Non-emergency medical transportation in Georgia: how to start

Last updated 2026-07-24

What is non-emergency medical transportation (NEMT)?

NEMT is scheduled transportation for people who have a medical appointment, treatment, or pharmacy pickup but no emergency and no way to get there on their own. Think dialysis three times a week, chemo infusions, physical therapy, or a prenatal visit. It's not an ambulance ride and it's not 911 dispatch. It's a wheelchair van, a sedan, or sometimes a stretcher van, running a pre-scheduled trip. Federal Medicaid rules require states to make sure eligible people can get to and from providers. The regulation at 42 CFR 431.53 says states must "ensure necessary transportation for beneficiaries to and from providers" ^[1]. Most states, including Georgia, meet that requirement by contracting with a transportation broker rather than paying individual drivers directly. The broker takes ride requests from members, screens eligibility, and dispatches the trip to a contracted transportation provider, which is where owner-operators come in. NEMT covers a wide mix of vehicle types: wheelchair-accessible vans, ambulatory sedans, and in some states stretcher vans or even bus passes and mileage reimbursement for a friend or family member who drives the member themselves. A brand-new operator with one wheelchair van is competing for the wheelchair-accessible trip category specifically. That category usually pays more per trip than ambulatory sedan work. It also requires a lift or ramp, tie-downs, and driver training most sedan operators skip. For a broader look at how this fits together nationally, see non emergency medical transportation.

Does Medicaid cover ambulance rides, and how is that different from NEMT?

Yes, Medicaid covers ambulance transportation, but that's a separate benefit from NEMT and it works under different rules. Ambulance transport is for emergency or medically necessary transport where the person needs monitoring, oxygen, or a stretcher with clinical staff, and it's billed through the state's ambulance/EMS fee schedule, not the NEMT broker contract ^[2]. NEMT is the non-emergency benefit. No clinical staff riding along. No lights and siren. Just getting someone from home to a medical appointment and back safely. If you're buying a wheelchair van and planning to bill through a broker like Modivcare or another contracted vendor, you are in the NEMT lane, not the ambulance lane. Running an ambulance service requires EMS licensure through Georgia's Department of Public Health, which is a completely different regulatory track with paramedics, EMTs, and DOT-inspected ambulances, not something a solo wheelchair-van owner-operator does. A lot of new operators get this confused when they read Medicaid's transportation page, because both benefits get lumped under "medical transportation." If you're only running a wheelchair-accessible minivan with a ramp and no medical equipment, you're squarely in NEMT territory.

Does Medicare cover medical transportation?

Original Medicare (Part B) covers ambulance transportation when it's medically necessary, generally when other transportation could endanger your health, but it does not cover routine non-emergency rides to doctor visits or dialysis in a wheelchair van ^[3]. That's a common source of confusion for new operators who assume Medicare works like Medicaid. Some Medicare Advantage plans do offer a limited NEMT-style transportation benefit as a supplemental perk, often a set number of one-way trips per year to plan-approved providers, arranged through a plan-contracted transportation vendor. Coverage varies plan by plan and changes every year during open enrollment, so if you want to work Medicare Advantage trips alongside Medicaid trips, you'd contract separately with whichever transportation network that specific plan uses. Don't build a business plan around Medicare fee-for-service NEMT work; it mostly doesn't exist. Medicaid and Medicaid managed care are where the volume is for wheelchair-van owner-operators.

How does NEMT work for Georgia Medicaid members?

Georgia Medicaid runs its non-emergency transportation benefit through a broker model, meaning Medicaid members call the state's contracted transportation broker to schedule rides rather than calling a transportation company directly. Georgia's Medicaid agency, the Department of Community Health (DCH), oversees the benefit, and Gainwell Technologies is the current fiscal agent handling Medicaid provider enrollment for the state. Confirm with Georgia Medicaid which company currently holds the statewide NEMT broker contract, since these contracts go out for rebid periodically and the vendor can change. Here's the two-step structure every new Georgia operator needs to understand clearly, because skipping either step means you can't bill anyone: 1. State Medicaid provider enrollment. You register as a Georgia Medicaid transportation provider through the Georgia Medicaid Management Information System (GAMMIS) portal managed by Gainwell, get a Georgia Medicaid provider number, and stay in good standing with DCH requirements. 2. Broker credentialing. Separately, you apply to become a network transportation provider with whichever broker holds the statewide (or regional) NEMT contract. The broker checks your vehicle inspection, insurance, driver background checks, and often a facility or vehicle inspection before assigning you any trips. Medicaid managed care matters here too. Georgia's Medicaid managed care program, Georgia Families, is run through several care management organizations (CMOs), and each CMO can route its NEMT benefit through the statewide broker or occasionally through its own arrangement. Confirm with DCH and with each CMO whether NEMT credentialing is centralized through one broker or split by plan, because that changes how many separate applications you'll need to file.

