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How to start a NEMT business in Illinois: plan brokers, IMPACT, and Transdev prior approval

Updated

Illinois pays for Medicaid rides two ways. HealthChoice Illinois managed care plans arrange rides through Modivcare or MTM Health, depending on the plan. Fee-for-service trips are billed straight to the Department of Healthcare and Family Services (HFS) after Transdev, the state's prior approval agent, authorizes them. Every transportation provider, managed care or fee-for-service, must enroll in HFS's IMPACT system, and every medicar and service car driver needs state-approved safety training every three years.

Illinois NEMT at a glance

Runs the program
Illinois Department of Healthcare and Family Services (HFS)
Program
Medical transportation (89 Ill. Adm. Code 140.490)
How rides are arranged
Health plans each contract a broker. HealthChoice Illinois plans arrange rides through Modivcare or MTM Health. HFS pays fee-for-service trips directly after Transdev approves each one.
Brokers you will contract with
Modivcare, MTM Health, plus Transdev prior approval for fee-for-service
State operating license
No NEMT license. The Illinois Secretary of State licenses each vehicle by type (medicar, livery service car, taxi), and stretcher service needs an IDPH license.
EVV for NEMT trips
Not required
Medicaid enrollment
2,677,965 (April 2026, Medicaid only)
On this page

How Medicaid NEMT works in Illinois

Most Illinois Medicaid members are in HealthChoice Illinois. Four plans serve every county: Aetna Better Health of Illinois, Blue Cross Community Health Plans, Meridian, and Molina Healthcare. CountyCare serves Cook County only, and YouthCare serves former youth in care and children of youth in care. Each plan hires a transportation vendor, and HFS publishes the vendor list. Charges for managed care members go to the plan, not to HFS.

For fee-for-service members, HFS contracts with Transdev (formerly First Transit) to run the Non-Emergency Transportation Services Prior Approval Program. A member, medical provider, or transportation provider requests approval at least seven business days before the trip, and Transdev connects members to enrolled providers in their area by random selection. The provider then bills HFS electronically within 180 days of service.

The categories are set in rule. A medicar carries a rider who stays in a wheelchair and needs a lift or ramp and wheelchair lockdown, without medical observation or oxygen. A service car carries a rider who needs neither an ambulance nor a medicar. Taxis, private autos, buses, trains, and transportation network companies round out the list.

Governing rule:89 Ill. Adm. Code 140.490: Medical transportation

Who brokers Medicaid rides in Illinois

HFS's June 2026 subcontractor list shows two vendors across the six HealthChoice Illinois plans. A fleet that wants trips from every plan needs contracts with both. Blue Cross Community Health Plans moves from Modivcare to MTM Health on October 1, 2026.

BrokerServesProvider sign-up
ModivcareAetna Better Health of Illinois (statewide) and CountyCare (Cook County). Also Blue Cross Community Health Plans (statewide) through September 30, 2026.Blue Cross Community Health Plans Medicaid rides move to MTM Health on October 1, 2026.Provider page
MTM HealthMeridian (866-796-1165), YouthCare, and Molina Healthcare (844-644-6354). MTM also serves all four FIDE SNP plans for dual eligibles: Aetna Medicare FIDE, Humana Dual Fully Integrated, Molina Medicare Complete Care Plus, and Wellcare Meridian Dual Align.Since January 1, 2026 (FIDE SNPs). Adds Blue Cross Community Health Plans Medicaid members on October 1, 2026. Members keep booking at 877-831-3148, and trips already scheduled past that date move to MTM Health.Provider page
Transdev (prior approval agent, not a broker)Fee-for-service Medicaid members statewide. Transdev approves each trip and refers it to an enrolled provider; the provider bills HFS directly.Provider line 866-503-9040

Transdev also handles non-emergency ambulance approvals for some managed care members, and plans such as Meridian point stretcher and ambulance requests to Transdev.

Fully Integrated Dual Eligible Special Needs Plans (FIDE SNPs) launched in every Illinois county on January 1, 2026 for full Medicaid members age 21 and older who also have Medicare Parts A and B.

How to become a NEMT provider in Illinois

Illinois is an enroll-first state. IMPACT enrollment is required even if you only plan to run managed care trips.

  1. License the vehicles with the Secretary of State

    Register medicars with the Illinois Secretary of State, service cars as livery vehicles, and taxis as taxis, plus any local license your city requires. Stretcher service needs an Illinois Department of Public Health license under 77 Ill. Adm. Code 515.835.

