How to start a NEMT business in Georgia (2025 guide)

Last updated 2026-07-25

what is NEMT and how is it different from an ambulance ride

Non-emergency medical transportation (NEMT) is scheduled transport for people who need to get to a medical appointment, dialysis, or pharmacy but don't need an ambulance or emergency care during the ride. Think wheelchair vans, stretcher vans, and ambulatory sedans, not lights and sirens. Ambulance transport is a separate category, billed and regulated differently, usually for emergencies or medically necessary transfers where a patient needs monitoring or clinical care en route. Federal Medicaid rules actually separate the two: NEMT is covered as an administrative necessity so Medicaid enrollees can "obtain Medicaid-covered services," while ambulance transport falls under a different benefit category tied to medical necessity. ^[1] If you're planning to buy a wheelchair van and drive people to dialysis three times a week, you're in the NEMT lane. That's a different license path, different insurance minimums, and a different Medicaid enrollment track than ambulance work, which usually requires EMT-level certification and a state ambulance license. See our overview of non emergency medical transportation if you want the national picture before drilling into Georgia specifics.

does Medicaid cover ambulance rides, and does it cover NEMT too

Yes to both, but under different rules. Medicaid covers ambulance transport when it's medically necessary, meaning any other form of transport would endanger the patient's health, per federal Medicaid regulations at 42 CFR 440.170. ^[2] Medicaid also covers NEMT separately, and federal rule requires state Medicaid agencies to "ensure necessary transportation for beneficiaries to and from providers" under 42 CFR 431.53. ^[3] In Georgia, both benefits exist, but NEMT is managed through a broker system rather than direct provider billing to the state. Georgia's Department of Community Health (DCH), which runs Medicaid, has historically contracted this out (Modivcare has held or currently holds Georgia's statewide NEMT brokerage contract in recent years, so confirm the current contractor with DCH before you build your business plan around a specific broker name). Ambulance rides, by contrast, are typically billed directly through Medicaid's fee schedule or through the Care Management Organizations if the patient is enrolled in Georgia Families or Georgia Families 360. If you're only running a wheelchair van business, you won't touch ambulance billing at all. That's a separate business with separate state EMS licensing through Georgia's Department of Public Health, Office of EMS and Trauma.

does Medicare cover medical transportation too

Medicare covers emergency ambulance transport under Medicare Part B when it meets medical necessity standards, and it can cover non-emergency ambulance transport in limited cases, such as a written order from a doctor stating that ambulance transport is medically necessary. ^[4] Medicare generally does not cover routine, scheduled non-emergency medical transportation like wheelchair van rides to a doctor's appointment, unless it's through a Medicare Advantage plan that offers NEMT as a supplemental benefit. That distinction matters for your business plan. If you build your revenue model assuming Medicare will pay for wheelchair van trips the way Medicaid does, you'll be wrong. Some Medicare Advantage plans in Georgia do contract separately for supplemental transportation benefits, but that's plan-by-plan, not a guaranteed line of business. Confirm directly with any Medicare Advantage plan's provider relations team before assuming coverage. Most new Georgia NEMT operators build their business around Medicaid enrollment first, then add Medicare Advantage or private-pay contracts later once they have vehicles, drivers, and insurance in place.

how do you start a medical transportation business in Georgia, step by step

Starting a medical transportation business in Georgia follows a rough sequence: form your entity, get your vehicle and driver requirements squared away, secure insurance, register with Georgia Medicaid, then credential with the regional broker. Skipping steps out of order (like buying a van before confirming insurance minimums) wastes money. Here's the realistic order: 1. Form an LLC or corporation with the Georgia Secretary of State. Filing an LLC costs $100 online. 2. Get a federal EIN from the IRS, free, done online in minutes. 3. Decide on your vehicle type: wheelchair-accessible van, stretcher van, or ambulatory sedan. Each has different conversion costs and inspection requirements. 4. Confirm whether your vehicle configuration requires a Georgia Department of Public Safety motor carrier registration or falls under Georgia Public Service Commission rules for passenger transport, since requirements depend on vehicle size and whether you're crossing county lines commercially. 5. Get commercial auto insurance with the liability limits your target broker requires (often $1,000,000 combined single limit is standard in the industry, though the exact figure depends on your broker contract, confirm with your broker and state Medicaid agency). 6. Enroll as a Georgia Medicaid provider through the Georgia Medicaid Management Information System (GAMMIS) portal run by DCH. 7. Apply for broker network credentialing (Modivcare or whichever contractor currently holds Georgia's statewide NEMT brokerage) separately from Medicaid enrollment. These are two different applications. 8. Pass any required background checks, vehicle inspections, and driver qualification reviews. 9. Get your dispatch and billing systems ready before you take your first trip. This isn't a same-week process. Between entity formation, insurance underwriting, and broker credentialing review times, plan for weeks of lead time before your first paid trip.

