# How to Start a NEMT Business in West Virginia (2027)

Canonical URL: https://nemtguide.com/states/west-virginia/ · Updated 2026-09-29

To start a NEMT business in West Virginia, form your company, get a business registration certificate from the State Tax Division, and insure and equip your vans. Then apply to Modivcare, the statewide Medicaid broker since 2018, whose new state contract began February 22, 2026. Vans used only for Medicaid rides need no Public Service Commission certificate, but they must follow its safety rules.

- Modivcare arranges non-ambulance Medicaid rides across West Virginia, and the state renewed that role in a new contract that took effect February 22, 2026.
- You contract with Modivcare, not with Medicaid, and state policy requires the broker to take any willing and qualified provider.
- Vans used only for Medicaid rides skip the Public Service Commission certificate, but carrying private-pay riders for hire brings you under it.
- Modivcare's rules set the real bar: drivers 18 or older with clean records and training, and vehicle inspections every six months.
- West Virginia does not set your rate. Modivcare negotiates it and must pay within 30 calendar days under its state contract.

## West Virginia NEMT at a glance

| Fact | Details |
| --- | --- |
| Medicaid agency | West Virginia Department of Human Services, Bureau for Medical Services (BMS), which pays the broker a monthly rate for each eligible member |
| How rides work | One statewide broker arranges non-ambulance Medicaid and WVCHIP rides in all 55 counties, with no regions |
| Medicaid broker | Modivcare, the broker since September 1, 2018, under a new state contract that took effect February 22, 2026 for one year, with up to five one-year renewals |
| How to join | Send Modivcare's Become a Transportation Provider form. The state requires the broker to take any willing and qualified provider. |
| State registration | A business registration certificate from the State Tax Division. Vans used only for Medicaid rides need no PSC certificate but follow PSC safety rules. |
| Insurance | Chapter 524 leaves the amount to state law or Modivcare. The state auto floor is $25,000 per person, $50,000 per accident, and $25,000 for property. |
| Drivers | At least 18 with a valid license, no DUI in 3 years, no suspension in 5 years, no violent, sexual, or drug felony in 7 years, and a clean 10-panel drug screen |
| Vehicle inspections | Modivcare inspects each vehicle before service and every six months. Since January 1, 2024, most vehicles need a State Police inspection every two years. |
| Pay | Modivcare negotiates your rate. The state contract defines timely payment as 30 calendar days, and Modivcare pays every two weeks. |
| EVV | No. West Virginia's EVV covers personal care and home health services, not NEMT. |

West Virginia runs non-ambulance Medicaid rides through one statewide broker, Modivcare. You do not enroll with Medicaid. You sign a provider agreement with Modivcare, and the Public Service Commission leaves Medicaid-only vans out of its certificate system. The rules below follow Chapter 524 of the BMS Provider Manual (effective June 1, 2024), the state's master agreement with Modivcare that took effect February 22, 2026, and the Modivcare West Virginia Transportation Provider Manual made part of that contract.

## How Medicaid rides work in West Virginia

The Bureau for Medical Services (BMS), part of the West Virginia Department of Human Services, runs Medicaid and the West Virginia Children's Health Insurance Program (WVCHIP). It pays one full-risk broker a set amount per member per month, a [capitation](https://nemtguide.com/glossary/capitation/) rate, and the broker pays for every covered ride out of that money. Chapter 524 bars the broker from owning any of the transportation companies it uses.

Modivcare, then called LogistiCare, became the broker on September 1, 2018. The state rebid the contract in 2025. Four companies bid, among them Verida and MTM Health, and Modivcare won. Its new master agreement runs from February 22, 2026 to February 21, 2027 and can be renewed for up to five more one-year terms. Modivcare left Chapter 11 on December 29, 2025. See [Modivcare's bankruptcy exit](https://nemtguide.com/news/modivcare-exits-bankruptcy/) for what that meant for providers.

Managed care does not change who you work for. Mountain Health Trust covers about 87% of Medicaid members through four health plans, and BMS carves NEMT out of it, so plan members book rides with Modivcare too.

