How to Start a NEMT Business in Wyoming (2027)

Wyoming runs Medicaid rides without a broker. Wyoming Medicaid approves each ride and pays enrolled taxi and non-taxi ride companies from its own fee schedule, so you sign your agreement with the state. The rules below follow the CMS-1500 Provider Manual, version 19.0, dated July 1, 2026, and the member Travel Assistance Guide effective the same day.

How Medicaid rides work in Wyoming

The Wyoming Department of Health runs Medicaid through its Division of Healthcare Financing. Chapter 36 of its rules, Administrative Transportation, in effect since June 14, 2017, has the department pick and approve how each member travels. It must choose the least expensive way that fits and is reasonably available: public transit, a private car, taxi, bus, shuttle, or airline.

Every trip needs prior authorization. The rule calls for approval at least three working days before the trip, and a claim without it is denied. There are no NEMT regions, and nobody sits between you and the state.

The program also pays members directly. Wyoming calls it travel assistance, and says it is not meant to cover the full cost of a trip. Here is how each way of traveling is paid, under the guide effective July 1, 2026:

Way to travel	Where it goes	How it is paid
Taxi	Same town or county	Enrolled taxi company bills Medicaid
Shuttle (non-taxi ride)	Varies by company	Enrolled ride company bills Medicaid
Member’s own car	Out of town or out of state	Member gets 26 cents a mile
Bus or airline	Out of town or out of state	The state buys the tickets
Public transit	Same town or county	The state may buy a punch card

Airline tickets, outside emergencies, and lodging help are only for children, with one parent or guardian. Lodging needs a trip of more than 200 round-trip miles, down from 400 before July 1, 2026, or 150 miles with appointments on consecutive days.

Who qualifies

The member’s benefit plan must include travel assistance. The plans that do are full adult and child coverage, the CHIP expansion child plans, pregnant women, Title 25, and four waivers: Community Choices, Children’s Mental Health, Comprehensive (adult and child), and Supports (adult and child). The appointment must be medically necessary, for a covered medical or dental service, with a provider enrolled in Wyoming Medicaid.

Travel assistance does not pay for:

• Trips to pick up prescriptions.
• Rides for nursing facility residents to services the facility offers.
• Transport for a detention ordered by a court or law enforcement.
• Trips to waiver services, whose fees already include transportation.
• Requests made more than 30 days after the appointment, unless eligibility was granted retroactively.

Trips out of state

The rules define a Wyoming Medical Service Area that includes 15 towns outside the state: Craig, Colorado; Idaho Falls, Montpelier, and Pocatello, Idaho; Billings and Bozeman, Montana; Kimball and Scottsbluff, Nebraska; Belle Fourche, Custer, Deadwood, Rapid City, and Spearfish, South Dakota; and Ogden and Salt Lake City, Utah. A trip to one of them is covered when the service is not available near home and that town is closer by highway than the nearest place in Wyoming that offers it. Trips beyond the area need a written referral from a doctor, dentist, psychiatrist, osteopath, or optometrist.

For how distance changes what a trip earns, see rural NEMT.

How to enroll with Wyoming Medicaid

With no broker, enrollment is the whole process of getting in. Wyoming Medicaid enrolls three kinds of NEMT providers, each with its own taxonomy code:

Provider type	Taxonomy	What Medicaid asks for
Taxi	344600000X	A city taxi license and proof of insurance
Non-taxi ride	347C00000X	Proof of insurance and proof you are a transport business
Lodging	177F00000X	Proof it is a medical lodging facility

For a non-taxi ride company, the proof can be a license, a contract, a certification, or a state or local approval, so include your WYDOT letter of authority. A fourth type, NEMT van (343900000X), is only for vans owned by a hospital or federally qualified health center under the same tax number.

1. Get your NPI. Apply through the federal NPPES system under the taxi or non-taxi ride taxonomy. See how to get an NPI number.
2. Gather your documents. Have your insurance proof, any license, your EIN, a W-9, and banking information (a voided check or a bank letter) ready.
3. Apply online. Register on the provider enrollment portal run by HHS Technology Group, called Discover Your Provider, and submit the application. Its line is 877-399-0121, 8 a.m. to 5 p.m. Mountain time.
4. Pass screening and sign. Wyoming screens every applicant, then you sign a provider agreement. Chapter 3 of the rules gives the department 30 calendar days to decide once it has your complete application.
5. Set up the Provider Portal. You pull each ride’s prior authorization number from it and see your remittance advice there.

