valid driver license of the class, with any endorsements, needed for the vehicle. The open card rule asks for an Oregon DMV license.
• No listing on the OIG exclusion list.
• A criminal background check that meets ORS 181A.195 and 181A.200 and OAR chapter 257, division 10. A CCO must have an exception process that can approve a driver with a record after weighing when the crime happened and what it was.
• A disclosure of any state drug law violation and the driver’s driving history, including traffic violations, under federal law.

Oregon’s NEMT rules set no minimum age, so the brokerages do. Transdev’s Oregon manual wants drivers who are at least 21 with two years of U.S. driving experience, and it excludes any felony involving harm to a person, any felony or driving-related license suspension in the past 10 years, and any traffic crime such as driving under the influence in the past 5 years. It requires drug testing before hire, at random, after an accident, and on reasonable suspicion. GOBHI accepts licenses from Oregon, Washington, Idaho, or California and wants a background check and driving record every year. Ride to Care accepts Oregon or Washington licenses.

Training deadlines depend on who pays for the trip:

Course	CCO trips	Open card trips
First aid, CPR, blood spill	Before driving any member	Within 6 months of hire
Defensive driving	Within 3 months, every 3 years	Within 6 months, every 3 years
Passenger Service and Safety	Within 3 months, every 3 years	Within 6 months, every 3 years

The defensive driving course is the National Safety Council course or an equivalent. See PASS certification for the passenger course, whose wheelchair securement part CareOregon’s template requires for wheelchair van drivers. Drivers also learn NEMT basics, reporting forms, vehicle operation, fraud and abuse reporting, emergency procedures, and the area they serve, and open card rules repeat that training every year. An EMT with a current Oregon license can drive NEMT once the CCO verifies the license and exclusion status and runs its own background check, and the EMT finishes the defensive driving, passenger, and NEMT basics training.

On the job, Transdev’s drivers identify themselves by name and company and never call or text while carrying a member. CareOregon’s template bars drivers from personal care and from going into an exam room, and, unless the brokerage has licensed, trained, and authorized them, from moving a member into or out of a wheelchair or bed or going inside a private home.

Keep a file on every driver with the license, background check, driving record, drug screens, and training certificates. Our driver file checklist tracks them.

Trip rules and how you get paid

The 2026 CCO contract sets these standards for CCO rides:

• Waiting. Drivers make their presence known and wait at least 15 minutes past the scheduled pickup time. If the member is not there, the driver tells dispatch before leaving as a no-show.
• Arriving. A driver may arrive early, but the member never has to board before the scheduled time. A vehicle more than 15 minutes late counts as late, and drivers may not change a pickup time without the ride service’s documented permission.
• Drop-off. Members arrive at least 15 minutes before the appointment, or the drop-off counts as late, and cannot be made to arrive more than one hour early.
• Returns. When no return time is set, the member is picked up within one hour of the call.
• Incidents. Any crash that injures or kills a driver or passenger, and any claim of abuse by a driver, must reach OHA within two business days of the plan learning of it, so tell your ride service the same day.

For CCO and open card rides alike, drivers may not drop a member off more than 15 minutes before the office opens, or pick up more than 15 minutes after it closes, unless the member asks or the visit runs late. Open card brokerages report a ride as late when the driver arrives 15 minutes or more past the scheduled pickup time.

Record the member’s name, the pickup and destination, the scheduled and actual pickup times, the appointment time, the drop-off time, the mode, the driver, the vehicle, and the mileage on every trip, as CareOregon’s template lists. Oregon’s CCO rules count transportation companies as participating providers for record keeping, and that rule keeps clinical records across a plan’s network for at least 10 years after the date of service. Our trip log template has room for all of them.

Oregon does not set the rate a brokerage pays you. Each brokerage agrees a base rate with you for each mode of transport. For open card trips, the state rules also say:

• Shared rides. The full base rate for the first member and half the base rate for each added member, paid from the first pickup to the last drop-off, on actual miles only.
• Waiting. No pay for waiting for a member to come to the vehicle or for helping them in or out. A brokerage may pay waiting time in special cases, such as a stretcher member who cannot move off your gurney, or a stop for medicine or a member who is sick after dialysis or chemotherapy.
• Wrong vehicle type. An ambulatory member carried in a wheelchair van is paid at the ambulatory rate.
• Members. You may never bill a member or send a member to collections for a covered ride.

OHA’s provider guide (December 22, 2025) lists the procedure codes for each ride type, with place of service code 99 for rides that are not ambulance trips. Partial miles round up to the next mile, and each added rider goes on a separate claim. Ask each brokerage which codes and trip details it wants on your invoices.