### Who qualifies and how rides are booked

A member qualifies when they have no other way to reach a service Medicaid covers, and they must say so when they call. Members book at least five business days ahead. Hospital discharges and urgent trips confirmed by a medical provider are the exception. Standing orders for repeat trips, such as dialysis, can be booked up to three months at a time.

The broker picks the least costly mode that fits the member. Public transit comes first where it works, and members, friends, or family can be paid mileage for driving. Doctors and clinics in Ohio, Virginia, Pennsylvania, Maryland, and Kentucky within 30 miles of the border count as in-network, and trips to medical providers farther out need prior approval.

Modivcare's West Virginia page reports these 2024 numbers: 479,000 people covered, more than 1.9 million ambulatory trips, 21,000 wheelchair trips, and 1.3 million mileage reimbursement trips. Its 2025 proposal says a pool of 59 wheelchair-equipped vehicles made more than 17,000 trips in 2024, so ask whether it needs wheelchair service where you are.

### Ride types and rides outside the broker

The state contract names fixed route transit, private auto, basic vehicles (sedans and vans for riders who need no lift), enhanced vehicles (wheelchair lift or ramp), and other carriers such as taxis. Modivcare also contracts stretcher vans. Drivers give [curb-to-curb](https://nemtguide.com/glossary/curb-to-curb/), [door-to-door](https://nemtguide.com/glossary/door-to-door/), or hand-to-hand help as assigned, and never lift a rider.

Some rides never reach the broker. Nursing facilities arrange and pay for their residents' rides, and psychiatric residential treatment facilities and ICF/IID homes include transport in their daily rate. School rides under an IEP and some behavioral health center and waiver rides are exempt too. Ambulance companies bill Medicaid directly.

## How to join Modivcare

BMS sends every interested transportation company to Modivcare. Chapter 524 requires the broker's network to include any willing and qualified provider. The steps:

1. **Send the provider form.** Fill out the Become a Transportation Provider form on Modivcare's join page, which also maps the areas where it needs providers most.
2. **List your fleet.** Submit a Vehicle Update Form with each vehicle's make, model, year, VIN, and West Virginia plate, and update it whenever the fleet changes.
3. **Send driver files.** Modivcare approves every driver's records and training before the first trip and again every year.
4. **Pass the vehicle inspection.** Field monitors inspect each vehicle and apply a green sticker when it passes.
5. **Sign and attend orientation.** Sign the Transportation Provider Agreement. Modivcare holds orientation for new providers' staff on its rules, scheduling, billing, and trip logs.

Modivcare's proposal says it checks providers and drivers against the HHS OIG exclusion list, the federal SAM list, sex offender registries, and the Social Security Death Master File. Federal law, 42 U.S.C. 1396a(a)(87), also requires every NEMT provider to have a process for drug law violations and a process to disclose each driver's driving history to the state Medicaid program. See the [OIG exclusion list](https://nemtguide.com/glossary/oig-exclusion-list/).

The West Virginia manual attached to Modivcare's 2026 contract lists the Transportation Provider Line as 844-889-1940 and the claims department as 844-889-1943. For the company's other states, see our [Modivcare guide](https://nemtguide.com/brokers/modivcare/).

## Licenses and registrations

### Your company

Register on the West Virginia One Stop Business Portal, where one filing reaches the Secretary of State, the State Tax Division, and WorkForce West Virginia. As of September 2026, an LLC or for-profit corporation costs $100, plus $1 online. Veteran-owned businesses and West Virginia residents aged 18 to 29 can have that fee waived. Processing within 24 hours costs $25 more.

File an annual report between January 1 and June 30 of each year after you register. It costs $25, and an LLC that files after June 30 pays $75.

Chapter 524 requires a valid West Virginia business license: the business registration certificate from the State Tax Division. It costs $30 once and stays valid until your name, location, or ownership changes. Get your employer identification number (EIN) free from the IRS. If a health plan asks for an NPI, see [how to get an NPI number](https://nemtguide.com/guides/how-to-get-an-npi-number-for-nemt/).

