Requirements to start a NEMT business in Georgia

Last updated 2026-07-25

What is non-emergency medical transportation (NEMT)?

Non-emergency medical transportation is scheduled transport for Medicaid or Medicare Advantage members who need a ride to a medical appointment but don't need an ambulance. Think dialysis three times a week, physical therapy, a primary care visit, or a specialist two counties over. The trip isn't an emergency, but the member can't drive themselves and has no other way to get there. NEMT covers a range of vehicle types: sedans and standard vans for ambulatory members who can walk and transfer on their own, wheelchair-accessible vans (WAVs) for members who use a wheelchair or scooter, and in some cases stretcher vans for non-ambulatory members who aren't sick enough to need an ambulance crew. Georgia's Medicaid NEMT benefit is a Section 1902(a)(70) requirement, meaning federal Medicaid law requires states to "ensure necessary transportation for beneficiaries to and from providers" ^[1]. States can run this in-house or contract it out to a broker. Georgia contracts it out. For a broader definition and how NEMT differs from ambulance service, see what is nemt. Owner-operators usually start with one wheelchair van because WAV trips pay better per mile than ambulatory trips and there's chronic demand from dialysis and dementia care riders who can't use a regular car.

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

Yes, Medicaid covers ambulance transportation when a beneficiary's medical condition requires emergency or urgent transport by ambulance, but that's a completely separate program from NEMT. Ambulance services require EMT/paramedic staffing and are billed differently than a wheelchair van trip ^[2]. NEMT is for members who are stable enough to ride in a van or car but still can't get to the doctor on their own. If you're picturing a business built around emergency runs, that's an ambulance company, a completely different license path through Georgia's Office of EMS and Trauma, not what this article covers. Does Medicare cover medical transportation? Original Medicare (Part A/B) covers ambulance transportation only when other transport would endanger the beneficiary's health, and it generally does not cover routine NEMT rides to routine appointments ^[3]. Some Medicare Advantage plans add a NEMT-style transportation benefit as a supplemental benefit, and those trips often route through the same brokers that manage Medicaid NEMT. It's worth asking Modivcare or the plan directly whether they credential providers for MA transportation benefits in Georgia.

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

Here's the order that actually works, based on how Georgia's system is structured. Skipping ahead (buying a van before you know insurance minimums, for example) is the most common way owner-operators waste money. 1. Pick a business structure and register with the Georgia Secretary of State (LLC is standard for a solo owner-operator). 2. Get an EIN from the IRS and open a business bank account. 3. Get commercial auto and general liability insurance quotes before you buy a vehicle, since your premium depends heavily on vehicle type and driver record. 4. Buy or lease a vehicle that meets ADA wheelchair-accessibility standards if you're doing WAV trips. 5. Line up driver requirements: valid Georgia driver's license, CPR/first aid certification, background check, drug screen. 6. Enroll as a Georgia Medicaid provider through the Department of Community Health's Medicaid Management Information System (MMIS) provider enrollment portal. 7. Apply for broker network credentialing with Modivcare (Georgia's NEMT broker) separately from Medicaid enrollment. 8. Set up dispatch and trip documentation systems the broker requires (mileage logs, trip verification, timestamps). Georgia doesn't run a separate standalone "NEMT operator license" the way some states do. Instead your legal authority to operate comes from a combination of general business registration, vehicle-for-hire rules (which vary by county/city), and your Medicaid provider agreement plus broker contract. Confirm current requirements with your county government and with DCH before committing money, because local vehicle-for-hire ordinances differ between, say, the City of Atlanta and a rural county.

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

One van is a completely normal way to start, and plenty of Georgia owner-operators run exactly one wheelchair van for years before adding a second vehicle or driver. The requirements don't change much for a fleet of one versus ten: you still need the insurance, the vehicle standards, the driver qualifications, and both the state and broker enrollment. What does change is your bandwidth. With one van you are the driver, the dispatcher, the biller, and the maintenance scheduler. Brokers assign trips through a portal or app and expect you to accept, complete, and document each one on time. Missing pickup windows repeatedly is one of the fastest ways to get suspended from a broker network. Build in real slack for vehicle downtime too. A wheelchair lift or ramp failure takes your only van out of service, so budget for a backup plan (a rental agreement, a second driver relationship, or at minimum a fast repair vendor) before your first credentialing decision, not after. One-van operators should also expect the broker credentialing paperwork to be identical in volume to what a five-van company files. There's no small-operator shortcut on insurance certificates, vehicle inspection forms, or driver files.

What licenses and business registrations does Georgia require?

