How to Start a NEMT Business in Wisconsin (2027)

Wisconsin runs Medicaid rides through one statewide manager. MTM, Inc. holds the Department of Health Services (DHS) contract today, and DHS announced on May 21, 2026 that it intends to move the program to Verida, with no switch date set. To get this work, you need a registered company, WisDOT Passenger Carrier authority, the right insurance, and, for wheelchair and stretcher vans, a ForwardHealth enrollment. The rules below follow the ForwardHealth Online Handbook as published through August 31, 2026.

How Medicaid rides work in Wisconsin

DHS runs Wisconsin Medicaid and BadgerCare Plus under the ForwardHealth name. It contracts with one NEMT manager for the whole state, with no regions. The manager verifies eligibility, schedules rides, credentials transportation companies, pays them, runs gas mileage reimbursement, and handles complaints. DHS says one vendor gives members and providers one process and lets it hold that vendor to standards for driver screening, vehicle upkeep, and response times.

Veyo took over the contract on November 1, 2021. MTM bought Veyo in August 2022, and rides moved onto MTM’s own systems on February 1, 2024. In the second quarter of 2026, MTM handled 921,497 trips for 46,527 members, with 314 transportation providers, 486 independent driver providers, and 4,432 vehicles.

Members qualify when they have no other way to reach a covered appointment. That covers Wisconsin Medicaid (including IRIS), BadgerCare Plus (including Express Enrollment), Family Planning Only Services, and Tuberculosis-Related Medicaid. Members covered only by programs such as SeniorCare, the Wisconsin Well Woman Program, or QMB-Only get no NEMT.

Two groups ride outside the manager. Nursing home residents who have not elected hospice get rides arranged by the nursing home. Family Care, Family Care Partnership, and PACE members get rides through their managed care organization.

The manager must book the least costly ride that meets the member’s needs. A member who lives and has an appointment within half a mile of a bus stop usually gets a bus pass, unless a health condition, age, or a young child rules it out. A member who can drive but cannot afford gas gets 24 cents a mile as of September 2026. Everyone else gets a ride in one of three modes:

Mode	What it is	Medicaid enrollment
Common carrier	Any vehicle other than an ambulance or SMV, such as a sedan or a van without a permanent lift	Not required. Contract with the manager.
Specialized medical vehicle (SMV)	A vehicle with a permanently installed ramp or lift, including stretcher vans	Required, plus a manager contract
Non-emergency ambulance	For members who need life support or must travel lying down	Required, plus a manager contract

Members book routine rides at least two business days ahead. Urgent rides, including hospital discharges, are provided in three hours or less. Standing orders run three months at a time, or six months for dialysis.

How to join MTM, Wisconsin’s NEMT manager

Every NEMT claim for covered members goes to the manager, not to ForwardHealth. MTM says it is recruiting transportation providers throughout the state. Its onboarding runs in this order:

1. Provider application. Apply on MTM’s Join Our Network page. Where MTM has no immediate need, it keeps your information on file.
2. Interview. A network representative explains onboarding.
3. Contracting. You sign an agreement with MTM.
4. Credentialing. You submit every required company, driver, and vehicle document. MTM has its own standards for driver qualifications, driving records, and CPR, defensive driving, and passenger assistance training.
5. Training. MTM walks you through its trip process.
6. First trip. MTM sends trips through its MTM Link provider portal, or through an API to your own dispatch system.

Wisconsin’s vendor account management team and provider ombuds are both at providerswi@mtm-inc.net. MTM’s office is at 8383 Greenway Blvd, Suite 400, Middleton, WI 53562, open 9 a.m. to 5 p.m. Central. Our MTM guide covers the company in its other states.