### West Virginia Public Service Commission

The Public Service Commission (PSC) licenses passenger carriers for hire. W. Va. Code 24A-1-3(13) exempts vehicles used only for Medicaid NEMT, including broker trips, from its certificate rules. Those vehicles and their drivers stay under PSC safety rules.

| If you | You need |
|---|---|
| Carry only Medicaid members | No PSC certificate, but PSC safety rules apply |
| Also carry private-pay riders for hire | A PSC certificate of convenience and necessity |
| Run multi-patient medical transport as an EMS agency | An EMS agency license and a PSC certificate |

The PSC's rule 150CSR9 (effective January 13, 2022) counts exempt carriers as motor carriers. Its Rule 4.3.3 says every vehicle of any size carrying passengers for hire must follow the federal motor carrier safety rules it adopts, which include driver qualification, vehicle maintenance, and hours of service. Ask the PSC Transportation Division which parts it enforces on small vans.

A certificate starts with PSC M.C. Form No. 8, notarized, with a $100 filing fee. You publish a legal notice, and anyone can protest within 10 days, which sends the case to a hearing. The PSC says the process typically takes two to six months. The Motor Carrier Section is at 1-800-247-8789.

Paid trips into a neighboring state can bring federal rules into play. See [DOT numbers for NEMT](https://nemtguide.com/guides/dot-number-for-nemt/) and [NEMT license requirements](https://nemtguide.com/guides/nemt-license-requirements/).

## Vehicle rules

Modivcare inspects every vehicle before it enters service and at least every six months after, and the state sticker never substitutes for it. A vehicle with minor problems gets a yellow sticker and a reinspection within 10 days. A red-lined vehicle cannot carry members, its trips go unpaid, and using one is grounds to end your contract.

Chapter 524 also calls for a yearly inspection by the appropriate regulator. State Police safety inspections moved to a two-year cycle on January 1, 2024, with a $19 maximum fee. Under W. Va. Code 17C-16-4, commercial vehicles covered by federal motor carrier safety rules should still be inspected every year.

Every vehicle needs, under Modivcare's manual:

- A cell phone or two-way radio linking it to your office. Pagers do not count.
- Working heat, air conditioning, interior light, speedometer, odometer, horn, wipers, and lights, and tire tread of at least 4/32 inch in front and 2/32 inch in back.
- Working seat belts, two seat belt extensions, and a belt cutter within the driver's reach.
- Two outside mirrors and an inside mirror for watching passengers.
- A 2.5 pound fire extinguisher, a first aid kit, a spill kit, and three reflective triangles. Flares are not allowed.
- A flashlight, an ice scraper, spare fuses, a spare tire and jack, and a tire traction device when the weather calls for one.
- A GPS unit or a current map of your service area.
- A step or step stool that holds 300 pounds and sits no more than 12 inches off the ground. A milk crate is never allowed.
- Your business name and phone number on both sides in letters at least 3 inches tall, and never the words Medicaid or Medicare.
- Inside, your name, vehicle number, phone, and Modivcare's toll-free numbers, its complaint procedures in writing, seat belt and no smoking signs, and the registration, insurance card, and accident forms.

Use only vehicles you own or lease, and never subcontract trips. Members bring child seats for children under 8 and under 57 inches tall.

Wheelchair vehicles need at least 56 inches of headroom, a lift interlock, and a tie-down at every wheelchair position. Lifts carry 600 pounds, or 800 for bariatric service, and ramps carry 600 pounds. Stretcher vans carry one stretcher rider at a time with a driver and an attendant. Use our [vehicle inspection checklist](https://nemtguide.com/templates/nemt-vehicle-inspection-checklist/) before Modivcare's visit.

## Driver rules and training

Modivcare's West Virginia manual keeps a driver or attendant off its trips for any of these:

- Being under 18, or lacking a valid license for the vehicle.
- A conviction for driving under the influence in the three years before service.
- A guilty plea or conviction in the last seven years for a barrier crime or a felony that is sexual or involves a child, an older adult, domestic abuse, drugs, weapons, or violence.
- A license suspended or revoked for moving violations in the last five years.
- Two moving violations or at-fault accidents within 36 months.
- A sex offender registry listing, or a failed 10-panel drug screen before hire.