At minimum you need: a Georgia business entity registration through the Secretary of State's Corporations Division, a federal EIN, and any city or county business license required where you're based. Georgia doesn't require a special state-level "NEMT license" separate from Medicaid enrollment, but some municipalities regulate "vehicles for hire," and that can include NEMT vans depending on local ordinance language, so check with your city or county clerk. If you'll transport Medicaid members, you must enroll as a Medicaid provider with the Georgia Department of Community Health (DCH), which administers Georgia Medicaid and PeachCare for Kids ^[4]. Provider enrollment happens through the Georgia Medicaid Management Information System (GAMMIS) portal, and DCH's provider enrollment unit can confirm current forms and required attachments. Separately, DCH contracts with Modivcare as the non-emergency transportation broker for Georgia Medicaid members ^[5]. Enrollment with DCH and credentialing with Modivcare are two different applications with two different reviewers, and completing one does not automatically complete the other. Confirm current application steps, required documents, and processing timelines directly with DCH's transportation unit and with Modivcare, since broker networks periodically open and close to new providers depending on regional capacity.

What vehicle and equipment standards do wheelchair vans need to meet?

Wheelchair-accessible vans used for NEMT need to meet Americans with Disabilities Act (ADA) accessibility standards for the lift or ramp, securement points, and interior clearance, since these vehicles are providing transportation service to the public under contract with a public program ^[2]. Practically, that means a working wheelchair lift or ramp, four-point wheelchair securement (tie-downs), a functioning lap and shoulder belt system for the wheelchair user, and interior height/width that lets a standard power chair turn and lock in. Brokers layer their own vehicle inspection requirements on top of ADA minimums. Typical items include vehicle age limits (many brokers won't credential a van older than 10 years, though this varies), current state vehicle inspection or emissions certificate, working heat/AC, seatbelts for every seated position, first aid kit, fire extinguisher, and a clean, odor-free interior. Confirm the specific inspection checklist with Modivcare before buying a used van, because failing the broker's inspection after purchase is an expensive mistake. For buyers comparing vehicle types and what counts as ambulatory versus wheelchair-accessible for broker purposes, see non emergency medical transportation.

What insurance coverage does a Georgia NEMT business need?

You'll need commercial auto liability insurance (not a personal auto policy) covering the vehicle for hire, general liability insurance for the business, and in most cases the broker will require specific minimum limits before it credentials you. Georgia's financial responsibility law sets minimum auto liability limits for all vehicles at $25,000 per person / $50,000 per accident for bodily injury and $25,000 for property damage , but NEMT brokers typically require far higher commercial limits, commonly in the $1 million combined single limit range, because they're moving vulnerable riders under a state contract. Some brokers and some Georgia counties also require workers' compensation coverage once you have employees driving for you, even part-time. If you're a true solo owner-operator with no employees, Georgia law generally doesn't require you to carry workers' comp on yourself, but confirm this with your insurance agent and with DCH since program-specific requirements can differ from general state labor law. Get insurance quotes before you buy the vehicle. Premiums vary a lot by vehicle type, driver history, and whether you're insuring one van or a growing fleet, and an insurance agent experienced in NEMT can tell you fast whether a used van you're considering is going to be affordable to cover.

What are the driver requirements for NEMT in Georgia?

Drivers need a valid Georgia driver's license (a Commercial Driver's License is generally not required for standard vans and wheelchair vans under the weight thresholds that trigger CDL rules, but confirm vehicle-specific requirements with the Georgia Department of Driver Services if you're considering a larger cutaway or stretcher van). Beyond licensing, brokers and DCH typically require a clean driving record review, a criminal background check, drug and alcohol screening, and CPR/First Aid certification. Many brokers also require passenger assistance training (sometimes called PASS certification) that covers safely helping a wheelchair user transfer, operating lift equipment, and securing a wheelchair correctly. This training isn't a Georgia state mandate by statute in the way a CDL is, but it's routinely a broker credentialing condition. Treat it as required in practice even if it's technically a contract term rather than a law. See drivers and training standards for a broader look at what brokers commonly check during driver file review.

How does Georgia Medicaid provider enrollment actually work?

Georgia Medicaid provider enrollment happens through GAMMIS, the state's Medicaid Management Information System portal, administered by the Department of Community Health ^[4]. You'll submit business documentation (entity formation, EIN, ownership disclosure), vehicle and insurance information, and attest to program requirements. Federal Medicaid rules require "necessary transportation" access for beneficiaries as a condition of the state plan, which is why transportation providers go through a formal enrollment process rather than an informal referral system ^[1]. Processing timelines for Medicaid provider enrollment vary and DCH doesn't publish a fixed universal turnaround for transportation providers specifically, so ask the DCH provider enrollment unit directly what current volume and review times look like when you apply. Don't assume enrollment approval means you're immediately eligible to get trip assignments. Enrollment makes you a recognized Medicaid provider. Getting actual trips requires the separate broker credentialing step described below. This two-step structure (state enrollment, then broker credentialing) trips up a lot of new owner-operators who assume one application covers both.

