Free tool
NEMT Business Checklist by State (2027): Your Steps and Rules
Overview
Pick your state and this free tool builds a printable checklist for starting a NEMT business there. It covers how Medicaid rides work, the state registration or license, insurance, drivers, vehicle inspections, signing up for trips, how you get paid, and electronic visit verification. Each step shows your state's own rules from its state guide and links to the section that explains them.
- The checklist puts eight steps in order, from learning how Medicaid rides work in your state to checking its EVV rule.
- Each step shows the facts from your state guide, so the list changes with the state you pick.
- Federal law has every state make sure NEMT providers and drivers are not excluded from federal health programs and that each driver holds a valid license.
- The federal EVV rule covers personal care and home health visits, so check your state's own EVV step.
- Tick the steps on screen, or print the list and tick it by hand.
Only the checklist prints.
Business checklist
Georgia NEMT business checklist
- Medicaid agency
- Georgia Department of Community Health (DCH), which pays the broker a monthly rate for each eligible member
- How rides work
- One statewide broker covers all five NEMT regions: North, Atlanta, Central, East, and Southwest
- State registration
- Georgia Department of Public Safety: a GIMC registration for vehicles carrying 10 or fewer elderly or disabled riders, or a passenger permit for 11 or more passengers
- Insurance
- Verida wants insurers rated A- or better and auto cover for owned, hired, and non-owned vehicles. DPS minimums start at $100,000 per person and $300,000 per accident.
- Drivers
- At least 21, licensed in Georgia or a bordering state, no DUI conviction in the 5 years before hire, and no suspended or revoked license in the last 5 years
- Vehicle inspections
- Verida inspects each vehicle before it enters service and every six months after. Passenger permit holders also get a yearly DPS inspection.
- Medicaid broker
- Verida, for all five regions since April 1, 2026, when Modivcare left the Central, East, and Southwest regions
- How to join
- Send Verida its Request for Qualifications form with a driver list and a vehicle list. Verida adds providers where a region needs them.
- Pay
- Verida sets your rate in your service agreement. If the agreement sets no payment date, an undisputed invoice is due within 15 business days.
- EVV
- NEMT is not on the list. Georgia's EVV covers personal support, community living support, pediatric personal care, and home health services.
Every rule above comes from the state guide at nemtguide.com/states/georgia/
What the checklist does
Starting a NEMT company takes the same kinds of steps in every state, but the details change at the state line. One state has a single broker for all its Medicaid rides, and the next has each health plan pick its own. The agency that registers your vans, the insurance you need, and the rules for your drivers change too.
This checklist puts those steps in order for the state you pick. Each step shows what that state’s guide says in its at-a-glance facts, and links to the part of the guide with the full rules, the sources, and the dates they took effect.
How to use the checklist
- Pick your state from the list.
- Read each step, and open its link for the full rules.
- Tick a step when it is done. The ticks start over when you pick another state.
- Press Print or save as PDF. Only the checklist prints, with a box beside each step to tick by hand.
The page address keeps the state you picked, so you can bookmark it or send it to a partner.
What each step means
Every state guide answers the same questions in the same order, so each step reads its answer from the same place in every guide.
| Step | What it tells you | Where to read more |
|---|---|---|
| Learn how Medicaid rides work | The Medicaid agency, and who sends the trips: a broker, health plans, counties, or the state | How Medicaid rides work |
| Get your state registration or license | The agency that registers NEMT companies, and which vehicles need what | Licenses and registrations |
| Buy the insurance you need | The minimum limits the state or the broker asks for | Insurance requirements |
| Hire drivers who meet the rules | Minimum age, license, and the history that rules a driver out | Driver rules and training |
| Make sure your vehicles meet the rules | Who inspects your vehicles, if anyone, and the checks you run yourself | Vehicle rules |
| Sign up for Medicaid trips | The broker or program, and the first step to join it | The guide’s section on joining |
| Learn how you get paid | Who sets your rate, and any payment deadline | Trip rules and how you get paid |
| Check if electronic visit verification (EVV) applies | Whether NEMT falls under the state’s EVV program | The guide’s facts at a glance |
Why the steps come in this order
Federal rules require every state Medicaid plan to ensure necessary transportation for members to and from their providers (42 CFR 431.53), and every state Medicaid agency to screen the providers it enrolls (42 CFR 455.410). Section 209 of the Consolidated Appropriations Act, 2021 added minimum requirements for NEMT providers and drivers, now section 1902(a)(87) of the Social Security Act. CMS lists them as assurances that:
- no provider or driver is excluded from federal health care programs or listed on the HHS Inspector General’s exclusion list;
- each driver has a valid driver’s license;
- each provider has a process to address any violation of a state drug law;
- each provider has a process to tell the state Medicaid program each driver’s driving history, traffic violations included.
So line up your license, your insurance, your drivers, and your vehicles first. Then, when you sign up for Medicaid trips, you can show each one. You can search the exclusion list yourself before you hire a driver.
Electronic visit verification and NEMT
Section 12006(a) of the 21st Century Cures Act requires states to use electronic visit verification (EVV) for all Medicaid personal care services and home health services that need an in-home visit, CMS says. NEMT is not on that federal list. The last step shows what your state guide says about the state’s own EVV program, so you know whether your rides fall under it. The guide to EVV for NEMT explains the checks NEMT rides face instead, such as GPS data, trip logs, and signatures.
What the checklist leaves out
The steps here are the ones that change by state. The steps that are the same everywhere, such as forming your company and getting a free EIN, are in the NEMT startup checklist. To see what it costs to open and whether your trips will pay the bills, use the business plan builder. The guides to NEMT license requirements, NEMT insurance, and becoming a Medicaid transportation provider explain each step in more depth.
Frequently asked questions
What do I need to start a NEMT business?
In every state you need a company, insurance, drivers who meet the rules, vehicles that meet your state's rules (and your broker's, where one sends the trips), and a way into Medicaid trips through a broker, a health plan, a county program, or the state. The agency that registers you, the insurance limits, and the driver and vehicle rules depend on the state. Pick yours in the checklist to see them.
Where does the checklist get its rules?
From the state guides on this site. Each step shows the facts in that state guide's at-a-glance list and links to the section with the full rules and the official sources behind them. When you pick a different state, every step fills in from that state's guide.
Do I sign up with a broker or with Medicaid?
That depends on how your state runs its Medicaid rides. Where a broker or a health plan sends the trips, you apply to that broker. Where the state pays providers directly, you enroll with the state Medicaid program. The "Sign up for Medicaid trips" step shows what your state guide says to do first.
Does the checklist cover EVV?
Yes, in its last step, which shows what your state guide says about the state's own EVV program. The federal rule, section 12006(a) of the 21st Century Cures Act, requires electronic visit verification for Medicaid personal care services and home health services that need an in-home visit. NEMT is not on that list, so your state's own rule is the one to check.
Can I save my progress?
Your ticks last while the page is open, and they start over when you pick another state. To keep a record, print the list or save it as a PDF and tick it by hand. The page address keeps your state, so a bookmark opens the same list.