NEMT driver pay: BLS wage data, pay structures, and the wage rules that apply
BLS has no separate NEMT driver category. The closest match, shuttle drivers and chauffeurs, earned a median $17.93 an hour in May 2025, with the 10th percentile at $13.51 and the 90th at $26.47. In other transit and ground passenger transportation, the industry group that includes special needs transportation, the same job averaged $19.44 an hour. Any pay structure must still meet minimum wage and overtime rules.
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What NEMT drivers earn, by BLS data
The Bureau of Labor Statistics does not publish a separate NEMT driver occupation. Three occupations cover the work, and the May 2025 Occupational Employment and Wage Statistics release, the most recent available, reports them nationally.
| Occupation (SOC code) | Employed | 10th percentile | Median | Mean | 90th percentile | Annual median |
|---|---|---|---|---|---|---|
| Shuttle drivers and chauffeurs (53-3053) | 248,530 | $13.51 | $17.93 | $19.17 | $26.47 | $37,290 |
| Taxi drivers (53-3054) | 41,050 | $16.66 | $20.24 | $24.01 | $36.44 | $42,100 |
| Ambulance drivers and attendants, except EMTs (53-3011) | 12,630 | $13.15 | $17.04 | $17.41 | $22.10 | $35,450 |
Shuttle drivers and chauffeurs is the closest match for an employee who drives an NEMT sedan, minivan, or wheelchair van. Ambulance drivers and attendants who are not EMTs are the closest match for stretcher van crews at companies that also run ambulances.
Pay by industry
Where a driver works changes the average. BLS also breaks the shuttle driver and chauffeur occupation out by industry. Other transit and ground passenger transportation (NAICS 4859) is the industry group that includes special needs transportation, NAICS 485991, which covers transportation for the disabled or elderly, other than to and from school or work.
| Industry, May 2025 | Shuttle drivers and chauffeurs employed | Mean hourly | Median hourly |
|---|---|---|---|
| Other transit and ground passenger transportation (4859) | 61,520 | $19.44 | $18.09 |
| Taxi and limousine service (4853) | 25,960 | $21.78 | $20.79 |
| Nursing and residential care facilities (623) | 19,370 | $18.59 | $18.02 |
| Individual and family services (6241) | 19,280 | $17.13 | $17.07 |
| Other ambulatory health care services (6219) | 3,130 | $17.91 | $17.57 |
For ambulance drivers and attendants who are not EMTs, the mean in other ambulatory health care services (6219) was $16.86 an hour, across 9,030 jobs.
Treat these as national benchmarks. Your local market, shift times, and the work involved matter more. A driver who lifts, secures wheelchairs, and starts at 4:30 a.m. for dialysis runs is doing a different job from an airport shuttle driver.
How NEMT companies structure driver pay
These are the five common pay structures. Each shifts risk between you and the driver.
| Structure | How it works | Works well when | Watch out for |
|---|---|---|---|
| Hourly | A rate for every hour on the clock | Trip volume and wait times vary a lot | You pay for slow hours, so dispatch has to fill the day |
| Per trip | A fixed amount per completed leg | Trips are short and steady | Long waits and deadhead drag pay below minimum wage |
| Commission | A percentage of what each trip bills | Rates are stable and trips are mostly private pay | Pay swings with payer rates, and commissions still count in the overtime rate |
| Hourly plus trip bonus | A lower hourly base plus a small amount per trip | You want to reward productivity with a floor | More complex to explain and check |
| Salary | A fixed weekly amount | Supervisors and lead drivers | Overtime rules still apply to non-exempt drivers |
Whatever you choose, write it down and explain how waiting, no-shows, and deadhead miles are paid. Federal recordkeeping rules also require you to keep each employee’s hours worked each workday and workweek, straight-time earnings, overtime premium, and total wages for each pay period.
The wage rules that apply to drivers
Federal rules set the floor for employees, and state rules can be higher.
- Minimum wage. The federal minimum wage is $7.25 an hour, in effect since July 24, 2009. Many states set higher minimums, and employers must comply with both.
- Overtime. Nonexempt workers must get at least one and one-half times their regular rate for hours over 40 in a workweek.
- Motor carrier exemption. The FLSA overtime exemption in section 13(b)(1) applies only to employees within the Secretary of Transportation’s authority. The small vehicle exception keeps overtime for work on vehicles weighing 10,000 pounds or less, except vehicles designed or used to carry more than 8 passengers, including the driver, for compensation.