    89 Ill. Adm. Code 140.490: Medical transportation

  2. Enroll in IMPACT

    Enroll in HFS's Illinois Medicaid Program Advanced Cloud Technology (IMPACT) system with the right provider type and specialty, and list every vehicle. Both managed care and fee-for-service transportation providers must be enrolled. New enrollment is conditional for one year, and the HFS Office of Inspector General may visit your site.

    HFS: Handbook for Providers of Transportation Services

  3. Complete fingerprint background checks

    Owners of 5 percent or more, officers, partners, and managers submit to a fingerprint-based state and FBI background check through an Illinois State Police approved vendor within 30 days of the application. The provider pays the fees.

    89 Ill. Adm. Code 140.498: Fingerprint-based criminal background checks

  4. Train every driver and attendant

    Medicar, service car, and taxi drivers and employee attendants must complete an HFS-approved safety program before their first Medicaid trip and every three years. IDPH-licensed medicar and service car providers can apply to HFS to run approved in-house training.

  5. Contract with Modivcare and MTM Health

    Apply to each vendor for the plans you want. Modivcare's checklist covers PASS wheelchair certification, First Aid and CPR, defensive driving, a drug screen, a motor vehicle report, and a background check for each driver. MTM Health requires fraud, waste, and abuse training and HIPAA training for every employee each year. Once Blue Cross Community Health Plans moves on October 1, 2026, an MTM contract covers four of the six HealthChoice plans.

    Modivcare: Transportation providers

  6. Get prior approval and bill HFS for fee-for-service

    For fee-for-service trips, confirm the Transdev approval before you drive. Trips from a hospital or nursing facility need an HFS 2270 Physician Certification Statement, and one form covers recurring medicar and service car trips for up to 180 days. Bill HFS electronically within 180 days of service.

Vehicle and driver requirements in Illinois

HFS rules focus on licensing and training. Most day-to-day vehicle and driver standards come from the vendor contracts.

Vehicles

RequirementState ruleBroker contract
Medicar (wheelchair van)Licensed by the Secretary of State, with a hydraulic or electric lift or a ramp and wheelchair lockdown (89 Ill. Adm. Code 140.490). IDPH licensing is added if the provider bills for stretchers.Vehicle inspection and current registration at credentialing.
Service carLicensed as a livery car by the Secretary of State and by local regulators where they require it.Current registration, state inspection where required, and insurance (Modivcare).
Vehicle listEvery vehicle listed in the IMPACT enrollment and kept current.Every vehicle added to the vendor roster before it takes a trip.
Trip recordsA dispatcher's log and a trip ticket for every trip showing the client, who requested the ride, the vehicle type and plate number, and the driver and any attendant (89 Ill. Adm. Code 140.494). An HFS 2270 for trips from hospitals and nursing facilities, and an HFS 2271 for trips from home.Trip data through the vendor portal or app.

Drivers

RequirementState ruleBroker contract
Safety trainingHFS-approved program before the first trip and every three years, covering passenger assistance, vehicle operation and passenger safety, and emergency procedures. Licensed EMTs are exempt while licensed.PASS wheelchair certification, First Aid and CPR, and defensive driving (Modivcare).
LicensingDrivers and vehicles must meet Secretary of State licensing requirements and local rules.Motor vehicle report (Modivcare).
Background checksFingerprint checks for owners, officers, and managers at enrollment (89 Ill. Adm. Code 140.498).Background check and drug screen for each driver (Modivcare).
Compliance trainingNot set by HFS rule.Annual fraud, waste, and abuse and HIPAA training for every employee (MTM Health).

Insurance minimums in Illinois

Illinois law sets a higher liability floor for passenger-for-hire vehicles operating in cities, filed with the Secretary of State. Vendors add general liability.

CoverageMinimumSet by
Passengers for hire in an incorporated city, town, or village$250,000 bodily injury per person, $50,000 property damage, up to $300,000 per vehicle, with proof on file with the Secretary of State625 ILCS 5/8-101 and 8-109
Any vehicle$25,000 per person, $50,000 per crash bodily injury, $20,000 property damage625 ILCS 5/7-203
General liability and sexual abuse and molestation (SAM)Required, limits vary by stateBroker contract (Modivcare)

Does Illinois require EVV for NEMT?

No. Illinois uses electronic visit verification for Medicaid personal care services and home health care services, as the 21st Century Cures Act requires. NEMT is not part of it.

Proof of service in Illinois rests on the trip record, the Transdev approval for fee-for-service trips, and the medical necessity forms: the HFS 2270 Physician Certification Statement for trips from hospitals and nursing facilities, and the HFS 2271 Certificate of Transportation Services for trips from home. HFS recoups payments when records are missing or incomplete, and it recovers every payment for a trip run by a driver without current safety training.