how to start a NEMT business in Georgia with just one van

You can start with a single wheelchair van in Georgia. Owner-operators do it all the time. The paperwork burden is largely the same whether you have one van or ten, so a one-van operation just means lower vehicle costs, not less compliance. With one van, focus your energy on three things: getting the vehicle properly equipped and inspected, getting your own driver qualifications in order (a clean MVR, DOT physical if required by your insurer or broker, and any state-required background check), and getting through Medicaid enrollment and broker credentialing without gaps in your paperwork. A lot of new owner-operators underestimate the insurance cost for a single wheelchair van. Commercial auto policies for wheelchair-accessible vehicles typically run higher than a standard commercial vehicle policy because of the passenger assistance risk and vehicle modification value. Get quotes before you buy the van, not after, so you know your real monthly cost. One-van operators also tend to underestimate how long broker credentialing review takes. Build in a cushion. Don't sign a vehicle loan assuming you'll be moving Medicaid trips within two weeks of applying.

how to start a non-emergency medical transportation business (entity and licensing basics)

Beyond the Medicaid-specific steps, a Georgia NEMT business needs the same basic small-business infrastructure as any transportation company. You need a Georgia sales tax registration if you'll be selling any taxable goods or services (most Medicaid-billed NEMT services are not subject to sales tax, but confirm with the Georgia Department of Revenue for your specific service mix). You'll also want a local business license from the county or city where you're based, since Georgia doesn't issue a single statewide "NEMT license." Requirements vary by jurisdiction. Some counties require a separate for-hire vehicle permit or livery permit on top of your business license, especially in metro Atlanta. If you plan to operate across state lines (say, picking up a Georgia Medicaid patient for a trip to a specialist in Alabama or Tennessee), you may trigger federal Motor Carrier Safety Administration registration requirements, including a USDOT number, depending on vehicle weight and passenger capacity. Confirm with FMCSA's registration guidance if interstate trips are part of your plan. See our broader guide on medical transportation for the general licensing landscape across states, since some of what applies in Georgia mirrors requirements you'll see elsewhere.

how does Georgia Medicaid NEMT enrollment actually work

Georgia Medicaid enrollment for NEMT providers runs through DCH's Georgia Medicaid Management Information System (GAMMIS), the same portal used for other Medicaid provider types. You'll submit provider enrollment paperwork, tax ID verification, and ownership disclosure information as part of the standard Medicaid provider enrollment process required under federal rule at 42 CFR 455.104. ^[5] But enrollment with DCH as a Medicaid provider is not the same thing as getting trips. Georgia runs its NEMT benefit through a managed transportation broker model, meaning DCH contracts with a company to manage trip scheduling, driver credentialing, and payment for the actual rides. That broker (Modivcare has held Georgia's statewide contract in recent years) runs its own separate network credentialing process, with its own vehicle inspection standards, driver background check requirements, and insurance minimums. In plain terms: you need to be enrolled with DCH as a Medicaid provider AND accepted into the broker's network to actually get paid for trips. Missing either piece means no revenue, even if the other is done. Always confirm current broker assignment and credentialing requirements directly with DCH's transportation unit and the broker, since state contracts get rebid and requirements shift. ^[6]

what insurance and vehicle standards does Georgia require

Georgia doesn't publish one single statewide NEMT vehicle standard, so most of your specific requirements come from your broker contract and your commercial auto insurer, not from a state regulation. That said, a few baseline things apply across almost every Georgia NEMT operation. Your vehicle needs a valid Georgia vehicle registration and must pass any inspection your broker requires (wheelchair lift function, tie-down anchor points, interior cleanliness, ADA-compliant securement systems are common broker checklist items). Your commercial auto insurance needs to meet or exceed whatever combined single limit your broker specifies in its provider manual, commonly seen in the $1,000,000 range industry-wide, though you must confirm the exact figure with your specific broker contract. Drivers typically need a clean motor vehicle record, a background check (often including a check against state and federal excluded provider lists, since federal rule bars Medicaid payment to excluded individuals under 42 CFR 1001.1901), and CPR/first aid certification depending on broker requirements. For a deeper look at the vehicle side of this business, our nemt transportation guide covers conversion costs and inspection standards in more detail.

