How to become a Medi-Cal NEMT provider in California: PAVE, permits, and rules

Updated September 2026

Medi-Cal managed care plans are responsible for their members' medical transportation, and most of them hand the work to a broker. The two largest brokers are Modivcare (Health Net, CalOptima, Anthem, and others) and Call the Car (L.A. Care, Blue Shield Promise, and IEHP's non-medical rides). Molina uses American Logistics. Providers enroll with DHCS through the PAVE portal, and since March 27, 2025 every NEMT application needs a Vehicle Safety Systems Inspection certificate. You also need a CPUC permit unless your vehicles carry only medical passengers.

California NEMT at a glance

Runs the program
California Department of Health Care Services (DHCS)
Program
Medi-Cal Non-Emergency Medical Transportation (NEMT) and Non-Medical Transportation (NMT)
How rides are arranged
Health plans each contract a broker. Each Medi-Cal managed care plan arranges NEMT and NMT for its members, usually through a broker. Fee-for-service trips need a Treatment Authorization Request first.
Brokers you will contract with
Modivcare, Call the Car, American Logistics
State operating license
DHCS enrollment through PAVE. A CPUC charter-party permit unless vehicles are used exclusively for medical transportation.
EVV for NEMT trips
Not required
Medicaid enrollment
13,910,180 (April 2026)

How Medicaid NEMT works in California

DHCS runs Medi-Cal. All Plan Letter 22-008 (May 18, 2022) makes each managed care plan responsible for both NEMT and NMT. NEMT is transport by wheelchair van, litter van, or ambulance when a member's condition makes a car, taxi, or bus medically contraindicated. NMT is ordinary car, taxi, rideshare, or transit travel to covered services. Plans may hire a broker to build the network and pay providers, but they cannot delegate oversight, grievances, utilization management, or Physician Certification Statement review, and they must be able to supplement a broker's network if it falls short.

NEMT needs a prescription and a Physician Certification Statement, valid for up to 12 months, and the plan or broker may not downgrade the mode the physician certified. There is no limit on NEMT while it is medically necessary. Hospital discharges to a nursing facility do not need a PCS and must be arranged within three hours. NMT needs plan approval but no PCS. A member who wants mileage reimbursement for a private vehicle must also attest that other transportation is exhausted.

Fee-for-service members follow the DHCS process under 22 CCR 51323: a Treatment Authorization Request and a prescription stating the medical condition that rules out ordinary transport, with the acute hospital to nursing facility transfer as the only exception. Medi-Cal pays the lowest-cost mode that meets the member's needs.

Governing rule: 22 CCR 51323: Medical transportation services

Who brokers Medicaid rides in California

Modivcare and Call the Car hold the largest plan contracts. Molina uses American Logistics, CenCal Health uses Ventura Transit System, and Kaiser and IEHP arrange NEMT themselves. The relationship is per plan, so a fleet in Los Angeles County can work with both brokers on the same block.

BrokerServesSinceProvider sign-up
Call the CarL.A. Care Health Plan and Blue Shield of California Promise Health Plan for NEMT and NMT. Inland Empire Health Plan for NMT only, since IEHP began arranging its own NEMT trips on May 12, 2026.February 1, 2023 (IEHP)Provider page
ModivcareHealth Net, CalViva Health, and California Health & Wellness, plus Anthem Blue Cross, CalOptima Health, Alameda Alliance for Health, San Francisco Health Plan, and Community Health Plan of Imperial Valley.Provider page
American LogisticsMolina Healthcare of California, statewide.
Ventura Transit SystemCenCal Health (Santa Barbara and San Luis Obispo counties).

Inland Empire Health Plan arranges all NEMT trips itself since May 12, 2026 and keeps Call the Car for NMT. Kaiser Permanente schedules Medi-Cal rides through its own regional transportation hubs. Other county plans name their own vendor, so check the plan before contracting.

How to become a NEMT provider in California

Enrollment runs through DHCS. Broker credentialing runs through each broker. A CPUC permit is a third track that applies to most fleets that do NMT or any non-medical work.

  1. 1

    Form the business and get an NPI

    Register the entity with the California Secretary of State, get a federal EIN, and apply for a National Provider Identifier for the company.