The criminal check is national, with state and county detail, and repeats every year. Modivcare's proposal says drivers get fingerprint-based state and FBI checks. Chapter 524 adds that multi-passenger van drivers file current first aid and CPR certificates with the broker.

Before their first trip, drivers complete orientation, sensitivity and customer service, pre-trip inspection, the National Safety Council DDC-4 defensive driving course or an approved equivalent, a passenger assistance course such as [PASS](https://nemtguide.com/glossary/pass-certification/), mobility aid securement, first aid and CPR, spill kit use, and HIPAA. A driver who fails to secure a wheelchair once is suspended until retrained, and a second failure bars the driver for good. See [wheelchair securement](https://nemtguide.com/guides/wheelchair-securement/).

On the job, drivers wear a name tag with their name and your company's. They use the phone only for dispatch or 911 and never while moving, never leave a member alone, and confirm each rider is inside before driving away.

Keep a file on each driver: a license copy, five years of driving records updated yearly, the background and registry checks, drug screen results, and every training certificate, plus any complaints, accidents, and violations. Modivcare can ask for it on three days' notice. Our [driver file checklist](https://nemtguide.com/templates/nemt-driver-file-checklist/) covers it.

## Trip rules and how you get paid

Modivcare posts trip manifests on its provider website, or faxes them at least 48 hours ahead, and calls to confirm any trip added within 24 hours of pickup. Send back a trip you cannot run at least 24 hours before pickup, or you may pay for the replacement ride. Never change a pickup time without Modivcare's approval.

The standards in your agreement:

- **Pickup.** A trip is late 15 minutes after the scheduled pickup. You may arrive early, but the rider never has to board before the scheduled time.
- **No-shows.** Wait at least five minutes past pickup time, and call Modivcare before you leave. See [no-shows](https://nemtguide.com/glossary/no-show/).
- **Delays.** Call waiting riders once you run 15 minutes late.
- **Returns.** Arrive within 60 minutes of a [will-call](https://nemtguide.com/glossary/will-call-trip/) request, and within one hour for a same-day hospital discharge.
- **Shared rides.** No rider spends more than 45 minutes longer than a direct trip.
- **Late and missed trips.** The state contract caps them at 5% of trips per day. BMS may waive that for non-critical services during floods, heavy snow, or other widespread weather.

That waiver matters in the mountains, where one storm can close the only road to a clinic. Our [rural NEMT guide](https://nemtguide.com/guides/rural-nemt/) covers long empty miles.

Each driver keeps a daily trip log with the date, driver and member signatures, the last six digits of the VIN, the trip number, the level of service, and actual pickup and drop-off times in military time. Report the previous day's cancellations by noon, and send completed logs with an invoice at least weekly. See our [trip log](https://nemtguide.com/templates/nemt-trip-log-template/).

West Virginia does not set rates for non-ambulance providers. Chapter 524 lets Modivcare pay through any arrangement both sides agree to, including a sub-capitation, and van providers may get a multi-load rate. Modivcare pays only for trips it assigned, and nothing extra for escorts. The state contract defines timely payment as 30 calendar days, and Modivcare's manual says it pays every two weeks. Its proposal puts the filing window at typically 90 to 120 days from the date of service. Ask how Exhibit B of your agreement pays no-shows before you sign.

Report every accident at once, and file Modivcare's report form within 24 hours. Chapter 524 gives you 15 calendar days to ask for a review of a broker decision. A disputed termination goes to a meeting of senior managers, then binding arbitration.

## Insurance requirements

Chapter 524 requires every non-ambulance provider to carry errors and omissions liability, auto liability, or both, in the amount state law or the broker sets. Send copies when you enroll, and Modivcare's manual has you send them again as policies renew, at least once a year. The state contract asks you to list Modivcare as an additional interested party.

Modivcare's national join page asks for general liability, sexual abuse and molestation coverage, auto liability at or above your state's minimum, and workers' compensation where required. Ask its West Virginia staff for the exact limits in writing before you buy.