Ride type	Code
Sedan or taxi	A0100
Wheelchair car or van	A0130
Stretcher car or van	T2005
Secured or specialty care transport	A0434
Bus tickets or passes	A0120
Volunteer driver	A0080

GOBHI’s manual (July 2025) shows how one brokerage pays. It assigns most trips by rate, takes rate requests no more than every 90 days, and answers within 30 days. It pays on the second and fourth Wednesday of each month, wants every claim settled within 120 days of the trip, and does not pay for a trip with no member on board, such as a no-show. For CCO members, Oregon’s billing rule gives providers 120 days from the date of service to submit most claims, and requires CCOs to pay or deny 90 percent of valid claims within 30 days.

If a brokerage suspends or disqualifies one of your drivers, the GOBHI and CareOregon manuals let you appeal in writing to the brokerage.

Oregon’s electronic visit verification (EVV) program does not cover NEMT. It covers Medicaid personal care and attendant care, and home health visits since January 1, 2024.

Insurance requirements

Oregon’s rules make NEMT companies show proof of liability coverage when OHA asks, and the CCO contract makes each plan check that its transportation companies carry workers’ compensation, general liability, and auto liability. Most dollar limits come from the brokerages and cities. These are the ones posted:

Who asks	Auto liability	General liability
Transdev (January 2024)	$1 million per occurrence	$1 million per occurrence
Portland PBOT (July 2026)	$500,000 combined	$1 million per occurrence, $2 million total
ODOT, over 26,000 pounds	$750,000 on file	None set

Transdev’s auto cover must include owned, hired, and non-owned vehicles, and its general liability must include sexual abuse and molestation coverage. It wants an insurer rated B+ or better by A.M. Best, Transdev listed as an additional insured, and a new certificate every six months with a vehicle schedule that matches your roster. Portland wants an A- rating and the city as an additional insured. Ask every ride service for its limits in writing before you buy a policy, and see NEMT insurance requirements for what brokers ask for elsewhere.

Oregon requires almost every employer to carry workers’ compensation, and you are an employer once you pay one or more workers who are not independent contractors. The NEMT rules make brokerages require it of their subcontractors unless an exemption applies. Transdev accepts a valid workers’ compensation waiver in place of coverage.

What it costs and how long it takes

These are the fees Oregon and Portland set, as of September 2026. Vehicles, insurance, and equipment depend on your quotes. See what it costs to start a NEMT business for those.

Item	Cost	Paid to
EIN	Free	IRS
LLC or corporation filing	$100	Secretary of State
Annual renewal	$100 a year	Secretary of State
Assumed business name	$50 every 2 years	Secretary of State
Class 1R permit, if needed	$300	ODOT
Portland company application	$262.50	PBOT
Portland company permit	$525	PBOT
Portland vehicle permit	$236.25 per vehicle	PBOT
Portland driver permit	$105 a year	PBOT

Portland renewals cost $525 for the company and $189 per vehicle, as long as the permits have not expired.

A workable order, from first call to first trip:

1. Call the provider teams for your counties and ask which service levels they need.
2. Form your company with the Secretary of State, get your EIN, and get your city business license.
3. Buy insurance that meets each ride service’s limits, plus workers’ compensation if you have employees.
4. Ask ODOT about the Class 1R permit and file form 735-9751 if you need it.
5. Get an NPI for your company.
6. Equip your vehicles and get them inspected by an ASE-certified mechanic, with an ADA check for wheelchair vans.
7. Hire drivers who pass the background and exclusion checks, and book First Aid, CPR, and blood spill training before their first CCO trip.
8. Apply to the ride services, pass credentialing, and sign each agreement.
9. Apply for PBOT permits if you will pick up riders in Portland, now that you have a brokerage contract.

The ride services set the pace. Transdev answers within a week and replies within two weeks of a complete file, and PBOT can take up to 60 days for a new company. For the same steps in any state, see how to start a NEMT business.

Work beyond Medicaid

• ODHS community transportation. The Oregon Department of Human Services pays contracted transportation providers for non-medical community rides in some Oregon Project Independence-Medicaid service plans. Its April 22, 2026 guide caps contracted rides at eight one-way rides per pay period unless the central office approves more, and none may go to medical appointments.
• Health-related trips. Ride to Care uses its contracted NEMT companies for Flex Trips, such as rides to housing appointments or for fresh food, which Health Share offers beyond the NEMT benefit.
• Public transit agencies. Lane Transit District runs RideSource paratransit, and Rogue Valley Transportation District runs Valley Lift. ODOT’s Statewide Transportation Improvement Fund gives public transportation across Oregon a dedicated source of money. Ask those agencies how they buy service.
• Veterans. The VA pays eligible veterans for special mode transportation, such as a specially equipped vehicle or an ambulance, when their local VA health facility approves it in advance.
• Facilities and private pay. Dialysis centers, hospitals, senior living communities, and riders who pay for themselves add work that does not depend on one brokerage. See how to get NEMT facility contracts and private pay NEMT. For long rides in eastern and southern Oregon, see rural NEMT.