How to start a NEMT business in Alabama: the state-run NET program
Alabama has no NEMT broker. The Alabama Medicaid Agency runs the Non-Emergency Transportation (NET) program itself through a call center and 10 district offices. Members book through Medicaid at least five days ahead, choose a transporter from Medicaid's directory, and Medicaid pays only after the matching medical visit is billed. To get trips, you get approved as a NET transporter, follow the federal driver rules in Alabama's NET rules, and document every ride on Medicaid's forms.
Alabama NEMT at a glance
- Runs the program
- Alabama Medicaid Agency
- Program
- Non-Emergency Transportation (NET) program
- How rides are arranged
- No broker: providers bill Medicaid directly. No broker. Alabama Medicaid's own NET staff approve every trip, and Medicaid pays the member or the approved transporter directly once it receives an approved claim for the medical visit.
- Brokers you will contract with
- None. Alabama Medicaid NET program (call center 800-362-1504, option 4)
- State operating license
- No NEMT-specific license. The Public Service Commission requires a certificate or permit to carry passengers for pay within Alabama unless the law exempts the service, and Alabama Medicaid approves transporters for its NET directory.
- EVV for NEMT trips
- Not required
- Medicaid enrollment
- 734,652 (May 2026, Medicaid only)
On this page
How Medicaid NEMT works in Alabama
Chapter 18 of the Alabama Medicaid Administrative Code makes NET an administrative service run by agency staff. Regional NET coordinators and central office staff check eligibility and the appointment, look for free transportation first, pick the least costly appropriate mode, and issue a prior authorization number for each trip.
Members call the NET call center at 800-362-1504 (option 4), Monday through Friday from 8 a.m. to 4:30 p.m., at least five days before the appointment or within 24 hours after urgent care. They receive a seven-digit request number, and they can ask for transporters that serve their county. The member chooses the transporter.
Payment follows the medical claim. When the doctor, clinic, or dialysis unit bills Medicaid for the visit, NET pays the transportation automatically, either onto the member's EBT Transportation card or to the transporter. NET staff cannot override that match. Conduent, the agency's payment vendor, builds transporter pay files on the 1st and 16th of each month and sends funds to banks on the 2nd and 17th.
Governing rule:Alabama Medicaid Administrative Code, Chapter 18: Transportation Services (Rules 560-X-18-.16 to .25)
Who brokers Medicaid rides in Alabama
There is no broker to credential with. The Medicaid agency's own district offices coordinate trips, and each covers a set of counties.
| Broker | Serves | Provider sign-up |
|---|---|---|
| Alabama Medicaid NET program (statewide) | All full-Medicaid members statewide. Ten district offices coordinate trips: Auburn/Opelika, Birmingham, Decatur, Dothan, Florence, Gadsden, Mobile, Montgomery, Selma, and Tuscaloosa. | Provider pageNET call center 800-362-1504, option 4 |
District office coverage (NET coordinators list, July 2026): Birmingham serves Jefferson County. Mobile serves Baldwin, Clarke, Conecuh, Escambia, Mobile, and Washington. Tuscaloosa serves Greene, Hale, Pickens, Sumter, and Tuscaloosa. Montgomery serves Autauga, Bullock, Elmore, and Montgomery. The full county list for each office is in the NET coordinators list under official resources.
Stretcher trips are not part of NET. Alabama Medicaid covers them as non-emergency ambulance service under separate ambulance rules.
How to become a NEMT provider in Alabama
Because Alabama pays through its own NET program, the path is agency approval, clean driver files, and complete trip paperwork rather than broker credentialing.
Form the business
Register with the Alabama Secretary of State and get a federal EIN. Use the same legal name on everything you give the Medicaid agency. Carrying passengers for pay between points in Alabama needs a Public Service Commission certificate or permit unless the law exempts you. The passenger carrier application is Form 14, with a $100 filing fee.
Alabama Public Service Commission: Motor carrier applications and forms
Meet the federal provider and driver rules
Rule 560-X-18-.25, effective July 15, 2022, requires that neither the company nor any driver is excluded from federal health care programs or on the HHS Inspector General exclusion list, that every driver has a valid license, and that you have processes for handling drug law violations and for disclosing each driver's driving history to Medicaid.
