NEMT Fleet Size Calculator (2027): How Many Vans and Drivers You Need

What the fleet size calculator does

The calculator turns a day of trips into the fleet it takes to run them. You enter how many trips you carry, how many need a wheelchair van, how many one vehicle can run in a day, and the hours and days you work. It returns the vehicles you need, split into wheelchair vans, ambulatory vehicles, and spares, and the drivers it takes to keep them moving all week.

Two rules shape the answer. A wheelchair trip needs a wheelchair van, but any other trip fits in any vehicle, so wheelchair vans can fill their open seats with riders who walk. And one driver drives one vehicle at a time for one shift a day, so long service days and six-day weeks take more drivers than vehicles.

Brokers plan around the same numbers. The NEMT provider manual CareOregon uses in Oregon (version 1.3, February 2024) says trips are assigned by your stated service area, hours, vehicle types, and level of service. It requires enough driver, vehicle, and dispatch resources for the volume you are assigned, and asks you to tell the brokerage right away when you cannot cover it. Use the calculator before you tell a broker what you can handle, before you bid on a facility contract, and before you buy or hire.

How to use the calculator

1. Enter the trips on your busiest day. Count each one-way ride as one trip.
2. Enter the share of those trips where the rider stays in a wheelchair.
3. Enter how many trips one vehicle runs in a day, from your trip logs.
4. Enter the hours from the first pickup to the last drop-off, and the length of one driver’s shift.
5. Enter the days a week you run trips and the days a week one driver works.
6. Enter the share of spare vehicles you want for repairs.

The results change as you type. Reset to example puts the example numbers back, and Show the formula lists every step of the math.

What each number means

Box	What to enter	Where to find it
Trips a day	One-way trips on your busiest day	Your schedule, standing orders, or the contract you are bidding on
Wheelchair trips	Share of trips where the rider stays in a wheelchair	Trip logs or the broker’s trip offers, by level of service
Trips one vehicle runs a day	Average trips per vehicle on the road	A normal day’s trips ÷ vehicles that ran that day
Hours the vehicles run a day	First pickup to last drop-off	Your schedule or the hours you give each broker
Hours one driver works a day	Length of a full shift	Your driver schedule
Days a week you run trips	Include Saturdays and Sundays if you run them	Your schedule
Days a week one driver works	A full-time driver’s week	Your driver schedule
Spare vehicles	Extra vehicles as a share of those on the road	Your repair history: days out of service each year

Trips a day

Plan for the busiest day of the week, not the average. Dialysis riders set much of the weekly pattern for the companies that carry them. NIDDK says in-center hemodialysis patients usually get a fixed slot three times a week, on Monday, Wednesday, and Friday or on Tuesday, Thursday, and Saturday, and each session lasts about 4 hours. Two riders with opposite schedules fill six days of your week. The guide to dialysis transportation covers how those runs work.

Recurring trips make the base of the day. In Wisconsin’s statewide NEMT program in May 2026, 203,022 of 301,246 completed trip legs, about two thirds, were standing orders for recurring appointments. Another 36,143, about 12%, were booked with less than 24 hours’ notice. Of the 406,006 trip legs scheduled that month, 104,602 were cancelled. Size the fleet for the trips that actually run, and keep some room for same-day requests.

Wheelchair trips

Enter the share of trips where the rider needs a ramp or lift and stays seated in the wheelchair. Statewide, that share can be small. In Wisconsin in May 2026, wheelchair vehicles completed 6,832 trip legs and stretcher vehicles 496, against 168,467 in sedans, vans, and taxis. Your own share depends on the riders and facilities you serve, so take it from your trip logs or the contract.

A wheelchair van can cover an ambulatory trip, but the pay follows the rider. Indiana’s Medicaid module (version 6.1, August 19, 2025) says a trip for an ambulatory member in a wheelchair-equipped vehicle is billed at the ambulatory level and rate, not by vehicle type. Arizona covers a wheelchair van trip only when the member needs to travel by wheelchair and is physically unable to use other modes (manual revised July 31, 2026). At Arizona’s fee-for-service rates effective October 1, 2026, a 10-mile trip that starts in the Phoenix or Tucson metro area pays:

Trip	Base rate	10 loaded miles	Pay
Ambulatory rider (A0120 plus S0215)	$6.64	10 × $1.28	$19.44
Wheelchair rider (A0130 plus S0209)	$11.15	10 × $1.54	$26.55

So a wheelchair van that spends the day on ambulatory trips earns ambulatory pay while costing wheelchair van money. Fill wheelchair vans with wheelchair trips first. The guide to choosing a wheelchair van for NEMT covers ramps, lifts, and seating layouts.

Trips one vehicle runs a day

This number moves the answer a lot. Take it from a normal day: trips completed ÷ vehicles that ran. Long trips, wheelchair loading and securement, waits at the clinic, and empty drives between trips all lower it. If your wheelchair vans run fewer trips a day than your sedans, use the wheelchair van number, or run the calculator twice, once for each kind of trip. The trips per day calculator works it out from shift length and trip time.

