Non-emergency medical transportation in New Orleans: how to start

Last updated 2026-07-25

What is non-emergency medical transportation?

Non-emergency medical transportation, or NEMT, is transportation for people who need to get to a medical appointment, dialysis, physical therapy, or a pharmacy pickup but don't need an ambulance or emergency response. Federal Medicaid rules require states to make sure eligible members can get to and from covered services, and NEMT is how states meet that obligation for people who have no other way to travel. The Centers for Medicare & Medicaid Services describes this as "assurance of transportation," a longstanding requirement tied to state Medicaid plans ^[1]. In practice, NEMT covers wheelchair van rides, ambulatory sedan trips, and sometimes stretcher van trips, plus mileage reimbursement for a friend or family member who drives the member themselves in some states. It does not cover 911 dispatch, lights-and-sirens response, or care during active medical emergencies. That distinction matters a lot for a new operator in New Orleans, because the vehicle you buy, the insurance you carry, and the agency you enroll with all depend on which side of that line you're on. Most states, including Louisiana, don't run NEMT trip assignment directly. They contract with a transportation broker who manages ride requests, driver credentialing, and payment on the state's behalf. That's the model relevant to almost every wheelchair van owner-operator reading this.

Does Medicaid cover ambulance rides?

Yes, Medicaid covers ambulance transportation when it's medically necessary, but that's a separate benefit from NEMT and it's billed and regulated differently. Federal Medicaid regulation at 42 CFR 440.170 defines transportation as a covered service states may provide, and ambulance transportation is treated distinctly from other transportation methods under the state plan ^[2]. If you're planning to run wheelchair vans, you are not in the ambulance business and you should not represent your service that way to a broker or to riders. Ambulance providers carry EMS licensure through the Louisiana Department of Health's Bureau of EMS and typically hold state EMS agency licenses, which is a different regulatory track than NEMT broker credentialing ^[3]. Confusing the two on an application is a fast way to get an enrollment rejected. So: does Medicaid cover ambulance? Yes, for medically necessary emergency or medically necessary non-emergency ambulance transport ordered by a provider. Does Medicaid cover a wheelchair van ride to a dialysis appointment? Also yes, but through the NEMT benefit and broker network, not the ambulance benefit.

Does Medicare cover medical transportation?

Medicare's coverage of medical transportation is much narrower than Medicaid's. Original Medicare Part B covers ambulance transportation when other transportation would endanger the person's health, and only under specific medical necessity conditions ^[4]. Medicare does not have a general NEMT benefit the way Medicaid does. That said, some Medicare Advantage plans offer non-emergency transportation as a supplemental benefit. CMS's 2019 final rule expanded the definition of primarily health-related supplemental benefits for Medicare Advantage plans, which opened the door for plans to include transportation to medical appointments as a supplemental benefit starting in plan year 2019 ^[5]. If you want to serve Medicare Advantage members in New Orleans, you'd need to contract directly with the plan or with a transportation network the plan uses, which is a separate credentialing path from Louisiana Medicaid NEMT. For a new owner-operator, the practical takeaway is this: your bread and butter in New Orleans NEMT is Louisiana Medicaid, run through the state's broker. Medicare Advantage transportation contracts are worth exploring later, once you have a vehicle, insurance, and a track record, but don't build your first-year plan around them.

How do you start a medical transportation business?

Starting a medical transportation business has two tracks that run in parallel: business formation and healthcare enrollment. You need both before you can legally bill a single trip. On the business side, you'll register your entity with the Louisiana Secretary of State, get an EIN from the IRS, open a business bank account, and get commercial auto insurance for a vehicle used to transport paying passengers. Louisiana requires liability insurance for vehicles for hire, and your broker will set its own minimum coverage limits, often higher than the state's bare minimum for personal vehicles. On the healthcare side, you enroll as a Louisiana Medicaid transportation provider through the Louisiana Department of Health (LDH), then separately get credentialed with the transportation broker that manages trip assignment in the New Orleans region. Louisiana Medicaid uses managed care organizations, and NEMT is coordinated through those plans or a designated broker; confirm the current broker structure with LDH's Medicaid transportation unit and with each managed care plan operating in Orleans Parish, because broker contracts and coverage areas do change ^[6]. Don't skip vehicle inspection requirements. Louisiana Medicaid NEMT vehicles generally need to meet age, mileage, and safety equipment standards set by the broker, on top of normal state vehicle inspection rules. Get the specific vehicle spec sheet from the broker before you buy anything.

