What is a NEMT broker and what does it do?
A NEMT broker is a company or public agency that manages Medicaid rides for a state or a health plan. It takes ride requests, confirms the rider qualifies, picks the mode of transport, and assigns the trip to a credentialed transportation provider in its network. The broker usually pays the provider too. Federal rules for state broker programs sit in 42 CFR 440.170(a)(4).
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What a NEMT broker does
A broker sits between whoever pays for Medicaid rides and the fleets that drive them. Its daily work runs in a fixed order:
- Takes the request. Riders, caregivers, and facilities book by phone, app, or web portal.
- Checks the trip. The broker confirms the rider is eligible and the destination is a covered service.
- Picks the mode. Options run from a bus pass or mileage reimbursement up to a wheelchair van or stretcher.
- Assigns the trip. A credentialed provider in the network gets the ride, often through the broker’s portal or app.
- Oversees and pays. The broker handles complaints, monitors trips, and pays providers for completed work.
In Georgia, every NEMT ride must be scheduled and authorized by the broker. Because of the federal conflict-of-interest rule below, state brokers generally do not run their own vehicles. New York’s broker, Medical Answering Services (MAS), has none and does not compete with the fleets in its network.
The federal rules behind broker programs
42 CFR 440.170(a)(4) lets a state run NEMT through a broker without meeting the usual statewide, freedom-of-choice, and comparability rules. In exchange, the broker contract must:
- Be awarded through competitive bidding that weighs experience, performance, references, resources, qualifications, and cost.
- Include oversight of rider access, complaints, timeliness, and whether drivers are licensed, qualified, and courteous.
- Bar the broker from steering trips to providers it has a financial tie to, with narrow exceptions.
Providers may not pay a broker anything to win referrals. CMS also expects states to watch broker rates, so a broker cannot pay so little that local fleets refuse to join.
Who hires the broker
| Arrangement | Hired by | Example |
|---|---|---|
| One statewide broker | State Medicaid agency | New York: MAS statewide, with Nassau and Suffolk counties added December 1, 2023 |
| Regional brokers | State Medicaid agency | Georgia: five regions, all served by Verida from April 1, 2026 |
| Plan brokers | Each managed care plan | California: Health Net contracts with Modivcare for Medi-Cal rides, except for members whose physician group carries the transportation risk |
| Moving to one broker | State Medicaid agency | Colorado: MediDrive in the nine Denver metro counties since July 1, 2026, and statewide from January 1, 2027 |
A broker trip, start to finish
Colorado’s MediDrive model shows the steps. A member books through the MediDrive app, the online portal, or the call center. MediDrive checks the member’s identity and confirms the trip qualifies: it goes to a covered service, it is the least costly option, and the member has no car, transit, or free ride available. MediDrive then assigns the trip to a provider whose vehicles run on its trip system and who has room in the schedule. The MediDrive broker guide and the Colorado NEMT guide cover the transition in more detail.
Broker vs nearby terms
- Managed care organization: the health plan responsible for a member’s care. It may hire a broker to run rides.
- Transportation provider: the fleet that does the driving under the broker’s contract.
- Taxonomy code: brokers identify as 347E00000X, Transportation Broker, in the NUCC taxonomy code set.
Broker profiles, including Modivcare, Verida, and MAS, are in the broker directory.
HealthRide puts every trip on one dispatch board, whoever pays for it, and records every payment in one ledger.
Frequently asked questions
- Do NEMT brokers pay transportation providers directly?
- In most broker programs, yes. The provider bills the broker for completed trips under its provider agreement. New York works differently. Its broker, Medical Answering Services, authorizes each trip, and the provider bills eMedNY, the state Medicaid claims system, using the prior authorization number the trip generates.
- Can a NEMT broker run its own vans?
- Generally no. A state broker contract must bar the broker from providing trips itself or sending trips to providers it has a financial relationship with. The federal rule allows narrow exceptions, such as rural areas with no other qualified provider, highly specialized transport, a shortage of other providers, and government brokers.
- How does a fleet join a broker network?
- Enroll with your state Medicaid program if the state requires it, then apply to the broker and pass its credentialing. Colorado spells out the order. New providers enroll with the state as NEMT provider type 73, then contract with MediDrive, which credentials the company, vehicles, and drivers before assigning trips.