ForwardHealth enrollment for wheelchair and stretcher vans

If you will run specialized medical vehicles, enroll with ForwardHealth on its provider enrollment portal before MTM can pay you for them. The criteria are in Wis. Admin. Code DHS 105.39, and no NPI is required. As of September 2026, the SMV provider type works like this:

• Screening. New SMV providers are screened at ForwardHealth’s high risk level. That means site visits before and after enrollment, and fingerprints from the provider and every person with a 5 percent or larger ownership share, taken within 30 calendar days of applying. Fingerprinting costs $7.75 a person through the state’s vendor.
• Fee. The federal application fee is $750 for 2026. Pay it within 10 business days of applying, or the application is denied. You do not pay it again if you are enrolled in Medicare or another state’s Medicaid program and paid it there.
• Documents. Upload a notarized Specialized Medical Vehicle Providers Affidavit (F-11237), a copy of your commercial auto policy or a certificate of insurance with a schedule of vehicles, the insurer’s letter confirming payment, a workers’ compensation certificate, and each driver’s CPR card from the American Heart Association or the American Red Cross.
• Timing. Finish the online application within 10 calendar days of starting it. ForwardHealth usually decides within 10 business days of a complete application, and no later than 60 days.
• Provisional status. New SMV providers and new owners get provisional enrollment until an audit.

The affidavit also has you attest to the federal rules from the Consolidated Appropriations Act, 2021: no one on the OIG exclusion list, a valid license for every driver, a process for handling state drug law violations, and a process for sharing each driver’s driving history with Medicaid.

Getting ready for Verida

On May 21, 2026, DHS announced its notice of intent to select Verida, Inc. under RFP S-1699 DMS-25. As of its August 25, 2026 update, DHS has no time frame for the transition. MTM’s contract continues until then, and DHS says providers do not need to do anything right now.

Elsewhere, Verida credentials providers in four steps: a Request for Qualifications with driver and vehicle lists, business documents with background checks and drug screens for owners and drivers, vehicle inspections and driver training, and an owner orientation. It adds providers only where a region needs them. Keep those files current now. See Wisconsin picks Verida, our Verida guide, and the broker transition checklist.

To hear the date, join the DHS Non-Emergency Medical Transportation Manager email list. The public Transportation Advisory Council meets the first Thursday of March, June, September, and December, next by Zoom on December 3, 2026, from 10:30 a.m. to 12:30 p.m.

Licenses and registrations

Your company

Form an LLC or corporation with the Wisconsin Department of Financial Institutions (DFI). As of September 2026, LLC articles of organization cost $130 online or $170 on paper, and business corporation articles cost $100. Next-day processing costs $100 more. You need a registered agent in Wisconsin to receive official mail.

Each year after the year you form, file an annual report during the calendar quarter of your formation date. An LLC formed in May, for example, files by June 30. The report costs $25 online or $40 on paper for an LLC or business corporation. A company that stops filing can be dissolved.

Get your employer identification number (EIN) from the IRS, which never charges for one, and ask your city or county clerk whether a local license applies. See LLC or corporation for NEMT.

Wisconsin Department of Transportation

WisDOT’s Motor Carrier Services unit licenses for-hire passenger carriers under Wis. Stat. chapter 194. WisDOT says intrastate Passenger Carrier (PC) authority is required for any for-hire passenger operation within Wisconsin unless it is a taxi service, a car pool or van pool of 7 or fewer people including the driver, or a school bus.

If you	You need
Carry passengers for pay within Wisconsin	PC authority on form MV2843, $50
Run a vehicle over 10,000 pounds, or one designed or used for more than 8 people including the driver, for pay	A USDOT number from FMCSA, which is free
Carry passengers across state lines	Federal operating authority from FMCSA
Drive a vehicle designed for 16 or more people, driver included	A commercial driver license with a P endorsement

Before you mail the MV2843, your insurance company must file your for-hire liability coverage with WisDOT electronically, on a Form E or a scheduled filing. The legal name on your USDOT number, your DFI filing, and the insurance filing must match. Mail the form with a check payable to Registration Fee Trust to the Wisconsin Motor Carrier Unit, PO Box 7955, Madison, WI 53707. Questions go to irp-ifta@dot.wi.gov or 608-266-9900. See USDOT numbers for NEMT for the federal side.

