How to Start a NEMT Business in Florida

Florida issues no state-wide 'NEMT license,' which surprises new operators. Instead you are stacking several requirements: a business entity, transportation-disadvantaged registration, commercial insurance, driver credentialing, and contracts with the Medicaid managed-care plans or a broker. Here is the order that gets you paid the fastest.

1. Form a business entity

Register an LLC or S-Corp with the Florida Division of Corporations (Sunbiz). Obtain a federal EIN. Open a dedicated business bank account — commingling personal and business funds voids most insurance and audit defenses.

2. Register with the Commission for the Transportation Disadvantaged

Every Florida county has a Community Transportation Coordinator (CTC). To carry Medicaid-funded passengers you either become the CTC (rare), operate as a coordinated contractor, or subcontract to the CTC as a coordinated Community Transportation Provider (CTP). Contact your county's CTC first — the application, insurance minimums, and drug-testing requirements are set locally.

3. Buy commercial insurance

Minimum requirements in most Florida counties: $300,000 combined single-limit auto liability, $1M general liability, workers' compensation for W-2 drivers, and umbrella coverage that most contracts require at $1M. Sedan-only operators can sometimes start at $100,000, but no managed-care plan will contract without $1M.

4. Buy or lease vehicles

Start with what your first contract requires. A wheelchair-accessible cutaway van runs $65,000-$110,000 new; a used lift-equipped minivan can be sourced for $25,000-$40,000. Do not skip a pre-purchase inspection of the lift and tie-down anchors.

5. Credential drivers

• Class E Florida driver license minimum; CDL not required for sub-15-passenger vehicles
• Level 2 background check (FDLE + FBI)
• DOT physical (Medical Examiner's Certificate)
• Pre-employment and random drug testing per DOT 49 CFR Part 40
• Defensive driving certification
• PASS or equivalent passenger-assistance training
• CPR and first aid

6. Contract with the plans

Florida Medicaid transportation flows through six managed-care plans (Sunshine, Simply, Molina, Aetna Better Health, Humana, United) and their transportation brokers (typically Access2Care, ModivCare, or MTM). Each broker has its own credentialing packet, rate sheet, and IVR/dispatch platform. Expect 60-120 days to complete credentialing.

7. Build a billing workflow

Most My Florida NEMT is billed as trip records to the broker, not CMS-1500 claims. Payment is per-loaded-mile plus a base rate, with add-ons for wheelchair, additional attendants, and after-hours pickups. Set up trip verification (signature capture, GPS breadcrumbs, timestamps) from day one — brokers deny claims without them.