how do broker credentialing timelines and costs typically work

What it grants	Medicaid provider ID, ability to bill the state	Access to actual trip dispatch and payment
Application portal	GAMMIS online portal	Broker's own provider portal (confirm current broker)
Background checks	Standard Medicaid ownership/exclusion screening [5]	Broker-specific driver background check, often deeper
Insurance verification	Not typically required at this stage	Required, often $1M CSL minimum, confirm with broker
Typical timeline	Weeks	Weeks, can run longer during high application volume	Because these run in parallel but on separate systems, submit both applications as early as you reasonably can rather than waiting for one to finish before starting the other.

Broker credentialing in Georgia (and most states) runs on its own clock, separate from your Medicaid provider enrollment timeline. Expect a multi-week review process once you submit a complete application, longer if documents come back incomplete or if the broker's provider network is at capacity in your service area. Costs vary. Some brokers charge a nominal application fee, some don't charge anything beyond the cost of the background checks and inspections you're already required to complete. There's no standard national fee schedule for this, so treat any number you hear from a forum post as anecdotal, not official. Confirm actual costs directly with the broker before budgeting. Here's a rough comparison of what differs between the two enrollment tracks you'll be running in parallel: | Step | Georgia Medicaid (DCH/GAMMIS) | Regional Broker Network |

what mistakes do new Georgia NEMT owner-operators make

The most common mistake is buying the van before confirming insurance cost and broker vehicle standards. Wheelchair-accessible vans with lift systems and tie-downs cost more to insure than a standard passenger van, and if your broker requires a specific tie-down system or lift certification you didn't know about, you're paying for retrofit work you could have avoided. The second mistake is assuming Medicaid enrollment alone means you can start taking trips. As covered above, DCH enrollment and broker network acceptance are two separate gates. New operators sometimes get their Medicaid provider number, buy a van, and then wait weeks for broker credentialing they hadn't started yet. The third mistake is underestimating driver qualification timelines. If you're the sole driver and owner, your own background check and any required drug screening still has to clear before you can run broker trips, and that process isn't instant. Last, some new operators skip getting a written service area confirmation from the broker. Broker networks sometimes cap enrollment in certain counties if they already have enough vehicles there. Call before you commit to a specific county as your home base.

where do the actual application forms and contacts come from

For Georgia Medicaid provider enrollment, the starting point is DCH's Georgia Medicaid Management Information System portal, which handles all Medicaid provider types including NEMT. DCH's transportation unit is the correct contact for current broker assignment questions, since broker contracts get rebid periodically and forum information goes stale fast. ^[6] For entity formation, the Georgia Secretary of State's Corporations Division handles LLC and corporation filings online, with the $100 LLC filing fee current as of recent published fee schedules. For federal Medicaid rules that govern both NEMT and ambulance coverage nationally, the Code of Federal Regulations sections on transportation (42 CFR 431.53) and ambulance services (42 CFR 440.170) are the primary sources, not blog summaries of them. ^{[2] [3]} If you want a structured way to work through both the state Medicaid enrollment paperwork and broker credentialing checklist without missing a step, the $199 one-time State + Broker NEMT Launch Kit walks through both tracks side by side. It's a reference tool, not a guarantee of approval by DCH or any broker.

Frequently asked questions

How do you start a medical transportation business in Georgia from scratch?

Form an LLC with the Georgia Secretary of State ($100 filing fee), get commercial auto insurance meeting broker minimums, buy or convert a wheelchair-accessible vehicle, enroll as a Medicaid provider through GAMMIS, and credential separately with the current statewide NEMT broker. Confirm current broker assignment with Georgia DCH's transportation unit before finalizing your business plan.

What is NEMT and who typically needs it?