Hours, shifts, and driver weeks

Service hours run from the first pickup of the day to the last drop-off. Waiting counts as work. Under 29 CFR 785.15, an employee who is engaged to wait is working, so a driver who has to stay with the van at the clinic is on the clock. Under 29 CFR 785.16, time off counts only when the driver is completely relieved from duty, told in advance when work starts again, and the break is long enough to use for their own purposes. A split shift that meets that test can cover a morning and an afternoon peak without paying the middle.

The days box matters because of overtime. Under 29 CFR 778.101, 40 hours is the most a covered employee can work in a workweek without overtime pay. Five 8-hour shifts is exactly 40 hours, so a sixth shift in the same week is all overtime. The calculator adds drivers instead. The guide to NEMT driver pay covers overtime in more detail.

Some rules cap the day itself:

Rule	Who it covers	Limit
49 CFR 395.5	Passenger-carrying commercial motor vehicles in interstate commerce: rated 10,001 pounds or more, or designed or used to carry more than 8 people including the driver for pay (49 CFR 390.5)	No more than 10 hours of driving after 8 hours off, no driving after 15 hours on duty, and no driving after 60 hours on duty in 7 days (70 in 8 days for a carrier that runs every day)
Portland City Code 16.40.780	NEMT drivers permitted in Portland, Oregon	No for-hire rides after more than 12 hours of driving in any 24-hour period

Most minivans and small wheelchair vans on in-state trips fall outside the federal limits. Check your state and city rules before you plan long shifts.

Spare vehicles

A spare covers a van in the shop, a failed lift, or a driver who needs a different vehicle. Make at least one spare a wheelchair van, because it can cover both wheelchair and ambulatory trips. Spares have to meet the same rules as the rest of the fleet. Virginia Medicaid’s fee-for-service NEMT requirements (updated May 26, 2026) require the provider network to have adequate backup vehicles to recover trips, and backup drivers and vehicles must meet every driver and vehicle requirement. Every vehicle is inspected before it carries a member and again twice a year, so in Virginia a spare that has not passed the broker’s inspection cannot take a trip.

Without a spare, a breakdown means handing trips back. CareOregon’s manual lists a vehicle out for maintenance and a driver out sick as acceptable reasons to reassign a trip. It also says a pattern of handing back trips, or of handing them back at the last minute, can lead to a corrective action plan and fewer rides offered.

A worked example

The calculator opens with example numbers. They show how the math works. They are not industry figures, so replace them with your own.

Step	Math	Result
Wheelchair trips a day	60 trips × 40%	24 trips
Wheelchair vans on the road	24 ÷ 10 trips a vehicle = 2.4, rounded up	3 vans
Vehicles on the road	60 ÷ 10	6 vehicles
Ambulatory vehicles on the road	6 minus 3	3 vehicles
Spare vehicles	6 × 10% = 0.6, rounded up	1 vehicle
Vehicles you need	6 + 1	7 vehicles
Driver shifts a day	6 vehicles × 12 hours ÷ 8-hour shifts	9 shifts
Drivers you need	9 shifts × 6 days ÷ 5 days = 10.8, rounded up	11 drivers

The 3 wheelchair vans have room for 30 trips. The 24 wheelchair trips take most of it, and the other 6 go to riders who walk. The 3 ambulatory vehicles carry the remaining 30.

What moves the answer most

Each table keeps every other box at its example value and changes one number.

Trips one vehicle runs a day	Vehicles on the road	Vehicles you need	Drivers you need
8	8	9	15
10	6	7	11
12	5	6	9
15	4	5	8

Two more trips per vehicle each day saves a vehicle and two drivers in the example. Better routing is often cheaper than a new van. The guide to NEMT vehicle utilization covers how to raise it.

Hours the vehicles run a day	Driver shifts a day	Drivers you need, 6-day week	Drivers you need, 7-day week
8	6	8	9
10	7.5	9	11
12	9	11	13
14	10.5	13	15

Longer days and more days a week add drivers, not vehicles.

Wheelchair trips	Wheelchair vans on the road	Ambulatory vehicles on the road	Vehicles you need
0%	0	6	7
20%	2	4	7
40%	3	3	7
60%	4	2	7
100%	6	0	7

The mix changes which vehicles you buy, not how many, as long as every vehicle runs the same number of trips.

How to use the answer

• Check a new contract before you sign. Add its trips to your day. In the example, going from 60 to 80 trips a day takes 9 vehicles and 15 drivers instead of 7 and 11: one more wheelchair van, one more ambulatory vehicle, and four more drivers.
• Hire and credential ahead. New drivers cannot start the day you need them. In Virginia, every driver must be credentialed and complete the broker’s driver training, or an approved equivalent, before carrying a member. The guides to hiring NEMT drivers and broker credentialing cover the steps and the paperwork.
• Budget the vehicles. The guide to wheelchair van cost covers prices, and the vehicle loan calculator works out the payment.
• Tell each broker your real capacity. Update your hours, service area, and vehicle types when the fleet changes, so offers match what you can run.
• Check that each vehicle pays. A bigger fleet only helps if each vehicle earns more than it costs. The profit per vehicle calculator shows what one van makes, and the break-even calculator shows how many trips cover your costs.
• Grow in steps. The guide to growing a NEMT business covers when to add the next vehicle and the next contract.