  2. 2

    Pass the Vehicle Safety Systems Inspection

    Applications received on or after March 27, 2025 must include a Vehicle Safety Systems Inspection certificate from a station licensed by the Bureau of Automotive Repair. Brake and lamp certificates are no longer accepted; AB 471 ended that program on September 27, 2024. The certificate itself costs $7 at a BAR-licensed station.

    DHCS: Updated Medi-Cal NEMT provider requirements

  3. 3

    Enroll with DHCS through PAVE

    Litter van and wheelchair van providers enroll as NEMT providers in the Provider Application and Validation for Enrollment portal. The package is the Medical Transportation Provider Application (DHCS 6206), the Provider Agreement (DHCS 6208), the Disclosure Statement (DHCS 6207), and the federal application fee, $750 for 2026. NMT is a separate, lighter enrollment (a PAVE supplemental change for existing providers, or the Medi-Cal Provider e-Form for new companies) that lists each vehicle and each driver with a California license, a DMV driving record, and federal medical examination forms MCSA-5875 and MCSA-5876.

    DHCS: PAVE provider enrollment portal

  4. 4

    Meet the wheelchair van driver and vehicle rule

    Under 22 CCR 51231.2, wheelchair van drivers hold a California driver license or Ambulance Driver Certificate, a current American Red Cross Standard First Aid and Personal Safety certificate or equivalent, and a physical exam within the past two years on DMV form DL-51. Vehicles carry current street maps and an annual safety inspection certificate, now the VSSI.

    22 CCR 51231.2: Wheelchair van requirements

  5. 5

    Decide whether you need a CPUC permit

    Vehicles used exclusively for medical transportation are exempt from CPUC authority under Public Utilities Code sections 226 and 5353. Fleets that also run NMT, ambulatory rides, or any charter work need a Charter-Party Carrier permit, usually the "P" permit for vehicles seating 15 or fewer. The application costs $1,000 and the permit renews every three years for $100. Permit holders show the TCP number on both bumpers and put every vehicle through a BAR 19-point inspection every 12 months or 50,000 miles.

    CPUC: Passenger carrier FAQs

  6. 6

    Credential with each broker

    Apply to Modivcare or Call the Car depending on which plans cover your service area. Modivcare asks for a PASS wheelchair certificate, First Aid and CPR, a defensive driving certificate, a background check, a motor vehicle record, and vehicle registration, inspection, and insurance.

    Modivcare: Transportation providers

  7. 7

    Run the CPUC driver program if you hold a permit

    Permit holders with drivers of vehicles seating 15 or fewer run a controlled substance and alcohol testing program modeled on 49 CFR Parts 40 and 382 (General Order 157-E). They also enroll every driver in the DMV Employer Pull Notice program, which went electronic-only on April 1, 2026.

    CPUC General Order 157-E

Vehicle and driver requirements in California

DHCS sets enrollment and wheelchair van rules. The CPUC sets inspection, driver testing, and insurance rules for permit holders. Brokers add their own.

Vehicles

RequirementState ruleBroker contract
Safety inspectionVehicle Safety Systems Inspection certificate from a BAR-licensed station for applications on or after March 27, 2025, and annually for wheelchair vans (22 CCR 51231.2).Broker inspection at credentialing.
Vehicle definitionsWheelchair van: for members who must ride in a wheelchair and cannot transfer unassisted. Litter van: for members who must ride prone or supine, with more space and equipment but no ambulance-level care (Medi-Cal provider manual).Same.
CPUC permit and markingsNot required for vehicles used only for medical transportation (PU Code 226 and 5353). Permit holders display the TCP number on front and rear bumpers and pass a BAR 19-point inspection every 12 months or 50,000 miles (General Order 157-E).Brokers ask for the permit where the service mix requires it.
Trip recordsRecords under 22 CCR 51476; GPS tracking or digital mapping may replace odometer logs (Medi-Cal provider manual).Broker app trip records and field visits.