Specialized medical vehicles add one layer: DHS 105.39 makes SMV providers meet the WisDOT human service vehicle rules in Wis. Stat. 110.05 and chapter Trans 301, including a yearly State Patrol inspection. For how the layers stack up in every state, see NEMT license requirements.

Vehicle rules

The State Patrol inspects human service vehicles at least once a year. Under Trans 301.96, a vehicle that must be inspected under DHS 105.39 may not drive on public roads without an unexpired WisDOT inspection decal near the lower right corner of the windshield. ForwardHealth also says human service vehicles used as common carriers must keep a current State Patrol inspection. Ask your State Patrol region’s human service vehicle coordinator for an appointment early, since the patrol inspects when its other duties allow.

Between those inspections, DHS 105.39 requires a driver or mechanic to inspect each SMV at least every 7 days, in writing. The check covers lights, brakes, steering, suspension, heat, defrost, air conditioning, doors, lifts, ramps, wheelchair locks, restraints, and tires with at least 1/8 inch of tread. Fix every problem before a member rides, and keep the records for 12 months. Form F-01302 lists every item, and our vehicle inspection checklist helps with the daily check.

Every SMV needs:

• A lift or ramp for loading wheelchairs, permanently installed. ForwardHealth does not accept a portable ramp.
• A restraint for every passenger. The rider and the wheelchair, cot, or stretcher are both secured.
• Secure storage for removable equipment and riders’ belongings.
• A working flashlight, a first aid kit of at least 10 units, and a fire extinguisher rated at least 10 BC, mounted in a bracket in the driver’s area. CO2 extinguishers are not allowed.
• A two-way communication system linking the driver to your base.
• Police, sheriff, and ambulance numbers posted on the dash, and no smoking.

Keep a list of each vehicle’s plate, VIN, make, model, year, capacity, insurer, and restraints, with its State Patrol inspection attached. Only vehicles on your ForwardHealth file and your policy may carry members. A new vehicle can start once it is insured and inspected, but ForwardHealth must get its papers within 14 calendar days of its first trip.

Trans 301 adds equipment rules for wheelchair vehicles. A power lift must hold at least 700 pounds, lock when stowed, and be interlocked so the vehicle cannot move while the lift is out. A webbing tiedown attaches to the vehicle at two or more points, and no tiedown attaches to a door. Vans with a raised roof or raised doors placed in service after May 1, 1997 must meet the federal rollover standard, 49 CFR 571.220. Vans placed in service after February 25, 1992 must meet the federal ADA vehicle standards, which call for at least 56 inches of clearance between the door top and the raised lift or ramp on vehicles 22 feet long or less.

A stretcher van needs a fastener that secures the cot to the side and the floor, never to a door. Its riders must be medically stable, and your staff may not give medical care in transit. See stretcher van and wheelchair securement for the basics.

ForwardHealth’s SMV handbook adds a fleet rule. A provider that runs only one or two vehicles must have a ramp or lift on each. Once you run at least two ramp or lift vehicles, you may add inspected human service vehicles without one for SMV riders who do not use a wheelchair.

Driver rules and training

Wisconsin’s rules for SMV drivers come from DHS 105.39, the affidavit, Trans 301, and the ForwardHealth handbook:

• A valid regular or commercial license with no restrictions. A vision restriction can be waived if glasses or contacts correct the driver to 20/30, and the driver wears them on every trip.
• No exclusion from any federal health care program.
• No driving under the influence of alcohol or drugs, and no smoking or audio headsets in the vehicle, under Trans 301.05.
• A current entry on your driver list with the license number, expiration date, and type, any restrictions or violations, and the date of each required training.

DHS says NEMT drivers must get background checks, regular drug tests, and training, with special training for drivers who carry children. MTM sets its own standards for driving records and training during credentialing.