To qualify at all, Chapter 3 says you must meet any license or certification standard that applies, hold an NPI, and not be excluded by the HHS Office of Inspector General. You must also follow OIG guidance on hiring, so check every employee against the OIG exclusion list. The manual’s application fee applies to a list of institutional providers, such as nursing facilities, home health agencies, and mental health centers. Taxi and ride companies are not on that list.

Keeping your enrollment

Your enrollment lasts five years, then you re-enroll, repeat the screening, and sign a new agreement. A provider that submits no claim for 15 months may be terminated for inactivity. The provider agreement cannot be assigned without the department’s written consent, and a change of ownership requires a new enrollment. The agreement asks for notice 60 days before the change. Wyoming Medicaid Provider Services is at 888-996-6223.

Licenses and registrations

Your company

Form an LLC or corporation with the Wyoming Secretary of State, online through WyoBiz. Articles of Organization for an LLC cost $100 under the fee schedule effective July 1, 2026. A company filed online is active right away, and mailed filings take up to 15 business days. You need a registered agent with a physical address in Wyoming.

Every year, your annual report is due on the first day of the month you formed. The license tax is $60, or two-tenths of a mill on each dollar of assets in Wyoming if that is more. A company that has not filed within 60 days of the due date is administratively dissolved, and reinstating an LLC for tax costs $100.

Get your EIN from the IRS, which never charges for one. The Secretary of State says other licenses depend on your line of business and sends owners to the city clerk where they operate. Taxi companies need a city taxi license to enroll with Medicaid. For the layers of licensing across states, see NEMT license requirements.

Wyoming Department of Transportation

Wyoming law calls anyone who carries people on Wyoming highways for pay a contract motor carrier. WYDOT’s Regulatory Section issues the intrastate operating authority a contract carrier needs, and its manual lists taxis and buses as examples. Only ambulances, government-owned vehicles, and a few other exemptions are left out.

If you	You need
Carry riders for pay on trips that start and end in Wyoming	WYDOT intrastate operating authority, form MC-100
Carry riders for pay across a state line	Federal rules, which depend on vehicle size
Drive a vehicle built for 16 or more, driver included	A CDL with a passenger endorsement
Run a taxi	A city taxi license where your city issues one

To get operating authority:

1. Fill out form MC-100. Check contract carrier and passengers, and list how many passengers each vehicle carries, driver included.
2. Have your insurer file Form E. The filing must come from an insurance broker, underwriter, or company representative, show at least $750,000 combined single limit, and be emailed to mvs@wyo.gov. WYDOT does not accept ACORD certificates, binders, or ID cards.
3. Pay the $50 filing fee. Email or mail the application, and pay by check, or by card for $2.50 more. The Regulatory Section is at 5300 Bishop Blvd., Cheyenne, 307-777-4850.
4. Wait for the letter of authority. WYDOT holds an incomplete application for 30 days before returning it.

The authority stays valid until it is cancelled, suspended, or revoked. Carry a copy in each vehicle, and show it to a WYDOT investigator or trooper who asks. The 2026 form says a vehicle carrying more than 9 passengers, driver included, needs a USDOT number, and a Wyoming intrastate number carries a “WY” suffix. For interstate trips, see DOT numbers for NEMT.

Vehicle rules

Wyoming Medicaid sets no vehicle standard and runs no vehicle inspection for NEMT. The state rules that apply come from WYDOT and depend on the size of the van.

Wyoming’s motor carrier law defines a commercial vehicle as one used to carry people for pay, and for trips inside the state it names any vehicle carrying 8 or more people, driver included, for pay, or rated at 26,001 pounds or more. WYDOT applies the federal motor carrier safety rules, 49 CFR Parts 390 to 399, to intrastate motor carriers, with its own changes. A van that counts as commercial needs a federal periodic inspection at least once every 12 months, with proof carried on the vehicle. WYDOT and the Highway Patrol can stop commercial vehicles for inspection at ports of entry and on the road.

Keep these in or on each vehicle:

• A copy of your WYDOT letter of authority.
• Proof of insurance.
• Your company name or trade name, legible from 50 feet in daylight. The law requires it on every commercial vehicle.
• The yearly inspection record, on vans that count as commercial.

Use our vehicle inspection checklist for daily checks even where no rule requires one.

Wheelchair and stretcher rides

Standard Wyoming Medicaid pays no separate wheelchair van or stretcher van rate. The fee schedule dated September 25, 2026 does not allow A0130 (wheelchair van), S0209 (wheelchair van mileage), T2005 (stretcher van), or T2007 (wait time) for standard Medicaid. Rides for wheelchair users bill as taxi or non-taxi rides.