- Per-trip pay. Pay per trip is a piece rate. Minimum wage is measured across the workweek, so pay for the week divided by all hours worked must reach at least the minimum. For overtime, the regular rate is total weekly earnings, including any pay for waiting time, divided by all hours worked, and overtime hours earn an extra half of that rate.
- Commissions. A percentage of trip revenue is a commission, and DOL rules count commissions in the regular rate used for overtime.
State and local law can add more, so check your state labor department.
Wait time: when it counts as work
Waiting is a big share of an NEMT driver’s day, so the rule matters. Federal hours worked rules turn on who controls the time.
| Situation | Work time? | Rule |
|---|---|---|
| Driver waits at the clinic for a return trip and must stay ready | Yes | Engaged to wait, 29 CFR 785.15 |
| Driver is told they are free until a set time, and the gap is long enough to use for themselves | No | Off duty, 29 CFR 785.16 |
| Driver must stay at the base or so close they cannot use the time freely | Yes | On-call on premises, 29 CFR 785.17 |
| Driver is home and only has to be reachable | No | On-call off premises, 29 CFR 785.17 |
The facts decide each case. When in doubt, pay for the time, and design schedules so drivers are clearly released between runs.
Example: comparing two pay plans
This is a hypothetical with round numbers for easy math, not a market rate. A driver works 45 hours in a week and completes 40 trips.
| Hourly at $18 | Per trip at $20 | |
|---|---|---|
| Straight-time pay | 45 hours x $18 = $810 | 40 trips x $20 = $800 |
| Regular rate | $18.00 | $800 / 45 hours = $17.78 |
| Overtime premium for 5 hours | 5 x $9.00 = $45 | 5 x $8.89 = $44.44 |
| Weekly total | $855 | $844.44 |
| Cost per trip | $21.38 | $21.11 |
The plans cost about the same in a busy week. In a slow week with long waits, the per-trip plan pays the driver less, and you still owe at least the minimum wage for every hour. Use the profit per vehicle calculator to see what driver pay does to your margins, and the guide to how much an NEMT business makes for the rest of the cost picture.
Employee or contractor
Paying per trip does not make a driver a contractor. Classification depends on how the work is actually controlled. DOL’s 2024 rule on employee or independent contractor status took effect March 11, 2024, and DOL published a new proposed rule on February 27, 2026. States can apply stricter tests. Get advice before you classify drivers as contractors, and see our guide on hiring NEMT drivers for the rest of the hiring paperwork.
Payroll prep in HealthRide
HealthRide keeps driver timecards and exports hours and miles, so payroll prep happens without the spreadsheets. Driver and timecard reports show hours and on-time performance for each driver, so pay questions start from the same record.
Frequently asked questions
- How much do NEMT drivers make an hour?
- BLS does not track NEMT drivers separately. For shuttle drivers and chauffeurs, the closest occupation, the May 2025 national median was $17.93 an hour and the mean was $19.17, or a median of $37,290 a year. Pay varies by state, city, and vehicle type, so compare local job posts before you set a rate.
- Can I pay NEMT drivers per trip?
- Yes, if you still meet federal and state wage rules for employees. Federal rules treat per-trip pay as a piece rate. Total weekly pay, including any pay for waiting time, is divided by all hours worked to get the regular rate, and that rate has to reach at least the minimum wage for every hour in the workweek. Hours over 40 earn an extra half of the regular rate.
- Do NEMT drivers get paid for waiting time?
- Often, yes. Under 29 CFR 785.15, an employee who must wait as part of the job is engaged to wait, and that time is work time. Time is not work time only when the driver is completely relieved of duty, told in advance they can leave and when to return, and the break is long enough to use for their own purposes.
- Are NEMT drivers owed overtime?
- Usually. The FLSA motor carrier exemption applies only to employees under the Secretary of Transportation's authority, and the small vehicle exception keeps overtime for work on vehicles of 10,000 pounds or less. That exception does not apply to vehicles designed or used to carry more than 8 passengers, including the driver, for compensation, so check larger vans with an employment attorney.
- What do ambulance drivers who are not EMTs make?
- BLS tracks them as ambulance drivers and attendants, except emergency medical technicians. In May 2025 the national median was $17.04 an hour and the mean was $17.41, with 12,630 people employed. In other ambulatory health care services, the industry that includes ambulance companies, the mean was $16.86.