NEMT stands for non-emergency medical transportation, scheduled rides for Medicaid enrollees or patients who need transport to appointments, dialysis, or pharmacy visits but don't require ambulance-level medical care during the trip. It covers wheelchair vans, stretcher vans, and ambulatory sedans, distinct from emergency ambulance transport.

Does Medicaid cover ambulance rides in Georgia?

Yes. Federal rule under 42 CFR 440.170 requires Medicaid to cover ambulance transport when it's medically necessary, meaning other transport methods would endanger the patient. This is billed separately from NEMT and requires ambulance licensure through Georgia's Department of Public Health, Office of EMS and Trauma, not a NEMT provider registration.

Does Medicare cover medical transportation like wheelchair van rides?

Medicare Part B covers emergency ambulance transport and limited non-emergency ambulance transport with a doctor's written medical necessity order. Medicare generally does not cover routine wheelchair van or NEMT rides unless a Medicare Advantage plan offers it as a supplemental benefit, which varies plan by plan.

Can I start a NEMT business in Georgia with just one van?

Yes, plenty of Georgia owner-operators start with a single wheelchair van. The compliance steps (entity formation, insurance, Medicaid enrollment, broker credentialing) are largely the same regardless of fleet size, so a one-van start mainly reduces your upfront vehicle cost, not your paperwork load.

How long does Georgia Medicaid NEMT provider enrollment take?

There's no single published timeline, and it varies by application completeness and current processing volume at DCH. Realistically, plan for several weeks for Medicaid provider enrollment through GAMMIS, plus additional time separately for broker network credentialing, which runs on its own schedule.

Do I need a special license to drive a wheelchair van in Georgia for Medicaid patients?

Georgia doesn't have one single statewide NEMT driver license, but most brokers require a clean motor vehicle record, background check, and sometimes CPR/first aid certification. Requirements come primarily from your broker's provider manual and your insurer, so confirm specifics with your broker and DCH's transportation unit.

What's the difference between Georgia Medicaid enrollment and broker credentialing?

Medicaid enrollment through GAMMIS gets you a provider ID and the legal ability to bill the state. Broker credentialing (with whichever company holds Georgia's statewide NEMT contract) is a separate process that actually grants you trip dispatch and payment access. You need both to operate and get paid.

What insurance minimums does Georgia NEMT require?

Georgia doesn't set one statewide NEMT insurance minimum by regulation; the requirement comes from your broker contract, commonly around $1,000,000 combined single limit in the industry, though this varies. Always confirm the exact figure required with your specific broker before buying a policy.

Does starting a NEMT business in Georgia require a Public Service Commission permit?

It depends on your vehicle type and whether you cross county or state lines commercially. Some for-hire passenger vehicle configurations trigger Georgia Department of Public Safety motor carrier rules or PSC oversight. Confirm your specific vehicle class and route plan with the relevant Georgia agency before you assume you're exempt.

How much does it cost to form an NEMT business entity in Georgia?

Filing an LLC with the Georgia Secretary of State costs $100 online as of the current published fee schedule. That's separate from your federal EIN (free through the IRS), commercial insurance costs, and any local business license fees your county or city requires.

Who currently runs Georgia's Medicaid NEMT broker network?

Georgia's DCH has contracted statewide NEMT management to a broker in recent years, with Modivcare holding or having held that role, but broker contracts get rebid periodically. Confirm the current contractor directly with DCH's transportation unit rather than relying on outdated online sources.

Sources

1. Medicaid.gov, Non-Emergency Medical Transportation: NEMT is covered so enrollees can obtain Medicaid-covered services, distinct from ambulance benefits
2. eCFR, 42 CFR 440.170 Any other medical care or remedial care: Medicaid covers ambulance transport when medically necessary
3. eCFR, 42 CFR 431.53 Assurance of transportation: States must ensure necessary transportation for Medicaid beneficiaries to and from providers
4. Medicare.gov, Ambulance Services coverage: Medicare Part B covers emergency ambulance transport and limited non-emergency ambulance transport with medical necessity documentation
5. eCFR, 42 CFR 455.104 Disclosure by provider entities: Federal Medicaid provider enrollment requires ownership and disclosure information
6. eCFR, 42 CFR 1001.1901 Scope and effect of exclusion: Federal rule bars Medicaid payment to excluded individuals or entities, relevant to driver background check screening