Get approved as a NET transporter
Ask the NET program or the district office that covers your counties how to be approved. Once Alabama Medicaid approves a transporter, it adds the company to the NET Transporters Directory, which the call center uses when members ask for transporters in their county. The rules direct NET staff to keep information on certified and licensed transporters.
Alabama Medicaid: NET coordinators by district office and counties served
Document every trip on Medicaid's forms
Submit the Transporter Trip Validation Log (Form 174). Each line records the member, the request number, the time, the destination, wheelchair use, and the member's and transporter's signatures, and you attest that it was signed on the date of the visit. Dialysis units certify monthly treatment dates on Form 173. Wheelchair trips are paid only when a physician's Form 177 is on file.
Know what NET will not pay for
NET does not pay transporters for trips to methadone clinics, does not cover stretcher transport, and does not pay when free transportation is available. Minibus and wheelchair van trips are not covered more than 30 miles past the state line, and the limit is one round trip per member per date of service without an approved exception.
Alabama Medicaid: Non-Emergency Transportation procedures (July 10, 2025)
Vehicle and driver requirements in Alabama
Alabama's NET rules focus on who may ride and how trips are proved, plus the federal driver screens. There is no broker, so there is no broker contract layer on top.
Vehicles
| Requirement | State rule | Broker contract |
|---|---|---|
| Covered modes | Volunteer, family, or the member's own car, minibus, wheelchair van, commercial or city bus, train, air, and ambulance, always the least costly mode that fits the member (Rule 560-X-18-.22). | No broker in Alabama. |
| Wheelchair vans | Paid only with a physician's Wheelchair Use Certification (Form 177) on file. Escorts in wheelchair vans need prior approval. | No broker in Alabama. |
| Distance limits | Minibus and wheelchair van trips are not covered beyond 30 miles past the state line. Care more than 100 miles from home needs approval and medical documentation. | No broker in Alabama. |
| Stretcher transport | NET does not reimburse stretcher transport. Stretcher trips go by ambulance, which Medicaid pays fee-for-service under the ambulance rules, 560-X-18-.01 to .15. | No broker in Alabama. |
Drivers
| Requirement | State rule | Broker contract |
|---|---|---|
| Exclusion screening | Company and drivers must not be excluded from federal health care programs or listed by the HHS Inspector General (Rule 560-X-18-.25). | No broker in Alabama. |
| Driver license | Every driver holds a valid license (Rule 560-X-18-.25). | No broker in Alabama. |
| Drug law and driving history | A process to address a driver's state drug law violations, and a process to disclose each driver's driving history and traffic violations to Medicaid (Rule 560-X-18-.25). | No broker in Alabama. |
| Escorts | One escort per member, usually a relative, guardian, or volunteer, and never the transporter's employee. Members 21 and older need a physician's statement; members under 21 may have one without it (Rule 560-X-18-.20). | No broker in Alabama. |
Insurance minimums in Alabama
Alabama's NET rules set no insurance minimum. Carriers the Public Service Commission regulates must file and maintain proof of liability insurance with the commission.
| Coverage | Minimum | Set by |
|---|---|---|
| NEMT-specific minimum | None in Chapter 18 NET rules | Ala. Admin. Code 560-X-18 |
| Motor carriers regulated by the PSC | Proof of liability insurance filed and maintained with the commission | Alabama Public Service Commission, Motor Carrier Services Section |
Does Alabama require EVV for NEMT?
No. Alabama requires EVV for Medicaid personal care and home health services under the 21st Century Cures Act. NET is not covered.
NET proves trips differently. Every trip needs a request number issued before the ride, the transporter's log (Form 174) signed by the member and the transporter on the visit date, and a matching medical claim from the doctor or facility, because Medicaid pays transportation only after it receives an approved claim for the visit. Dialysis units attest treatment dates on Form 173, and NET staff run retrospective reviews of reimbursements.
Alabama Medicaid: Electronic Visit Verification (EVV) System
What changed in Alabama in 2025 and 2026
Alabama had 734,652 people on Medicaid in May 2026, and 933,487 counting CHIP (CMS preliminary data). NET serves members with full Medicaid coverage on the date of the appointment.
The program leans on reimbursement rather than contracted fleets. Medicaid pays mileage to members who drive or ride with family, friends, or volunteers, and pays approved transporters for the rest. Rule 560-X-18-.18 uses a tiered payment structure based on mileage, the member's condition, the mode, and prevailing regional rates. Transporters are paid twice a month. Medical providers have one year to bill Medicaid, and the ride is paid once Medicaid receives an approved claim for the visit.