Before an SMV driver drives or serves as an attendant, the driver needs first aid and CPR training, instruction in caring for a passenger having a seizure, and instruction on every ramp, lift, and restraint you use. First aid refresher training is due at least every 3 years, and CPR must be renewed at least every 2 years through the American Red Cross or the American Heart Association. ForwardHealth wants a copy of each new CPR card whenever a driver renews.

A tighter rule applies to human service vehicles in grant-funded programs, such as county elderly and disabled transportation. Under Wis. Stat. 346.923, their drivers need a school bus endorsement or must meet its background standards, and must have been trained on the vehicle’s restraints within the last 2 years. Those standards bar drivers convicted of offenses such as drunk driving, reckless driving, or leaving an accident scene in at least the last 2 years, and of violent felonies, sexual assault, or abuse of a child or vulnerable adult in at least the last 5 years.

On the job, DHS’s rules for drivers and attendants say to:

• Wear an easy-to-read company ID badge, and drive a vehicle marked with the company name.
• Use a phone only in hands-free mode.
• Touch a rider only to help them in or out, fasten a seat belt, or give first aid.
• Open the door, help the rider between the vehicle and the door, and stow a wheelchair when the rider asks.

Keep a file for each driver with the license, driving record, background check, drug tests, and training dates. Our driver file checklist tracks them, and NEMT driver training covers what to teach.

Trip rules and how you get paid

The ForwardHealth handbook sets the day of the ride:

• The day before. Call each member to confirm the ride and the pickup time.
• Pickup. The member is ready 15 minutes early. A member more than 10 minutes late for the pickup time may miss the ride. Members who have waited 15 minutes past the pickup time call MTM. Drivers generally do not come to the door unless the rider asks for help.
• Return rides. If a scheduled ride home is more than 15 minutes late, the member or clinic calls MTM. A member who books the ride home after the appointment calls again if it has not come within one hour.
• Signatures. The member signs your driver log on the way to the appointment and again when leaving.
• Extra stops. Only stops MTM approves in advance, such as a pharmacy on the way home.
• Children. Parents bring car seats: a car seat until age 4 and 40 pounds, then a booster until 8 years, 80 pounds, or 4 feet 9 inches. Minors ride alone only in the cases the handbook allows, some with a signed parental consent form.

MTM requires every trip to be tracked in the MTM Link driver app or provider portal as proof of completion or cancellation. Keep your own record of each ride on a trip log.

Wisconsin does not set rates for manager trips. MTM discusses and sets rates with each provider individually, and pays weekly by direct deposit. It does not pay for no-shows. When a member tells you they will not go, have them call MTM at 866-907-1493 to cancel. If they have not canceled by the pickup time, cancel the trip in the MTM Link provider portal yourself.

For SMV trips, ForwardHealth has you ask the member for a $1 copay each time a base rate is billed, unless the member is exempt. Members should not tip.

SMV providers keep service records for 5 years under DHS 105.39, and DHS may audit them. DHS holds the manager to 99.7 percent complaint-free rides, so complaints about your drivers matter. NEMT is not on Wisconsin’s electronic visit verification (EVV) list, which covers personal care, supportive home care, and home health care services.

Insurance requirements

MTM’s Wisconsin provider page says your insurance must match the class of vehicle you registered, and sets its own floor:

Item	What MTM asks for
General liability	$1,000,000 combined single limit
Auto liability	$1,000,000 combined single limit
Certificate	MTM listed as certificate holder and additional insured

State law sets these minimums as of September 2026:

Rule	Who	Minimum
Wis. Stat. 194.41	Intrastate passenger carrier, 15 or fewer passengers	$500,000
Wis. Stat. 194.41	Intrastate passenger carrier, 16 or more	$1,000,000
DHS 105.39	Each SMV	$250,000 per person, $500,000 per occurrence, $10,000 property
Wis. Stat. 344.55	Human service vehicle, 7 or fewer seats	$75,000 per person, $150,000 per accident, $10,000 property
Wis. Stat. 344.55	Human service vehicle, 8 to 15 seats	$75,000 per person, $200,000 per accident, $10,000 property

WisDOT’s insurance page lists $300,000 for for-hire passenger vehicles of 10,000 pounds or less, so ask Motor Carrier Services which figure fits your vehicle. MTM’s $1 million limit clears every figure for vehicles of 15 or fewer passengers.