Drivers

RequirementState ruleBroker contract
Wheelchair van driversCalifornia driver license or Ambulance Driver Certificate, Red Cross Standard First Aid and Personal Safety certificate or equivalent, physical exam within two years on DMV form DL-51 (22 CCR 51231.2).PASS wheelchair certificate and CPR at broker credentialing.
NMT driversCalifornia driver license, DMV driving record, and federal medical examination forms MCSA-5875 and MCSA-5876 listed on the enrollment application.Same.
Drug and alcohol testingRequired for CPUC permit holders with drivers of vehicles seating 15 or fewer (PU Code 1032.1 and 5374; General Order 157-E).Modivcare requires a drug screen at credentialing.
Driving recordDMV Employer Pull Notice enrollment for CPUC permit holders.Motor vehicle record checks at credentialing and on renewal.
Background checkStandard Medi-Cal provider screening at enrollment.Broker criminal background checks.

Insurance minimums in California

The CPUC sets dollar minimums for permit holders by seating capacity, counting the driver since Resolution TL-19147 (adopted March 21, 2024). Medi-Cal enrollment requires proof of insurance that complies with state law, and brokers add their own requirements.

CoverageMinimumSet by
Vehicles carrying up to 8 people including the driver$750,000 combined single limitPU Code 1040 and 5391; CPUC General Order 115
Vehicles carrying 9 to 15 people including the driver$1,500,000 combined single limitCPUC General Order 115; Resolution TL-19147
Vehicles carrying 16 or more people including the driver$5,000,000 combined single limitCPUC General Order 115; Resolution TL-19147
Commercial auto and general liability for broker workSet by the brokerBroker contract

Does California require EVV for NEMT?

No. CalEVV covers personal care services (since January 1, 2022) and home health services (since January 1, 2023). DHCS specifically excludes attendant care during medical transportation trips.

Brokers check trips through their own apps and GPS records, the Physician Certification Statement must be on file for every NEMT trip, and Medi-Cal accepts GPS or digital mapping in place of odometer logs. Fraud scrutiny is rising: a May 2026 NBC Bay Area investigation into Medi-Cal taxi and NEMT billing around a methadone clinic prompted Santa Clara Family Health Plan to announce it would limit rides to the closest clinic that meets the member's needs.

DHCS: California Electronic Visit Verification (CalEVV)

What changed in California in 2025 and 2026

Medi-Cal covered 13,910,180 people in April 2026, down from a May 2023 peak of 16,051,575 as pandemic-era continuous coverage ended.

Fee-for-service rates are in the Medi-Cal provider manual. The wheelchair and litter van rate page was last updated in September 2023 and the non-medical transportation page in August 2020. A wheelchair van trip pays a $20.30 base plus $1.50 per mile, a stretcher van $26.29, an attendant $5.52, and waiting time $11.30 per half hour after the first 15 minutes. Non-medical transportation pays $17.65 plus $1.30 per mile. Managed care plans and brokers negotiate their own rates.

APL 22-008 still governs plan transportation duties. The enrollment side changed: the VSSI certificate replaced brake and lamp inspections for applications from March 27, 2025, and IEHP pulled NEMT in-house on May 12, 2026.

Modivcare, the broker for Health Net, CalOptima, Anthem, and several other plans, filed for Chapter 11 on August 20, 2025 and emerged on December 29, 2025 with more than 85 percent of its debt cut.

  1. APL 22-008 takes effect, making managed care plans responsible for NEMT and NMT. Notice

  2. Vehicle Safety Systems Inspections begin at BAR-licensed stations. The program regulations took effect March 27, 2024. Notice

  3. The brake and lamp inspection program ends under AB 471. Notice

  4. DHCS requires a VSSI certificate with every new NEMT enrollment application. Notice

  5. Modivcare files for Chapter 11. Notice

  6. CMS sets the 2026 provider enrollment application fee at $750. Notice

  7. Modivcare emerges from Chapter 11 with more than 85 percent of its debt eliminated. Notice

  8. The DMV Employer Pull Notice program goes electronic-only. Notice

  9. NBC Bay Area publishes its investigation into Medi-Cal taxi and NEMT billing. Notice

  10. Inland Empire Health Plan begins arranging all NEMT trips itself; Call the Car keeps NMT. Notice

Frequently asked questions

Who is the NEMT broker in California?