How does broker credentialing with Modivcare work in Georgia?

Modivcare is the transportation broker contracted by Georgia DCH to manage non-emergency Medicaid transportation statewide ^[5]. Broker credentialing is a separate application from state Medicaid enrollment, and it's usually the step that takes longer and requires more documentation, because the broker is directly responsible for vehicle safety, on-time performance, and complaint tracking across its whole network. Typical Modivcare credentialing steps include: submitting a provider application, uploading proof of insurance meeting broker minimums, vehicle inspection documentation, driver files (license, background check, training certificates), and agreeing to the broker's trip documentation and billing procedures. Some regions periodically pause new provider onboarding when network capacity is already sufficient for member demand, so confirm directly with Modivcare's Georgia provider relations team whether the region you plan to serve is currently accepting new applications before you finalize a vehicle purchase. Expect the broker to specify its own trip verification method (GPS-based mobile app check-in, electronic visit verification, or a paper log system depending on region) and its own billing cycle and reimbursement rate schedule, which is typically not identical to the state Medicaid ambulance or NEMT fee schedule. Get the current rate sheet and payment terms in writing from Modivcare before assuming any specific trip pays a specific amount, since broker rates are contract terms that change and this article makes no earnings claims. For a side-by-side look at how different states structure broker relationships, see nemt transportation and non emergency medical transportation services.

Georgia NEMT setup at a glance

Requirement	Who sets it	What's typically needed
Business registration	Georgia Secretary of State	LLC or corp filing, registered agent
Federal tax ID	IRS	EIN for the business entity
Local business license	City/county	Varies; some regulate vehicles for hire
Medicaid provider enrollment	Georgia DCH (GAMMIS)	Entity docs, ownership disclosure, attestation
Broker credentialing	Modivcare (Georgia's NEMT broker)	Insurance proof, vehicle inspection, driver files
Vehicle standards	ADA + broker inspection	Working lift/ramp, securement, age limits
Driver requirements	State + broker	GA license, background check, CPR, PASS training
Insurance	Broker minimums, state financial responsibility floor	Commercial auto ($25k/$50k GA floor, brokers require much more), general liability	Confirm every cell in this table directly with DCH and Modivcare before you spend money, since broker requirements and regional capacity change without much public notice.

What does it cost to get started, and where do people overspend?

There's no single official "cost to start NEMT in Georgia" figure published by any state agency, and anyone quoting you an exact all-in number is guessing. Your real costs are the vehicle (a used ADA-compliant wheelchair van typically costs more than a comparable non-accessible van because of the lift and securement hardware), commercial insurance premiums, business registration fees, and whatever training or certification courses the broker requires. The most common overspend is buying the vehicle before confirming insurance cost and broker vehicle-age limits. The second most common mistake is treating Medicaid enrollment as the finish line and being surprised that broker credentialing is a separate, often slower process. Build your budget and timeline around both steps happening, more than one. If you want a structured way to walk through both the state enrollment paperwork and broker credentialing paperwork without missing a step, the RideCredential Launch Kit Builder ($199 one-time) packages the state and broker application checklists together; it's a reference tool, not a guarantee of approval by DCH or Modivcare. You can start at /launch-kit-builder.

What documentation should you keep once you're credentialed and running trips?

Once you're moving members, keep a trip log for every ride: pickup and drop-off time, mileage, member identifier, and any incident notes, because brokers audit this documentation regularly and Medicaid programs generally require records retention for several years (confirm the exact retention period with DCH, since federal Medicaid record retention guidance and state-specific rules can differ). Keep insurance certificates current and file renewals before expiration, since a lapsed certificate is one of the fastest ways to get suspended from a broker network mid-contract. Keep driver files updated too: license renewal dates, background check refresh cycles (some brokers require rechecks every one to three years), and training certification expirations. A single expired credential on a driver file can flag your whole account during a broker audit. For a general primer on how NEMT businesses structure day-to-day compliance recordkeeping, see medical transportation and emergency medical transport if you're weighing whether to eventually add urgent or stretcher-level service.

Frequently asked questions

How do I start a medical transportation business in Georgia?

Register a business entity with the Georgia Secretary of State, get an EIN, secure commercial auto and general liability insurance, buy or lease an ADA-compliant vehicle, meet driver requirements (license, background check, CPR), then enroll as a Georgia Medicaid provider through DCH's GAMMIS portal and separately get credentialed with Modivcare, the state's NEMT broker.