A non-emergency ambulance trip is covered only when any other way of traveling would endanger the member’s health or life and the member meets a condition on the manual’s list, such as constant oxygen or confinement to bed. Ambulances are licensed separately. For vehicle types in general, see NEMT vehicle requirements.

Driver rules and training

Wyoming Medicaid’s rules and its NEMT chapter set no driver standards. Your drivers still answer to three kinds of rules:

• Exclusion checks. Chapter 3 requires you to follow OIG rules on employing excluded people, so check each hire against the federal exclusion list.
• Licenses. Every driver needs a valid license for the vehicle, and a CDL for vehicles built for 16 or more people.
• WYDOT rules for commercial vans. A van that carries 8 or more people for pay puts its driver under the federal driver rules WYDOT adopts.

For drivers of those vans, the federal rules disqualify anyone who:

• Has lost their license, until it is restored.
• Was convicted of driving a commercial vehicle under the influence of alcohol or a controlled substance.
• Was convicted of having or using illegal drugs while on duty.
• Left the scene of an accident in a commercial vehicle.
• Committed a felony using a commercial vehicle.

A first offense usually disqualifies the driver for 1 year. The federal minimum age is 21, but WYDOT’s Appendix A lowers it to 18 for trips inside Wyoming. CDL drivers also fall under federal drug and alcohol testing.

Driving hours

Wyoming law puts intrastate, for-hire passenger vehicles with room for 7 to 15 people under the federal hours rules for passenger carriers. A driver may drive no more than 10 hours after 8 hours off duty, may not drive after 15 hours on duty, and may not drive after 60 hours on duty in 7 days, or 70 hours in 8 days if you run every day. Wyoming’s version of the short-haul rule exempts drivers who stay within 150 air miles of their normal work reporting location from keeping federal logs.

Records for each driver

For drivers of commercial vans, keep a driver qualification file: the application, a driving record from each state that licensed the driver in the last three years, a road test certificate, the yearly driving record review, and the medical examiner’s certificate. Our driver file checklist keeps them in one place.

Trip rules and how you get paid

Getting the ride approved

• Taxi rides. The member calls the Customer Service Center at 855-294-2127 and chooses the travel request option.
• Non-taxi rides. Since July 1, 2026, the provider manual lets either the member or your company start the request, through the Customer Service Center or with a travel request form. If the member asked, the member calls you once the ride is approved. The member guide and the center’s phone listing still say only the member, parent, or guardian can request travel, so ask Provider Services how your company should send one.
• The number. An approved ride gets a prior authorization number. Pull it from the Provider Portal and put it on the claim.

What Wyoming Medicaid pays

Wyoming pays the lower of your billed charge and its fee schedule. The taxi rates and the non-taxi base rate took effect January 1, 2021, the non-taxi mileage rate on July 1, 2021, and all were still current on the fee schedule dated September 25, 2026:

Code	What it pays for	Rate
A0100	Taxi, each one-way trip	$5.02
S0215	Taxi mileage, each mile	$0.83
A0110	Non-taxi ride, each one-way trip, first 15 miles included	$9.75
A0080	Non-taxi mileage, each mile after 15	$0.25
A0180	Lodging, each night, members 20 and under	$29.25

Mileage always rounds up. A 23.2-mile non-taxi ride bills A0110 once plus 9 units of A0080, for $12.00. A 5.2-mile taxi ride bills A0100 plus 6 units of S0215, for $10.00. A 120-mile non-taxi ride to a specialist pays $36.00 one way.

You accept that payment in full and cannot bill the member for a covered ride. See how to bill Medicaid for NEMT for the claim itself.

Rules that limit pay

• Loaded miles only. Miles without the member on board are never billed, so plan around deadhead miles.
• No wait time. Waiting is not a covered service.
• No-shows. No-shows and late members are not paid. Report them to Provider Services.
• One date per line. Bill each date of service on its own line. Span billing is not allowed.

Records, deadlines, and appeals

Every ride is subject to review after payment, and Medicaid audits taxi and shuttle claims against the member’s attendance at the appointment. For each ride, keep the prior authorization and its number, the member’s information, the pickup date and time, the pickup and destination addresses, total mileage, and total charge. Record them on a trip log, and keep records at least six years after the end of the state fiscal year you were paid in.

