Transportation · LLC guide · updated
How to start a medical transportation business and form its LLC
An NEMT LLC enrolls with the state Medicaid program or its broker, which sets vehicle, driver and insurance standards. Interstate vehicles for 9 or more people need a USDOT number, and DOT's ADA rules apply. As of October 2026.
To start a medical transportation business, form an LLC in your state and get its EIN. Then line up what this business needs on top of that: Medicaid enrollment, commercial auto, wheelchair-accessible vehicle, and USDOT if interstate. Insurance to plan for: general liability and workers' compensation.
Registered agent service, provided through our partner Registered Agents Inc, is optional: $74.25 a year, the same at renewal. Questions first? Ray or Vinny picks up at (954) 470-8356.
- EIN
- Medicaid enrollment
- Commercial auto
- Wheelchair-accessible vehicle
- USDOT if interstate
Non-Emergency Medical Transportation (NEMT) businesses in the U.S.
Source: U.S. Census Bureau, County Business Patterns 2022 (NAICS 485991) and U.S. Census Bureau, Nonemployer Statistics 2022 (NAICS 48599), the latest U.S. totals.
Why non-emergency medical transportation business owners form an LLC
NEMT companies drive patients who use wheelchairs or have no ride to dialysis, therapy and doctor visits, often paid by Medicaid through a state broker. Passenger injuries, wheelchair securement failures and billing errors are the major risks. An LLC holds the Medicaid enrollment, the broker contract and the vehicles.
Passenger injuries
Falls during transfers and wheelchair securement failures.
Vehicle accidents
Passenger-carrying vehicles need higher liability limits.
Medicaid billing
Billing for trips not taken or not documented can mean repayment and fraud claims.
An LLC keeps the company's debts and claims away from your personal assets when you run it as its own business: its own bank account, contracts signed in its name, and no mixing of money. It does not cover your own negligence, and lenders often ask for a personal guarantee. Insurance comes first.
Licenses and registrations for a non-emergency medical transportation business
Federal items link to the agency's own page. State and local rules vary, so pick your state at the top for your state's business portal. Tick items off as you go; the list remembers your progress on this device.
- We do thisForm the LLC and get its EINAlmost every registration above asks for the company's legal name and EIN, so this comes first. We file the LLC with your state for $123.75 plus the state fee, and can get the EIN for $41.25; the IRS also issues it free online.
Insurance and taxes to plan for
Insurance
- Commercial auto
Passenger-carrying vehicles; brokers set minimum limits.
- General liability
Covers injuries during transfers outside the vehicle.
- Workers' compensation
Drivers lift and assist passengers.
Taxes
- Vehicles
Wheelchair vans and lifts are large purchases you can depreciate.
- Drivers are usually employees
Drivers you schedule, train and put in your vans are usually employees. IRS / agency page
Most Medicaid rides flow through a broker that decides which providers it contracts with and what vehicles, drivers and insurance it requires. Learn its standards before you buy vans. This is a common pattern, not advice for your situation; an attorney in your state can tell you whether it fits.
Forming the LLC itself: 7 steps in every state
- 1. Check the name
- 2. Name a registered agent
- 3. File with the state
- 4. Sign an operating agreement
- 5. Get an EIN
- 6. Open a bank account
- 7. Keep it in good standing
The filing office, fee and yearly report change by state. Open your state's step-by-step guide.
What it costs to form a non-emergency medical transportation business LLC
| Cost | File it yourself | With Vermilion Vitez |
|---|---|---|
| State filing fee (paid to the state) | $35 to $520 | $35 to $520 |
| Filing service, operating agreement included | $0 | $123.75 |
| EIN from the IRS | $0 | $0 yourself, or $41.25 if we get it |
| Registered agent service through our partner Registered Agents Inc, per year (optional) | $0 if you serve yourself | $74.25 |
State fees as charged at our checkout. Industry licenses, permits, bonds and insurance above are separate and set by each agency. Checkout shows the card processing fee before you pay.
Frequently asked questions
How do I get NEMT contracts?
Most states send Medicaid rides through a broker. Enroll with your state Medicaid program and apply to the broker's provider network.
Do NEMT vans need a DOT number?
If vehicles designed for 9 or more people cross state lines, yes. Most NEMT trips are in-state, where state rules apply.
Do I need wheelchair-accessible vehicles?
For wheelchair trips, yes, and DOT's ADA rules cover lift and securement use.
What insurance does an NEMT business need?
Commercial auto at the broker's limits, general liability and workers' comp.
How much does it cost to form an LLC for a non-emergency medical transportation business?
Your state's filing fee ($35 to $520 depending on the state) plus $123.75 if we file it, with the operating agreement included. Industry licenses, bonds and insurance are extra and set by each agency.
Is this page legal or tax advice for my non-emergency medical transportation business?
No. It summarizes public rules in general terms, with links to the agencies that set them. For your situation, talk to a licensed attorney or CPA. For help with the filing itself, book a free call with us.
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Have us file your Non-Emergency Medical Transportation (NEMT) LLC
$123.75 plus your state's filing fee, with the operating agreement included. Checkout shows the full total, card processing fee and all, before you pay.
Rather talk first? Call Ray or Vinny at (954) 470-8356.