Does Medicaid cover ambulance rides in Georgia?

Yes. Georgia Medicaid covers ambulance transportation when a beneficiary's condition requires emergency or urgent transport, billed separately from routine NEMT trips. This is distinct from non-emergency medical transportation (NEMT), which covers scheduled rides for stable members who don't need EMT-level care.

What is non-emergency medical transportation (NEMT)?

NEMT is scheduled, non-emergency transport to medical appointments for people, often Medicaid members, who can't drive themselves and have no other transportation option. It includes ambulatory sedan/van trips and wheelchair-accessible van trips, and it's federally required under Medicaid's transportation assurance rule at 42 CFR 431.53.

Does Medicare cover medical transportation?

Original Medicare covers ambulance transportation only when other transport would endanger the patient's health; it generally does not cover routine non-emergency rides to appointments. Some Medicare Advantage plans add NEMT-style transportation as a supplemental benefit, and those trips sometimes route through the same brokers used for Medicaid, so confirm coverage details directly with the specific plan.

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

The requirements are the same as a larger fleet: business registration, insurance, an ADA-compliant vehicle if doing wheelchair transport, driver qualifications, Medicaid enrollment, and broker credentialing. The difference is workload; a solo operator handles driving, dispatch, and documentation alone, so plan for vehicle downtime and backup coverage before your first credentialing application.

What licenses does Georgia require to start an NEMT business?

Georgia doesn't have a standalone state NEMT license. You need a registered business entity, a federal EIN, possibly a local city/county business license depending on vehicle-for-hire ordinances, Medicaid provider enrollment through DCH's GAMMIS system, and broker credentialing with Modivcare, Georgia's NEMT transportation broker.

How much insurance does a Georgia NEMT vehicle need?

Georgia's general financial responsibility minimum is $25,000 per person/$50,000 per accident bodily injury and $25,000 property damage, but that's a floor for any vehicle, not an NEMT standard. Brokers typically require much higher commercial auto limits, often $1 million combined single limit, so confirm exact minimums with Modivcare before buying a policy.

Do NEMT drivers need a CDL in Georgia?

Standard wheelchair vans and sedans used for NEMT generally don't require a Commercial Driver's License, since they fall below the weight thresholds that trigger CDL rules. Larger cutaway or stretcher vans may cross those thresholds, so confirm vehicle-specific licensing requirements with the Georgia Department of Driver Services before buying a bigger vehicle.

Is Medicaid enrollment the same as broker credentialing in Georgia?

No. Medicaid provider enrollment through DCH's GAMMIS portal makes you a recognized Georgia Medicaid provider. Broker credentialing with Modivcare is a separate application covering insurance proof, vehicle inspection, and driver files, and it's required to actually receive trip assignments. Completing one doesn't automatically complete the other.

What vehicle standards does a wheelchair van need to meet in Georgia NEMT?

Wheelchair vans need to meet ADA accessibility standards: a working lift or ramp, four-point wheelchair securement, functioning lap/shoulder belts for the wheelchair position, and adequate interior clearance. Brokers add their own inspection requirements on top, often including vehicle age limits and current state inspection certificates, so confirm the specific checklist with Modivcare.

How long does it take to get credentialed as an NEMT provider in Georgia?

There's no single published timeline; Medicaid enrollment and broker credentialing are reviewed separately and processing time depends on application volume and completeness. Ask DCH's provider enrollment unit and Modivcare's Georgia provider relations team directly for current turnaround estimates before setting a launch date.

Can I run an NEMT business in Georgia without a Medicaid contract?

Yes, some NEMT operators work private-pay trips, contracts with assisted living facilities, or Medicare Advantage transportation benefits without ever enrolling in Georgia Medicaid. But most owner-operator NEMT demand in Georgia flows through Medicaid via Modivcare, so skipping that enrollment usually means a much smaller pool of available trips.

Sources

1. 42 CFR 431.53, Assurance of transportation: Federal Medicaid law requires states to ensure necessary transportation for beneficiaries to and from providers
2. Medicaid.gov, Non-Emergency Medical Transportation: Ambulance services and NEMT are administered as distinct Medicaid benefits with separate billing and staffing requirements
3. Medicare.gov, Ambulance Services coverage: Medicare covers ambulance transportation only when other transportation would endanger health, and generally doesn't cover routine non-emergency rides
4. ADA.gov, ADA Standards for Accessible Design: Wheelchair-accessible vehicles providing public transportation service must meet ADA accessibility design standards
5. Georgia Code Title 40, Chapter 9, Motor Vehicle Accident Reparations: Georgia's minimum financial responsibility auto liability limits are $25,000 per person/$50,000 per accident bodily injury and $25,000 property damage