How to start a NEMT business with one van

You can absolutely start with one wheelchair van. Plenty of owner-operators in Louisiana and nationally begin exactly that way, and a single-vehicle operation is often easier to get approved because you're not juggling multiple driver files and vehicle inspections at once. The sequence that avoids wasted money looks like this. First, confirm eligibility and requirements before you buy anything: call the Louisiana Medicaid transportation unit and the broker serving Orleans Parish and ask directly what vehicle age, mileage, and equipment they require. Brokers frequently reject vehicles over a certain age (commonly seen limits are around 6 to 8 model years, though this varies by broker and changes over time, so confirm the current number rather than trusting an old forum post). Second, get your business entity, EIN, and commercial insurance in place before you shop for a vehicle, since insurers price wheelchair-accessible vehicles differently than standard passenger vans and you'll want a real quote, not a guess. Third, buy or convert the van to broker spec (ramp or lift, tie-downs meeting a recognized standard, working wheelchair securement points), then schedule any required state or broker vehicle inspection. Fourth, submit your Louisiana Medicaid provider enrollment application, then your broker credentialing packet, in that order or in parallel if the broker allows pre-enrollment applications. Processing times vary by state and broker, and neither this article nor anyone else can promise a specific number of days, so ask both the state Medicaid transportation unit and the broker for their current stated timeline in writing. A single van also means your driver file is simpler: background check, driving record, defensive driving or passenger assistance training if the broker requires it, and drug screening where applicable. If you're driving your own van yourself, that's one file instead of several, which speeds up the paperwork side considerably.

How to start a non-emergency medical transportation business, step by step

Here's the fuller checklist, in the order it actually needs to happen for a New Orleans-based operator. 1. Form your business entity with the Louisiana Secretary of State and get a federal EIN. 2. Get commercial auto and general liability insurance quotes specific to wheelchair-accessible passenger transport; don't use a personal auto policy. 3. Contact the Louisiana Department of Health Medicaid transportation unit to confirm current NEMT provider enrollment requirements, required forms, and whether Orleans Parish NEMT runs through a statewide broker or through managed care organization-specific transportation vendors ^[6]. 4. Contact each broker operating in the region (this has included companies like Modivcare, MTM, Access2Care, or others depending on the current contract) and request their driver and vehicle credentialing packet. Broker contracts change, so verify who currently holds the New Orleans-area contract rather than assuming. 5. Buy or convert your wheelchair van to meet the vehicle spec, insurance limits, and equipment standard the broker specifies. 6. Complete driver requirements: background check, motor vehicle record check, drug screen, and any passenger assistance or wheelchair securement training the broker mandates. 7. Submit your Medicaid provider enrollment application and your broker credentialing application. Keep copies of everything and follow up in writing. 8. Once approved, learn the broker's dispatch system, trip confirmation process, and billing/claims submission workflow before you take your first trip, since missed documentation is the single most common reason new NEMT providers get paid late or denied on claims. For a broader look at how this process works across different broker relationships, see nemt and medical transportation.

What does Louisiana Medicaid NEMT enrollment actually require?