HFS: Electronic Visit Verification

What changed in Illinois in 2025 and 2026

Illinois had 2,677,965 people on Medicaid and 309,500 on CHIP in April 2026, according to CMS enrollment data.

Fee-for-service rates are set by county group in the fee schedule effective January 1, 2026. In Cook and the collar counties, a service car pays a $20.00 base (A0120) and a medicar a $30.00 base (A0130), each plus $1.03 per mile and $20.00 per attendant. Madison and St. Clair counties pay $1.61 per mile, and most downstate counties $0.80. Managed care trips pay the rate in your vendor contract.

For dual eligibles, Fully Integrated Dual Eligible Special Needs Plans launched statewide on January 1, 2026, and HFS lists four of them. All four use MTM for transportation, so an MTM contract is the way into dual eligible plan trips. MTM also picks up Blue Cross Community Health Plans on October 1, 2026, which leaves Modivcare with Aetna Better Health and CountyCare.

Modivcare, the vendor for Aetna, Blue Cross, and CountyCare, filed for Chapter 11 on August 20, 2025 and emerged on December 29, 2025.

  1. HFS reissues its transportation handbook, renaming First Transit to Transdev and adding in-house safety training guidance.

    Notice

  2. Modivcare files for Chapter 11.

    Notice

  3. Modivcare emerges from Chapter 11.

    Notice

  4. FIDE SNPs launch statewide for dual eligibles, all using MTM for transportation. The 2026 non-ambulance fee schedule takes effect.

    Notice

  5. HFS publishes its current HealthChoice Illinois and FIDE SNP subcontractor lists, naming each plan's transportation vendor.

    Notice

  6. Blue Cross and Blue Shield of Illinois reminds providers that its Medicaid rides move from Modivcare to MTM Health.

    Notice

  7. MTM Health takes over NEMT for Blue Cross Community Health Plans members.

    Notice

Frequently asked questions

Who is the NEMT broker in Illinois?
It depends on the plan. Modivcare arranges rides for Aetna Better Health of Illinois and CountyCare, and for Blue Cross Community Health Plans until MTM Health takes over on October 1, 2026. MTM Health arranges rides for Meridian, YouthCare, Molina, and all four FIDE SNP plans. Fee-for-service trips are approved by Transdev and billed to HFS.
Is Transdev the Illinois NEMT broker?
No. Transdev is HFS's prior approval agent for fee-for-service trips. It reviews each request, confirms medical necessity, and refers the member to an enrolled provider by random selection. The provider bills HFS directly, not Transdev.
Do I need to enroll in IMPACT if I only run managed care trips?
Yes. The HFS transportation handbook says both managed care and fee-for-service transportation providers must be enrolled in IMPACT, with every vehicle listed. Enrollment includes fingerprint checks for owners, officers, and managers and may include an on-site visit.
What safety training do Illinois NEMT drivers need?
Medicar, service car, and taxi drivers and employee attendants must complete an HFS-approved safety program before their first Medicaid trip and every three years. It covers passenger assistance, vehicle operation and passenger safety, and emergency procedures. HFS recovers payment for any trip run by an uncertified driver.
How far ahead must fee-for-service trips be approved?
Requests go to Transdev at least seven business days before the trip. Standing approvals cover recurring trips, and a post-approval request must reach Transdev within 30 calendar days after service.
What insurance does an Illinois NEMT company need?
Vehicles carrying passengers for hire in a city, town, or village need at least $250,000 per person bodily injury and $50,000 property damage, up to $300,000 per vehicle, with proof filed with the Secretary of State. Vendors add general liability and sexual abuse and molestation coverage.
How much does Illinois Medicaid pay for medicar and service car trips?
Under the January 1, 2026 fee schedule, Cook and collar county trips pay a $30.00 medicar base or a $20.00 service car base, plus $1.03 per mile and $20.00 per attendant. Mileage is $1.61 in Madison and St. Clair and $0.80 in most other counties. Plan trips pay your vendor contract rate.
Does Illinois require EVV for NEMT?
No. Illinois EVV covers personal care and home health care services. NEMT trips rely on trip records, the Transdev approval, and the HFS 2270 or 2271 medical necessity forms.

Running NEMT in Illinois with HealthRide

Illinois fleets often run Modivcare and MTM Health trips alongside fee-for-service trips approved by Transdev. HealthRide keeps all three on one dispatch board and records every payment, whichever payer sent it, in one ledger.

Credential expiry reminders flag drivers before their three-year safety training lapses, and the driver app records timestamps, signatures, and the driver on every leg for the trip record.

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Official resources

HealthRide plans the whole day in one click and bills every ride.

$59 per vehicle per month. No contracts.

NEMT in other states

Comparing brokers across states?See who arranges Medicaid rides in every state