ForwardHealth accepts a $500,000 combined single limit policy for an SMV in place of the split limits. It must be a commercial policy in the exact business name on your Medicaid file, list every VIN, and carry an endorsement that makes the insurer notify Wisconsin Medicaid before cancellation. When ForwardHealth gets a cancellation notice, your enrollment ends in 20 days unless coverage is restored, and trips during a lapse are not paid. See NEMT insurance requirements for coverage types.

Wisconsin requires workers’ compensation from the day you employ a third full-time or part-time worker. With fewer workers, you need it by the 10th day of the first month of the next calendar quarter once you pay $500 or more in gross wages in a quarter. ForwardHealth asks SMV providers for a workers’ compensation certificate at enrollment.

What it costs and how long it takes

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

Item	Cost	Paid to
EIN	Free	IRS
LLC articles	$130 online, $170 on paper	DFI
Corporation articles	$100	DFI
Annual report	$25 online, $40 on paper	DFI
Passenger Carrier authority	$50	WisDOT
USDOT number	Free	FMCSA
SMV enrollment fee (2026)	$750	ForwardHealth
Fingerprints, per person	$7.75	State fingerprint vendor

A workable order, from first call to first trip:

1. Email MTM’s vendor account management team. Ask where it needs providers and which ride types it is short on.
2. Form your company with DFI and get your EIN.
3. Get a USDOT number if a vehicle is over 10,000 pounds or seats more than 8 people including the driver.
4. Buy insurance that meets MTM’s limits, and have your insurer file it with WisDOT.
5. Apply for PC authority on form MV2843.
6. For wheelchair or stretcher vans, book the State Patrol inspection, then enroll with ForwardHealth. Pay the fee within 10 business days and finish fingerprints within 30 calendar days. A decision usually follows within 10 business days of a complete application.
7. Hire and train drivers: first aid, CPR, seizure care, and lift and restraint use, plus background checks and drug tests.
8. Apply to MTM, then interview, contract, credential, and train before your first trip.

MTM’s need for providers where you are and the State Patrol’s inspection schedule set the pace. For the same steps in any state, see how to start a NEMT business.

Work beyond Medicaid

Several sources of rides do not run through MTM.

• Family Care, Family Care Partnership, PACE, and IRIS. These long-term care programs buy transportation as a service. Enroll with ForwardHealth as a waiver transportation provider, either as a common carrier under chapter 194 or as a specialized transport provider, with no application fee. An SMV provider adds the transportation service to its existing enrollment. The managed care organization or IRIS consultant agency then authorizes your services, and DHS runs a criminal and caregiver background check for individuals and sole proprietors.
• County elderly and disabled transportation. WisDOT funds county programs under Wis. Stat. 85.21, and counties may contract with private for-profit and nonprofit providers. WisDOT treats vehicles that receive its transportation assistance grants as human service vehicles: they carry Human Service Vehicle plates ($85 a year plus a $12 plate fee as of September 2026), carry the Wis. Stat. 344.55 insurance, pass the yearly State Patrol inspection, and use drivers who meet Wis. Stat. 346.923. Ask your county’s aging or human services office who runs its program.
• Nursing homes. Nursing homes arrange rides for residents who are not in hospice. Outside the manager, an SMV trip needs a Certification of Need for Specialized Medical Vehicle Transportation (F-01197) signed by a physician, physician assistant, nurse practitioner, or nurse midwife.
• Veterans. VA travel pay covers special mode transportation, such as a specially equipped vehicle, when the veteran’s local VA health facility approves it in advance. See VA special mode transportation.
• Facilities and private pay. Hospitals, dialysis centers, and senior living communities, along with riders who pay for themselves, add work that does not depend on one manager. See how to get NEMT facility contracts and private-pay NEMT.