How do I get Georgia Medicaid provider enrollment as an NEMT operator?

You start at the GAMMIS portal, the Georgia Medicaid Management Information System operated by Gainwell Technologies on behalf of DCH. This is where you apply for your Georgia Medicaid provider number under the transportation provider category, and it's a separate process from broker credentialing. Expect to submit business formation documents (your LLC or corporation paperwork), your federal EIN, ownership and background disclosure forms, proof of vehicle insurance meeting Georgia's minimums, and vehicle registration and inspection records. Georgia Medicaid provider enrollment also typically requires a criminal background check disclosure for owners and, depending on current DCH policy, a site visit or documentation of your business location. Fees and exact document lists change, so confirm the current checklist and any application fee directly on the GAMMIS provider enrollment pages before you start. One thing trips up first-time owner-operators. State Medicaid enrollment on its own does not get you trips. It makes you eligible to bill Georgia Medicaid, but the broker is who actually assigns rides and pays you per trip under the broker's rate schedule. You need both pieces done before your van earns a dollar. For a look at how broker credentialing generally works across states, see nemt and broker guides.

How does broker credentialing work with Modivcare, MTM, or the current Georgia broker?

Broker credentialing is the second gate, and it's usually more demanding on the operations side than state enrollment. Confirm with Georgia's current NEMT broker exactly what they require, but across states the pattern from companies like Modivcare and MTM is fairly consistent: a vendor application, proof of commercial auto insurance at broker-required limits (often $1 million combined single limit for wheelchair vans, though this varies), vehicle inspection meeting ADA-style lift/ramp and tie-down standards, driver background checks and drug screening, and driver training documentation covering passenger assistance and wheelchair securement. Most brokers also want a minimum fleet size or a plan for how you'll cover no-shows and cancellations, though a single-van operator can often start in a limited service area. Some brokers cap new-provider onboarding periodically when their network in a region is full, so timing matters; if the Georgia broker's network is saturated in your county, you may sit on a waitlist even after passing every check. Payment rates are set by the broker's contract with the state and typically pay per trip, sometimes with a base rate plus mileage, and rates for wheelchair-accessible trips run higher than ambulatory sedan trips because of the extra equipment and time. Georgia does not publish a single statewide NEMT trip rate that applies to every broker contract, so get the current fee schedule directly from the broker during credentialing rather than relying on numbers you find online. No credentialing outcome is guaranteed. Passing a broker's application checklist doesn't obligate them to assign you trip volume, and brokers can and do decline applicants or pause onboarding.

What vehicle and insurance requirements does Georgia NEMT credentialing typically check?

Wheelchair vans need a functioning ramp or lift, working tie-down/securement systems (typically four-point systems meeting recognized safety standards), a current annual safety inspection, and a fire extinguisher and first-aid kit in most broker checklists. Georgia state vehicle inspection and registration rules apply on top of whatever the broker requires, so your van needs to pass regular Georgia motor vehicle standards, more than broker-specific ones. Insurance is where new operators most often underestimate cost. Commercial auto liability limits for NEMT vehicles commonly run $1 million combined single limit when brokers require it, well above Georgia's mandatory personal auto minimum liability limits of $25,000 per person / $50,000 per accident for bodily injury and $25,000 for property damage under O.C.G.A. § 33-34-4 ^[4]. You'll also likely need general liability coverage and, once you hire any driver, workers' compensation coverage, which Georgia requires for most employers with three or more employees under O.C.G.A. § 34-9-2 ^[5]. Confirm current limits directly with your credentialing broker, since requirements are set contractually and do change. Budget realistically: a used wheelchair-accessible minivan typically runs $20,000 to $45,000 depending on age, mileage, and conversion quality, and commercial NEMT insurance for a single van often runs several thousand dollars a year, sometimes more depending on your driving record, location, and carrier. These are rough market ranges, not quotes. Get actual numbers from a commercial auto insurer that writes NEMT policies before you commit.

How do you start a medical transportation business, step by step?

The order matters more than most new operators expect, because doing it out of sequence wastes money. Here's the realistic sequence for Georgia: 1. Form your business entity (LLC is standard) and get an EIN from the IRS. 2. Get commercial auto insurance quotes before you buy a vehicle, so you know real cost before you're locked in. 3. Buy or lease your wheelchair-accessible van, making sure it can pass both Georgia vehicle inspection and broker-level ADA equipment checks. 4. Apply for Georgia Medicaid provider enrollment through GAMMIS with Gainwell. 5. Apply for broker credentialing with the current Georgia NEMT broker (confirm which company currently holds the contract). 6. Get driver background checks, drug screening, and passenger-assistance training done for yourself and any drivers. 7. Complete any required broker vehicle inspection and orientation before you're activated to receive dispatched trips. Don't skip step 2. A lot of first-time owner-operators buy the van first, fall in love with a specific conversion, and then discover their insurance cost or the broker's minimum coverage requirement makes the math ugly. Get quotes early.