There is no single broker. Each Medi-Cal managed care plan arranges its own rides. Modivcare serves Health Net, CalViva, California Health & Wellness, Anthem, CalOptima, Alameda Alliance, San Francisco Health Plan, and Community Health Plan of Imperial Valley. Call the Car serves L.A. Care and Blue Shield Promise, and IEHP for non-medical rides. Ventura Transit System serves CenCal Health, and Kaiser runs its own hub. Fee-for-service trips go through DHCS with a Treatment Authorization Request.

What is the difference between NEMT and NMT in Medi-Cal?

NEMT is transport by wheelchair van, litter van, or ambulance when a member's condition makes a car, taxi, or bus medically contraindicated, and it needs a prescription and a Physician Certification Statement. NMT is a ride by car, taxi, rideshare, or transit to any covered service for a member who can ride normally, with plan approval and no PCS. Providers enroll separately for each.

Do I need a CPUC permit to run NEMT in California?

Not if your vehicles are used exclusively for medical transportation; Public Utilities Code sections 226 and 5353 exempt them. If you run NMT, ambulatory rides, or any charter work with the same vehicles, you need a Charter-Party Carrier permit, usually the "P" permit for vehicles seating 15 or fewer. It costs $1,000 to apply and $100 to renew every three years.

What is the VSSI requirement?

Since March 27, 2025 every NEMT enrollment application must include a Vehicle Safety Systems Inspection certificate from a Bureau of Automotive Repair licensed station . It replaced the brake and lamp certificate program, which AB 471 ended on September 27, 2024. The certificate costs $7.

How do I enroll as a Medi-Cal NEMT provider?

Apply through the DHCS PAVE portal as a litter van or wheelchair van provider with the Medical Transportation Provider Application, Provider Agreement, and Disclosure Statement, the $750 federal application fee for 2026, and a VSSI certificate for each vehicle. Then credential with the brokers whose plans cover your area, because plans, not the state, pay for managed care rides.

What does Medi-Cal pay for a wheelchair van trip?

The fee-for-service maximum is a $20.30 base plus $1.50 per mile, $26.29 for a stretcher van, and $11.30 per half hour of waiting after the first 15 minutes. Non-medical transportation pays $17.65 plus $1.30 per mile. The wheelchair van rate page was last updated in September 2023. Managed care plans and brokers negotiate their own.

What insurance does California require for NEMT?

CPUC permit holders need $750,000 combined single limit for vehicles carrying up to 8 people including the driver, $1.5 million for 9 to 15, and $5 million for 16 or more. Medi-Cal enrollment requires proof of insurance that complies with state law, and brokers set their own requirements in the contract.

Does California require EVV for NEMT?

No. CalEVV covers personal care and home health services only and excludes attendant care during medical transportation trips. Brokers check trips with their own apps and GPS, and every NEMT trip needs a Physician Certification Statement on file.

Do drivers need drug testing in California?

CPUC permit holders must run a controlled substance and alcohol testing program under General Order 157-E for drivers of vehicles seating 15 or fewer and enroll every driver in the DMV Employer Pull Notice program. Modivcare requires a drug screen at credentialing even for exempt medical-only fleets.

Running NEMT in California with HealthRide

California fleets carry two enrollments, two brokers, and a CPUC program if they do any non-medical work. HealthRide runs every trip, from every payer, on one dispatch board and one billing ledger.

The driver app records GPS-recorded miles and timestamps for every leg, which Medi-Cal accepts in place of odometer logs, and the trip log exports as CSV or PDF for plan and broker audits.

See pricing

Official resources

NEMT in other states

NEMT in Texas

Health plans each contract a broker. Brokers: SafeRide Health, MTM Health, Modivcare.

NEMT in Florida

Health plans each contract a broker. Brokers: Modivcare, MTM Health, Alivi, Ride2MD.

NEMT in New York

One statewide broker. Brokers: Medical Answering Services (MAS).

NEMT in Pennsylvania

County-run programs. Brokers: County MATP offices statewide; Modivcare in Philadelphia.

NEMT in Colorado

Statewide broker, phasing in. Brokers: MediDrive.