Recent changes are procedural. Alabama Medicaid revised its NET procedures on July 10, 2025, the wheelchair certification (Form 177) on November 14, 2025, and the dialysis validation and transporter trip log forms (Forms 173 and 174) on December 2, 2025. The district office coordinators list was updated in July 2026.
Rule 560-X-18-.25 takes effect, adding the federal NET provider and driver requirements from the Consolidated Appropriations Act, 2021.
An amended escort rule takes effect. The rule caps meals and lodging for overnight medical travel at $50 per person per day.
Alabama Medicaid publishes revised NET procedures, including the transporter pay schedule.
Form 177, the physician wheelchair use certification required for wheelchair trips, is revised.
The Dialysis Validation Form (173) and Transporter Trip Validation Log (174) are revised.
Alabama Medicaid updates its list of NET coordinators by district office and county.
Frequently asked questions
- Who is the NEMT broker in Alabama?
- There is none. The Alabama Medicaid Agency runs the Non-Emergency Transportation (NET) program itself through its call center, 800-362-1504 (option 4), and 10 district offices. Members choose a transporter from Medicaid's NET Transporters Directory.
- How do NEMT transporters get paid in Alabama?
- Medicaid pays the ride after the doctor or facility bills Medicaid for the visit, either onto the member's EBT Transportation card or to the transporter. Transporter pay files are built on the 1st and 16th of each month and funds reach banks on the 2nd and 17th. The trip also needs a request number issued before the ride.
- How do I become a Medicaid transportation provider in Alabama?
- Contact the NET program or your district NET office to be approved as a transporter. Approved transporters are added to the NET Transporters Directory. Meet the federal requirements in Rule 560-X-18-.25: no excluded owners or drivers, valid driver licenses, and processes for drug law violations and driving history disclosure.
- Does Alabama Medicaid pay for stretcher transport?
- Not through NET. Stretcher trips are covered as non-emergency ambulance service under Alabama Medicaid's ambulance rules. NET covers cars, minibuses, wheelchair vans, buses, trains, and air travel.
- What paperwork does Alabama NET require for a wheelchair trip?
- A physician's Wheelchair Use Certification (Form 177) must be on file before Medicaid pays for wheelchair transportation. The physician's office emails it to the NET program. Each trip is also logged on Form 174 with a wheelchair column.
- How far in advance do Alabama Medicaid members book rides?
- At least five days before the appointment, or within 24 hours after an urgent or emergency visit. Members who miss that window are not eligible for reimbursement for the trip.
- Does Alabama require EVV for NEMT?
- No. Alabama's EVV applies to Medicaid personal care and home health services. NET trips are proved by a prior request number, the signed trip log, and the matching medical claim.
- Does Alabama Medicaid pay transporters for methadone clinic trips?
- No. Members going to methadone treatment centers use personal transportation and are reimbursed monthly after their social worker or case manager confirms attendance.
Running NEMT in Alabama with HealthRide
In Alabama the paperwork decides whether a ride is paid: a request number before the trip and a log signed by the member and driver on the day. HealthRide captures signatures on screen in the driver app and exports the trip log as CSV or PDF.
Recurring trips cover weekly dialysis schedules, and every payment, whichever payer it came from, lands in one ledger.
Official resources
- Alabama Medicaid: Transportation services
- Alabama Medicaid: Non-Emergency Transportation procedures (July 10, 2025)
- Alabama Medicaid: Frequently asked questions about NET
- Alabama Medicaid: NET coordinators by district office and counties served
- Alabama Medicaid Administrative Code, Chapter 18: Transportation Services
- Alabama Medicaid: NET Dialysis Validation Form 173
- Alabama Medicaid: NET Transporter Trip Validation Log, Form 174
- Alabama Medicaid: NET Wheelchair Use Certification, Form 177
- Alabama Medicaid: Electronic Visit Verification (EVV) System
- Alabama Public Service Commission: Motor Carrier Services Section
- Alabama Public Service Commission: Motor carrier applications and forms
- CMS: State Medicaid and CHIP applications, eligibility determinations, and enrollment data
HealthRide plans the whole day in one click and bills every ride.
$59 per vehicle per month. No contracts.