How do you start an NEMT business with just one van?

It's absolutely doable, and it's how most owner-operators start. But a one-van operation has real constraints you should plan around honestly. You have no backup vehicle, so a breakdown or scheduled maintenance day means you're turning down trips or scrambling for a rental. You also can't cover multiple simultaneous dispatch requests, which some brokers factor into how much volume they'll route to you. Single-van operators typically position themselves for a specific geographic zone and specific trip types, wheelchair-accessible dialysis runs, for example, rather than trying to cover a whole county's general NEMT demand. Recurring dialysis and treatment schedules are attractive precisely because they're predictable; you know Tuesday, Thursday, Saturday at 7 a.m. for months at a stretch, which is easier to plan around than one-off appointment trips. Most of the enrollment and credentialing steps are identical whether you own one van or twenty. The paperwork burden is the same size; it's just spread across less capacity. That's the real argument for getting your state enrollment and broker application paperwork organized correctly the first time, since redoing a rejected application costs you weeks of onboarding delay regardless of fleet size. A State + Broker NEMT Launch Kit built for a one-van start can help you sequence the state Medicaid application and broker credentialing checklist correctly instead of guessing at requirements broker by broker.

What does it cost to start a wheelchair-van NEMT business in Georgia?

Used wheelchair-accessible van	$20,000, $45,000	Conversion age/mileage drive the range
LLC formation + EIN	$100, $300	Georgia Secretary of State filing fee plus any registered agent cost
Commercial auto insurance (annual)	$3,000, $8,000+	Varies heavily by driving record, coverage limits, location
Georgia Medicaid provider enrollment	Confirm current fee with GAMMIS/Gainwell	Some states charge an application fee; confirm current amount
Broker credentialing/inspection	Often no direct fee, but vehicle must pass inspection	Confirm with your specific broker
Driver background check/drug screen	$50, $150 per driver	One-time per hire, may recur annually	The van and insurance are your two biggest line items by far. If you're financing the van, factor loan payments into your insurance and fuel math before you sign, because a wheelchair conversion adds real weight and maintenance cost compared to a standard minivan.

There's no single number, but here's a realistic range for a one-van operator starting from scratch in Georgia. These are market ranges based on typical costs reported by operators and insurers, not quotes for your specific situation. | Cost item | Typical range | Notes |

What licenses and business registrations does Georgia require beyond Medicaid enrollment?

Beyond Georgia Medicaid provider enrollment and broker credentialing, treat this like any other Georgia small business launch. Register your LLC or corporation with the Georgia Secretary of State, get a federal EIN from the IRS, and check whether your county or city requires a local business license or occupational tax certificate, since Georgia handles business licensing at the local level rather than a single statewide business license. If you'll drive a van rated for more vehicle capacity thresholds or plan to expand into a larger passenger vehicle fleet, check Georgia commercial driver's license (CDL) thresholds with the Department of Driver Services; most single wheelchair vans (typically under 15 passengers including the driver) don't require a CDL, but confirm against the specific vehicle's rated capacity. Workers' compensation coverage becomes mandatory once you have three or more employees under Georgia law ^[5], so factor that into your cost model the moment you plan to hire a second driver. Keep your Georgia Medicaid enrollment current with any required revalidation cycle. Medicaid provider enrollment isn't a one-time event, and lapses in revalidation can suspend your ability to bill until you're reprocessed.

How long does Georgia NEMT enrollment and credentialing actually take?

Nobody publishes a firm statewide timeline. It genuinely varies based on how clean your application is and how backed up Gainwell's processing queue or the broker's onboarding pipeline is at that moment. As a rough planning range, state Medicaid provider enrollment processing commonly takes several weeks once a complete application is submitted, and incomplete applications restart or stall the clock. Broker credentialing adds its own separate timeline on top, often another few weeks once the vehicle inspection and driver background checks are scheduled. Realistically, budget two to four months from "I've bought my van" to "I'm receiving dispatched trips," and treat anything faster as a pleasant surprise rather than the plan. The single biggest time-waster is submitting an incomplete application and having it bounced back, so double-check every document against the current GAMMIS checklist before submitting, and confirm the broker's current document list directly with them rather than relying on last year's requirements.

Frequently asked questions

What is non-emergency medical transportation?