Submit a clean claim within 12 months (365 days) of the date of service. See timely filing limits. Claims process weekly, and remittance advice is posted to the Provider Portal. Payment is by electronic funds transfer, and new providers get paper checks only in temporary, extenuating circumstances.

To appeal a claim denied in error, send the First Level Appeal and Grievance Request Form to Provider Services, or use the grievance and appeal process on the Provider Portal. If the department moves to recover a payment, Chapter 36 lets you ask it to reconsider.

NEMT is not on Wyoming’s electronic visit verification list. The state’s EVV system, run through CareBridge since February 15, 2022, covers in-home personal care and home health services, such as companion, personal support, and respite services on the Community Choices Waiver. See EVV for NEMT.

Insurance requirements

Wyoming Medicaid asks for proof of insurance at enrollment but sets no amounts. The amounts come from WYDOT, state law, and federal rules:

Coverage	Minimum
WYDOT Form E, contract carriers	$750,000 combined single limit
Any vehicle, bodily injury, one person	$25,000
Any vehicle, bodily injury, one accident	$50,000
Any vehicle, property damage	$20,000
Interstate for-hire, 15 seats or fewer	$1,500,000

The WYDOT filing stays in force until the insurer cancels it on at least 30 days’ written notice. A cancellation suspends your authority on its effective date, and you cannot run trips until new coverage is filed and approved. File in your company’s full, correct legal name.

The federal $1.5 million minimum applies to for-hire passenger carriers on interstate trips. A taxi seating fewer than 7 passengers that does not run a regular route is exempt. For what to ask your agent, see NEMT insurance requirements.

Workers’ compensation

Wyoming runs workers’ compensation through a state fund at the Department of Workforce Services. The law lists NAICS subsector 485, which DWS rates as transit and ground passenger transportation, among the extra-hazardous employments, and DWS says coverage is required before work begins for businesses in those industries. Register at WYUI.wyo.gov, and DWS assigns your class and rate.

DWS set the 2026 base rate for class 485000, transit and ground passenger transportation, at 7.13, down from 8.02 in 2025. That is the highest of the 127 classes on its 2026 list. DWS has proposed 6.55 for 2027. Your own rate moves with your claims history and the discount programs you join.

What it costs and how long it takes

These are the fees Wyoming sets as of September 2026. Vans, insurance premiums, 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 Articles of Organization	$100	Secretary of State
Annual report license tax	$60 or more	Secretary of State
Operating authority	$50	WYDOT

A workable order, from first call to first ride:

1. Call Wyoming Medicaid Provider Services at 888-996-6223 to confirm which taxonomy fits your service.
2. Form your company online, where it is active the same day, and get your EIN.
3. Check local licenses with your city clerk, including a taxi license if you run taxis.
4. Buy insurance and have your insurer file Form E with WYDOT.
5. Register for workers’ compensation with DWS before your first employee starts.
6. Apply for operating authority on form MC-100.
7. Get your NPI under the right taxonomy.
8. Enroll with Wyoming Medicaid on the HHS Technology Group portal. The department has 30 days to decide once your application is complete.
9. Set up the Provider Portal, then take requests and bill with each ride’s prior authorization number.

Medicaid screening and the WYDOT insurance filing set the pace. For the same steps in any state, see how to start a NEMT business.

Work beyond Medicaid

Wyoming’s Medicaid ride rates have stayed the same since 2021, so other work matters.

• Waiver transportation. The Community Choices Waiver, for adults 65 and older and adults 19 to 64 with a disability, pays Non-Medical Transportation at $7.59 per 15 minutes, up to 18 units a month, from July 1, 2026. Contract motor carriers with WYDOT intrastate authority may provide it. The Comprehensive and Supports (DD) waivers pay agency providers $14.77 per 5-mile trip and $18.25 per 10-mile trip, up to $2,000 a year, from July 22, 2026. Both need certification through the state’s HCBS Section, with training and background screening, apart from your Medicaid enrollment. See how to become a waiver transportation provider.
• Public transit. WYDOT runs the transit programs through its Office of Local Government Coordination, and all 23 counties have at least one public transportation provider, many of them senior centers.
• Veterans. The VA pays for special mode transportation, such as a specially equipped vehicle, when the veteran’s local VA health facility approves it in advance. Ask the beneficiary travel office at the VA facility the veteran uses, such as VA Cheyenne or VA Sheridan health care. See VA transportation contracts.
• Facilities and private pay. Dialysis centers, hospitals, and senior living communities, along with riders who pay for themselves, add trips that do not wait on a travel request. See how to get NEMT facility contracts.