Under W. Va. Code 17D-4-2, since January 1, 2016, every vehicle carries at least:

| Coverage | Minimum |
|---|---|
| Injury to one person | $25,000 |
| All injuries in one accident | $50,000 |
| Damage to others' property | $25,000 |

For carriers under a PSC certificate, 150CSR9 sets higher limits by vehicle size. The PSC says Medicaid-only carriers stay subject to its applicable insurance rules, so ask the Motor Carrier Section whether it expects a filing from you. The limits per person and per accident, as of September 2026:

| Passengers | Injury limits | Property |
|---|---|---|
| 5 or fewer | $100,000 / $200,000 | $25,000 |
| 6 to 12 | $200,000 / $500,000 | $25,000 |
| 13 to 20 | $200,000 / $600,000 | $50,000 |

For what brokers ask for elsewhere, see [NEMT insurance requirements](https://nemtguide.com/guides/nemt-insurance-requirements/).

West Virginia requires workers' compensation, from a private insurer, once you regularly employ another person. A sole proprietor may leave themselves out, and an LLC may leave out up to four managers, officers, or members. Employers also register for unemployment coverage with WorkForce West Virginia.

## What it costs and how long it takes

These are the fees West Virginia sets as of September 2026. Vehicles, insurance, and equipment depend on your quotes. See [what it costs to start a NEMT business](https://nemtguide.com/guides/how-much-does-it-cost-to-start-a-nemt-business/).

| Item | Cost | Paid to |
|---|---|---|
| EIN | Free | IRS |
| LLC or corporation | $100, plus $1 online | Secretary of State |
| Annual report | $25, or $75 late for an LLC | Secretary of State |
| Business registration certificate | $30, one time | Tax Division |
| State Police inspection | Up to $19 every two years | Inspection station |
| PSC certificate, private pay only | $100 filing fee | PSC |

A workable order, from first call to first trip:

1. **Call Modivcare's provider line.** Ask which counties and service levels need providers, and what insurance limits it requires.
2. **Register on the One Stop Business Portal** and get your EIN.
3. **Buy insurance**, including workers' compensation once you hire.
4. **Get your vehicles ready.** Pass the State Police inspection and fit every item on the manual's list.
5. **Hire and train drivers.** Run background, registry, and drug checks, and book defensive driving, PASS, and first aid and CPR.
6. **Send Modivcare's provider form**, then your fleet list and driver files. Pass the inspection, sign, and attend orientation.
7. **Decide on private pay.** If you will carry riders outside Medicaid, file PSC Form No. 8 early.

The pace depends on how fast your driver files clear and when Modivcare's field monitors can inspect, so ask for a timeline on your first call. For the same steps in any state, see [how to start a NEMT business](https://nemtguide.com/guides/how-to-start-a-nemt-business/).

## Work beyond Medicaid

Five other sources of rides are worth a call.

- **Recovery rides.** The same state contract has Modivcare run a Statewide Transportation Program for the Jobs and Hope program and the Bureau for Behavioral Health. It covers non-medical rides for people in recovery, booked by Jobs and Hope transition agents, and rides between behavioral health treatment settings. Modivcare fills them with ride-share, taxis, transit, and multi-passenger vans, so ask whether your vans can take them.
- **Facilities.** Nursing facilities arrange and pay for their residents' rides outside the broker. See [how to get NEMT facility contracts](https://nemtguide.com/guides/how-to-get-nemt-facility-contracts/), and ask the PSC whether that work needs a certificate.
- **Rural Health Link grants.** On August 24, 2026, the governor announced about $2.34 million through the Rural Health Transformation Program to add NEMT vehicles, drivers, and rides. The state invited transportation providers to apply through wvOASIS.
- **Section 5310 networks.** WVDOT's transit division funds accessible vehicles and rides for seniors and people with disabilities. Only non-profits and public bodies may apply, and they can use the money to buy rides from a transportation company.
- **Veterans.** The VA pays for special mode transportation, such as a wheelchair van, when the local VA health facility approves it in advance. Ask the beneficiary travel office at the VA in Beckley, Clarksburg, Huntington, or Martinsburg.