Non-emergency medical transportation (NEMT) is scheduled transportation to medical appointments, dialysis, therapy, or pharmacy visits for people who have no emergency but also no way to get there themselves. It's typically a wheelchair van, ambulatory sedan, or stretcher van, dispatched through a state Medicaid broker or managed care plan rather than 911 or an ambulance service.

Does Medicaid cover ambulance rides?

Yes, Medicaid covers medically necessary ambulance transportation, but that benefit is billed separately from NEMT through the state's EMS/ambulance fee schedule. Ambulance transport involves clinical staff and emergency response; NEMT is a scheduled, non-clinical ride to routine appointments and runs through a different provider and billing path.

Does Medicaid cover NEMT rides in Georgia?

Yes. Georgia Medicaid provides non-emergency transportation for eligible members through a state-contracted broker model overseen by the Department of Community Health. Members schedule rides through the broker rather than calling a transportation company directly; confirm the current broker name with Georgia Medicaid since contracts periodically rebid.

Does Medicare cover medical transportation?

Original Medicare Part B covers ambulance transport when medically necessary but generally does not cover routine non-emergency rides in a wheelchair van. Some Medicare Advantage plans offer limited supplemental NEMT trip benefits, but coverage varies by plan and isn't guaranteed, so check the specific plan's benefits before counting on that work.

How do I start a medical transportation business in Georgia?

Form an LLC, get commercial auto insurance quotes, buy a wheelchair-accessible van that passes state inspection, enroll as a Georgia Medicaid transportation provider through GAMMIS/Gainwell, then apply for broker credentialing with the current statewide NEMT broker. Complete driver background checks and any required vehicle inspection before accepting dispatched trips.

How do I start an NEMT business with just one van?

You follow the same state enrollment and broker credentialing steps as a larger fleet, just with less capacity to absorb breakdowns or simultaneous trip requests. Many one-van operators focus on recurring trips, like dialysis runs, that offer predictable scheduling rather than trying to cover general on-demand NEMT demand across a wide area.

What does it cost to start a wheelchair-van NEMT business?

Expect roughly $20,000 to $45,000 for a used wheelchair-accessible van, several thousand dollars a year for commercial auto insurance, and a few hundred dollars for LLC formation. Add Georgia Medicaid enrollment costs and broker inspection requirements on top; get current fee amounts directly from GAMMIS and your broker.

Who is the NEMT broker for Georgia Medicaid?

Georgia Medicaid contracts with a transportation broker to manage member scheduling and provider dispatch, but broker contracts go out for rebid periodically and the vendor can change. Confirm the current broker directly with the Georgia Department of Community Health before applying for credentialing.

Do I need a CDL to drive a wheelchair van for NEMT in Georgia?

Most single wheelchair vans, generally rated under 15 passengers including the driver, don't require a commercial driver's license under Georgia rules. Confirm the exact seating and weight rating of your specific vehicle against Georgia Department of Driver Services CDL thresholds before assuming you're exempt.

How long does Georgia Medicaid NEMT provider enrollment take?

There's no official published timeline, but complete applications commonly take several weeks to process through GAMMIS, and broker credentialing adds additional time on top. A realistic planning window from application to first dispatched trip is roughly two to four months, longer if paperwork is incomplete.

What insurance do I need for a Georgia NEMT wheelchair van?

Brokers commonly require commercial auto liability well above Georgia's personal auto minimums, often $1 million combined single limit, plus general liability coverage. Once you hire employees, Georgia requires workers' compensation coverage for most employers with three or more workers under O.C.G.A. § 34-9-2.

Can I do NEMT work for both Medicaid and Medicare patients?

Medicaid NEMT is the main volume source since it's a required state benefit. Medicare fee-for-service doesn't cover routine non-emergency rides, but some Medicare Advantage plans offer a limited transportation perk through their own contracted vendor, which would require a separate application from that plan's network, not Georgia Medicaid's broker.

Sources

1. eCFR, 42 CFR 431.53 (Assurance of Transportation): Federal Medicaid regulation requiring states to ensure necessary transportation for beneficiaries to and from providers
2. Medicaid.gov, Transportation: Medicaid's non-emergency medical transportation benefit and how it differs from ambulance coverage
3. Medicare.gov, Ambulance Services: Original Medicare Part B covers ambulance transportation only when medically necessary, not routine non-emergency rides
4. Justia, O.C.G.A. § 33-34-4 (Minimum Motor Vehicle Insurance Coverage): Georgia's minimum personal auto liability insurance requirements, which are far lower than typical NEMT broker commercial insurance requirements
5. Justia, O.C.G.A. § 34-9-2 (Workers' Compensation Applicability): Georgia requires workers' compensation coverage for most employers with three or more employees