Louisiana Medicaid provider enrollment for transportation providers runs through the Louisiana Department of Health, and the specific forms, fees, and supporting documents change periodically, so treat any list here as a starting point, not gospel. At minimum, expect to provide your business entity documents, EIN, proof of insurance meeting the state and broker minimums, vehicle registration and inspection records, and driver credentialing documentation (background checks, license, training records) ^[6]. Louisiana Medicaid, like most states, also requires ongoing compliance: periodic vehicle re-inspection, driver re-screening, and revalidation of your provider enrollment on a schedule set by LDH. Federal regulation requires state Medicaid agencies to revalidate enrolled providers at least every five years under 42 CFR 455.414, so missing a revalidation deadline can suspend your ability to bill; put it on a calendar the day you get approved, not the week before it's due . Because Louisiana Medicaid operates through managed care, your actual day-to-day trip assignments will likely come through a broker or managed care transportation vendor rather than directly from LDH. That means you're managing two relationships at once: LDH for your underlying Medicaid enrollment status, and the broker for trip volume, dispatch, and often the first level of claims processing. Confirm with both which one handles what, because the answer has changed in Louisiana before and could change again.

What vehicle and equipment do brokers require?

Broker vehicle standards for wheelchair vans typically cover four things: vehicle age and mileage limits, wheelchair lift or ramp condition, securement system standards, and general safety equipment (working seatbelts for all positions, functioning heat and air conditioning, clean interior, working turn signals and lights). Wheelchair securement is usually expected to meet or reference WC19 or similar crash-tested tie-down standards, though exact language varies by broker contract. Ask for the broker's written vehicle inspection checklist rather than relying on secondhand descriptions, since this is one of the most common points of rejection for first-time applicants who buy a van before confirming the spec. Age limits are a real cost consideration. If a broker won't accept vehicles older than roughly 6 to 8 model years (a range seen across various broker contracts nationally, not a Louisiana-specific rule you should assume applies), buying a bargain 12-year-old van because it's cheap can mean you're stuck with an asset you can't use for Medicaid trips. Get the vehicle spec confirmed in writing before you sign a purchase agreement. For more on how vehicle and equipment choices interact with broker approval, see non emergency medical transportation services.

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

Costs vary enormously depending on whether you buy new or used, convert a van yourself or buy pre-converted, and what insurance the broker requires, so treat any number here as a range, not a quote. A used, already-converted wheelchair van commonly runs from the high five figures into six figures depending on age, mileage, and lift type; new mobility vans from manufacturers that build wheelchair-accessible conversions cost considerably more. On top of the vehicle, you're budgeting for commercial insurance (higher than personal auto insurance because you're transporting paying passengers with mobility needs), background check and drug screening fees for each driver, any required training course fees, and Louisiana business registration costs. Medicaid provider enrollment itself typically doesn't carry a large state fee for transportation providers in most states, but confirm the current fee schedule directly with LDH, since fee structures do get updated. Broker credentialing sometimes involves its own administrative or background check fee separate from the state's. Budget time as a cost too. Between entity formation, insurance shopping, vehicle sourcing or conversion, and the enrollment and credentialing paperwork, most new operators spend weeks, not days, getting from zero to an approved, dispatch-ready status. Rushing any one step (especially vehicle spec confirmation) tends to cost more time later than it saves upfront.

Louisiana Medicaid NEMT enrollment timeline: what to expect

There's no single published timeline that covers every applicant, because processing speed depends on how complete your application is, how busy the state and broker are, and whether your vehicle passes inspection on the first try. That said, here's the honest shape of it. Medicaid provider enrollment applications commonly take several weeks for a first review, longer if anything is missing or needs clarification. Broker credentialing, which includes vehicle inspection scheduling and driver background check turnaround, often runs in parallel but has its own queue. A first-time applicant with clean paperwork, a compliant vehicle, and a driver who already has a clean background check on file might move faster; anyone missing documents or working with an older vehicle that needs a re-inspection should expect the process to stretch out. Neither LDH nor any broker guarantees a specific approval date, and this article isn't going to promise one either. The single best thing you can do to speed things up is call the Louisiana Medicaid transportation unit and your target broker before you submit anything, get their current checklist in writing, and submit a complete package the first time.