## Frequently asked questions

### Do I need a license to run a NEMT business in West Virginia?

You need a business registration certificate from the State Tax Division, the business license that Chapter 524 asks for, and you must stay current on workers' compensation, unemployment, and state and local taxes. Vehicles used only for Medicaid rides, including broker trips, are exempt from the Public Service Commission certificate under W. Va. Code 24A-1-3, but they follow PSC safety rules. Carrying private-pay riders for hire needs a PSC certificate.

### Who is the Medicaid NEMT broker in West Virginia?

Modivcare, formerly LogistiCare. It began managing West Virginia Medicaid NEMT on September 1, 2018 and won the state's 2025 rebid. The new master agreement took effect February 22, 2026 for one year and can be renewed up to five times. Mountain Health Trust plan members also book through Modivcare, because NEMT is carved out of managed care.

### Do I enroll with West Virginia Medicaid to give NEMT rides?

No. Chapter 524 of the BMS Provider Manual says non-ambulance transportation providers do not enroll directly with Medicaid. They must contract with the state's broker, provide rides through it, and meet the chapter's rules. Modivcare keeps your enrollment papers on file. Ambulance companies are the exception: they enroll with Medicaid and bill it directly.

### How much does Modivcare pay per trip in West Virginia?

West Virginia does not set a per-trip rate for non-ambulance providers. BMS pays Modivcare a monthly amount for each member, and Modivcare negotiates rates with each provider, which may include a sub-capitation or a multi-load rate. The state contract defines timely payment as 30 calendar days, and Modivcare's manual says it pays invoices every two weeks.

### What are the NEMT driver requirements in West Virginia?

Under Modivcare's West Virginia manual, drivers must be at least 18 with a valid license, pass a criminal background check, a sex offender registry check, and a 10-panel drug screen, and have no DUI in 3 years or license suspension in 5 years. They need defensive driving, first aid and CPR, passenger assistance, and wheelchair securement training before their first trip.

### How long does it take to start a NEMT business in West Virginia?

Mostly as long as Modivcare takes. You can register your company, tax account, and unemployment account in one online filing, and the Secretary of State offers 24-hour processing for $25. Modivcare must then approve every driver and inspect every vehicle before your first trip. A PSC certificate, needed only if you carry private-pay riders, typically takes two to six months.

### Does West Virginia require EVV for NEMT?

No. West Virginia uses electronic visit verification for in-home personal care, such as the Aged and Disabled, Traumatic Brain Injury, and Intellectual and Developmental Disabilities waivers and state plan personal care, and for home health services. NEMT is checked instead through signed trip logs and the broker's checks before and after each trip.

## Official resources

- [West Virginia BMS: Provider Manual Chapter 524, Transportation](https://bms.wv.gov/media/24376/download?inline=)
- [West Virginia BMS: NEMT information for providers](https://bms.wv.gov/non-emergency-non-ambulance-transportation-nemt-information-providers)
- [Modivcare: Become a Transportation Provider](https://www.modivcare.com/transportation-providers-contact-us/)
- [Modivcare: West Virginia facility resources](https://www.modivcare.com/facilities/wv/)
- [West Virginia Purchasing Division: State contract with Modivcare (2026)](https://www.state.wv.us/admin/purchase/Awards/Documents/2026/Q1/A_0511_CMA_BMS2600000003.pdf)
- [West Virginia One Stop Business Portal](https://business4.wv.gov/)
- [West Virginia Tax Division: Business registration questions and answers](https://tax.wv.gov/Business/BusinessRegistration/Pages/BusinessRegistrationQuestionsAndAnswers.aspx)
- [West Virginia PSC: Passenger service applications and the NEMT exemption](https://www.psc.state.wv.us/scripts/pages/passenger-service-application-instructions.cfm)
- [West Virginia DMV: Vehicle inspection](https://dmv.wv.gov/vehicle-inspection)
- [IRS: Get an employer identification number](https://www.irs.gov/businesses/small-businesses-self-employed/get-an-employer-identification-number)