NEMT vs. ambulance vs. rideshare: how New Orleans riders sort it out

Emergency ambulance	Licensed EMS agency	911 call, active medical emergency	Medicaid/Medicare ambulance benefit, private insurance
Non-emergency ambulance	Licensed EMS agency	Medically necessary stretcher transport between facilities	Medicaid/Medicare ambulance benefit
NEMT wheelchair van	Broker-credentialed NEMT provider	Routine appointment, dialysis, therapy, for a Medicaid member using a wheelchair	Medicaid NEMT benefit via broker
NEMT ambulatory sedan	Broker-credentialed NEMT provider	Routine appointment for a Medicaid member who can walk/transfer independently	Medicaid NEMT benefit via broker
Rideshare/taxi	Private company, no Medicaid credentialing	Anyone paying out of pocket or through a non-Medicaid transportation benefit	Rider or private plan, not Medicaid NEMT	A wheelchair van owner-operator in New Orleans is competing and cooperating in the third row of that table. You're not an ambulance service, and you're not a rideshare driver either, even though from the outside a van picking someone up looks similar. The credentialing, insurance, and vehicle standards for that third row are specific to Medicaid NEMT broker contracts, which is why skipping straight to 'I'll just drive for a rideshare app' doesn't get you Medicaid trip volume. For a deeper comparison of broker relationships across states, see nemt transportation and emergency medical transport.

Riders and even some new operators mix these up, so here's the practical breakdown. | Service type | Who provides it | Typical use case | Payer |

Where does the $199 Launch Kit fit into this process?

If you'd rather not piece together every state form and broker checklist yourself, RideCredential's $199 one-time State + Broker NEMT Launch Kit organizes the Louisiana Medicaid enrollment steps and broker credentialing checklists into one build-as-you-go packet, so you're not hunting across a dozen agency pages and broker portals to figure out what's actually required. It doesn't replace the state's application or a broker's own credentialing forms, and it doesn't guarantee approval (nobody legitimately can), but it saves you from the version of this process where you find out about a missing document after you've already scheduled a vehicle inspection. You can start building your packet at /launch-kit-builder.

What should you confirm directly with the state and broker before you commit?

A short list worth calling about before you sign a vehicle purchase agreement or lease: First, ask LDH's Medicaid transportation unit which broker or managed care transportation vendor currently handles NEMT trip assignment in Orleans Parish, since broker contracts change and an outdated answer wastes your time. Second, ask the broker for their current written vehicle spec sheet (age limit, mileage limit, lift/ramp and securement standard) before buying or converting a vehicle. Third, ask both LDH and the broker what their current provider enrollment and credentialing fees are, since fee schedules get updated and a number from two years ago may be wrong. Fourth, ask about revalidation and re-inspection schedules so you can put renewal deadlines on your calendar from day one. Fifth, if you plan to also pursue Medicare Advantage transportation contracts, ask those plans directly what credentialing they require, since it's separate from Louisiana Medicaid NEMT enrollment. None of this is legal advice, and specifics change. Treat every number and requirement in this article as a starting point for your own confirmation call, not a final answer.

Frequently asked questions

What is non-emergency medical transportation?

Non-emergency medical transportation (NEMT) is transportation for people who need to get to routine medical care, like dialysis, therapy, or doctor visits, but don't need an ambulance. Medicaid programs are required to help arrange transportation for eligible members who have no other way to get to covered services, and NEMT is the benefit and provider network that does this ^[1].

Does Medicaid cover ambulance rides?

Yes. Medicaid covers medically necessary ambulance transportation, both emergency and non-emergency, but this is a separate benefit from NEMT wheelchair van or sedan trips, billed under different codes and provided by licensed EMS agencies rather than NEMT broker-credentialed drivers ^[6][2].

Does Medicare cover medical transportation?

Original Medicare covers ambulance transportation under specific medical necessity conditions, but it doesn't have a general non-emergency van or sedan transportation benefit like Medicaid does ^[3]. Some Medicare Advantage plans offer non-emergency transportation as a supplemental benefit, which requires a separate contract from Medicaid NEMT enrollment ^[4].

How do I start a medical transportation business in Louisiana?

Form your business entity, get commercial insurance, then enroll as a Louisiana Medicaid transportation provider through LDH and get credentialed with the broker serving your parish. Confirm vehicle specs and current requirements with both LDH's Medicaid transportation unit and the broker before buying a vehicle.

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

Confirm vehicle spec and insurance requirements with the state and broker first, then buy or convert one wheelchair van to that spec, complete driver credentialing (background check, license, training), and submit your Medicaid provider enrollment and broker credentialing applications. One van simplifies your driver file and paperwork considerably.

What's the difference between NEMT and an ambulance service?

NEMT is routine transportation for Medicaid members going to non-emergency medical appointments, run through broker-credentialed drivers and vehicles. Ambulance service is for emergency or medically necessary stretcher transport, provided by licensed EMS agencies under a completely separate licensing and billing structure ^[6][2].

How much does it cost to start a wheelchair van NEMT business?

Vehicle cost alone commonly runs from the high five figures into six figures for a used, pre-converted wheelchair van, with new mobility vans costing more. Add commercial insurance, driver screening fees, and possible broker administrative fees. Confirm current Medicaid enrollment fees with LDH, since fee schedules change.

How long does Louisiana Medicaid NEMT enrollment take?

There's no universal timeline. Provider enrollment commonly takes several weeks for initial review, and broker credentialing (vehicle inspection, driver background checks) runs on its own schedule. A complete, error-free application submitted the first time is the biggest factor in speed. Confirm current processing estimates directly with LDH and your broker.

Do I need a special vehicle for NEMT in New Orleans?

Yes. Wheelchair van NEMT requires a vehicle with a working lift or ramp and a securement system meeting the broker's standard, plus compliance with age and mileage limits set by the broker. Get the broker's written vehicle spec sheet before buying or converting a vehicle.

Which brokers handle NEMT in Louisiana?

Louisiana Medicaid NEMT is coordinated through managed care organizations and their contracted transportation vendors, which have included companies like Modivcare, MTM, and others depending on the current contract. Broker assignments change over time, so confirm the current broker for Orleans Parish directly with LDH's Medicaid transportation unit before applying.

Can I drive for Medicaid NEMT and also do private-pay rides?

Generally yes, many owner-operators do both, but your Medicaid NEMT trips must go through the credentialed broker's dispatch and billing system, and your vehicle and driver records need to stay in compliance with broker standards regardless of what other work you take on. Check your broker agreement for any exclusivity or reporting terms.

Does Medicaid pay for gas mileage if a family member drives me?

Some state Medicaid programs offer a mileage reimbursement option for a friend or family member who provides the ride themselves, as part of the NEMT benefit. Availability and reimbursement rates vary by state, so confirm whether Louisiana Medicaid currently offers this option directly with LDH's Medicaid transportation unit.

What happens if my NEMT vehicle fails broker inspection?

You generally can't accept broker-dispatched trips until the vehicle passes inspection or the issue is corrected and re-inspected. This is why confirming the broker's written vehicle spec before you buy or convert a van matters: repairs or a vehicle swap after the fact cost time and money you could have avoided.

Sources

1. Medicaid.gov, Non-Emergency Medical Transportation: Medicaid's assurance of transportation requirement and the distinction between NEMT and ambulance benefits
2. Louisiana Department of Health, Bureau of EMS: Ambulance services require EMS agency licensure separate from NEMT broker credentialing
3. Medicare.gov, Ambulance Services coverage: Original Medicare covers ambulance transportation only under specific medical necessity conditions and has no general NEMT benefit
4. Louisiana Department of Health, Medicaid Provider Enrollment: Louisiana Medicaid provider enrollment process and requirements for transportation providers
5. 42 CFR 440.170, Transportation: Federal Medicaid regulation defining transportation, including ambulance transportation, as a coverable state plan service
6. 42 CFR 455.414, Revalidation of enrollment: Federal requirement that state Medicaid agencies revalidate enrollment of all providers at least every five years