How to start a NEMT business in Massachusetts: MassHealth brokers, MART, GATRA, and HST rules
MassHealth rides run through the Human Service Transportation (HST) brokerage, not through health plan brokers. Two regional transit authorities split the state: MART covers Western and Central Mass, Metro Boston, and Northeastern Mass, and GATRA covers Southeastern Mass, Cape Cod, and the Islands. A ride starts with a PT-1 request from the member's medical provider, and a transportation company gets trips by subcontracting with the broker for its region.
Massachusetts NEMT at a glance
- Runs the program
- Executive Office of Health and Human Services (EOHHS), Human Service Transportation (HST) Office
- Program
- MassHealth PT-1 transportation through the HST brokerage
- How rides are arranged
- Regional brokers, one per area. EOHHS contracts two regional transit authorities as HST brokers, each covering a set of cities and towns. The broker for the member's town schedules the ride and pays the provider.
- Brokers you will contract with
- MART, GATRA
- State operating license
- No NEMT license. HST vehicles must pass Registry of Motor Vehicles inspection, and drivers need a Massachusetts or bordering-state license.
- EVV for NEMT trips
- Not required
- Medicaid enrollment
- 1,362,386 (May 2026, Medicaid only)
On this page
How Medicaid NEMT works in Massachusetts
The HST Office in EOHHS runs one coordinated brokerage for MassHealth and five other agencies: the Department of Developmental Services, DPH Early Intervention, the Massachusetts Rehabilitation Commission, the Massachusetts Commission for the Blind, and the Department of Mental Health. Two regional transit authorities serve as brokers, together managing more than eight million trips. Participating agencies keep control of who qualifies for a ride.
The HST Office arranges non-emergency rides for members of MassHealth Standard, CommonHealth, and CarePlus. MassHealth rides start with a PT-1, the Provider Request for Transportation. The member's medical provider submits it online, since there is no paper form, and MassHealth approves it in up to three business days. The broker assigned to the member's town then sends a letter explaining how to book, online, in the QRyde app, or by phone, ideally three days ahead. A PT-1 for recurring trips can last up to six months for an acute illness and a year for a chronic one.
Providers work in one of two tracks. Brokered PT-1 trips go to transportation companies under a subcontract with MART or GATRA, and MART assigns trips through a low-cost bid system. Fee-for-service trips, such as wheelchair van service for members who live in institutions or need hands-on help to leave home, are billed to MassHealth directly with a Medical Necessity Form, which the provider keeps for six years, at rates set by 101 CMR 327.00.
Governing rule:130 CMR 407.000: Transportation services
Who brokers Medicaid rides in Massachusetts
The member's town decides the broker. The HST Office publishes a "Find your HST broker" spreadsheet listing every town, and each broker keeps its own provider application.
| Broker | Serves | Provider sign-up |
|---|---|---|
| MART (Montachusett Regional Transit Authority) | Western Mass, Central Mass, Metro Boston, and Northeastern Mass: 286 of the state's 351 cities and towns, across Berkshire, Franklin, Hampden, Hampshire, Worcester, Middlesex, Essex, Suffolk, and Norfolk counties.From May 1, 2026, MART stops taking new provider applications from May 1 through July 31 each year and reopens them on August 1. | Provider pageMember rides 866-834-9991 |
| GATRA (Greater Attleboro Taunton Regional Transit Authority) | Southeastern Mass, Cape Cod, and the Islands. | Provider pageMember rides 800-431-1713 |
| MassHealth fee-for-service | Fee-for-service trips outside the brokerage, such as wheelchair van service for members who live in institutions or need hands-on help getting from home to the vehicle, billed to MassHealth with a Medical Necessity Form. |
Both brokers want experience. MART requires at least a year of owning and operating your own livery service plus a contract with a facility or agency, and GATRA requires at least a year of medical transportation and an office in or near its territory.
MassHealth may terminate or limit direct provider agreements in regions and modes where a broker contract is in effect (130 CMR 407.407).
How to become a NEMT provider in Massachusetts
PT-1 rides run only through the HST brokers, so the broker for your region is the front door.
Register the business and build a track record
Register with the Secretary of the Commonwealth and get a Certificate of Good Standing, which GATRA asks for as proof of tax standing. MART asks for two: one from the Secretary of the Commonwealth and one from the Department of Revenue. Before applying, run your own passenger service for at least a year. MART does not count time spent driving for another company, a taxi, or a rideshare service.
Apply to the broker for your region
MART takes applications only through its online vendor portal, from a desktop or laptop, between August 1 and April 30. GATRA sends its HST Transportation Provider Application to companies that email Inquiries@gatra.org with "application" in the subject line. If MART awards you a contract, contracting and onboarding usually take up to 90 days.
Meet the HST Transportation Provider Performance Standards
Every HST subcontract carries the performance standards. Vehicles need a Registry of Motor Vehicles inspection, registration in Massachusetts or a bordering state, the company name in letters at least 2 inches high on the right passenger door and the rear, GPS that shares location with the broker and EOHHS, and a driver ID card visible to riders.
HST Transportation Provider Performance Standards (FY25, effective July 1, 2024)
Clear every driver before the first trip
Drivers must be at least 19 with three years of driving experience, pass a CORI and SORI check before any contact with riders and every year after, have a clean seven-year driving history from every state they lived in, and pass a drug test at an NLCP-certified lab. The provider enrolls drivers in the RMV Driver Verification System and gives the broker and HST Office view access.
Enroll with MassHealth for fee-for-service work
For fee-for-service wheelchair van or ambulance trips, apply to become a MassHealth provider, own, lease, or control your vehicles by written agreement, and meet the licensure rules for your mode. Screen every employee and contractor against the OIG exclusion list at hire and monthly, and keep written references and an annual CORI check on file for drivers and attendants.
Vehicle and driver requirements in Massachusetts
MassHealth sets provider eligibility in 130 CMR 407.000. The HST performance standards, written into every MART and GATRA subcontract, carry most of the vehicle and driver detail.
Vehicles
| Requirement | State rule | Broker contract |
|---|---|---|
| Control and licensure | Own, lease, or control vehicles by written agreement and meet DPH, MassHealth, or Registry of Motor Vehicles licensure rules for the mode (130 CMR 407.405). | RMV inspection before first use; garaged and registered in Massachusetts or a bordering state. |
| Vehicle age | Not set in 130 CMR 407.405. | 15 years from manufacture for demand-response vehicles; waivers in six-month steps for up to two more years, each with a fresh state inspection. |
| Trip records | Fee-for-service wheelchair van providers keep a trip log, separate from the claim, with the member, date, origin, destination, and vehicle ID (130 CMR 407.471). | GPS that reports the vehicle's actual arrival at pickup and drop-off to the broker and EOHHS in real time or near real time. |
| Wheelchair securement | Wheelchair van service limited to members who use wheelchairs, must be carried on stairs, or have severe mobility limits (130 CMR 407.471). | Q'Straint, AMF-Bruns, or Sure-Lok systems; four straps plus a lap and shoulder belt; every wheelchair faces forward. |
| Equipment and markings | Not set in 130 CMR 407.405. | Seat belt for every occupant, a seat belt cutter within the driver's reach, a Red Cross family first aid kit plus a biohazard bag, and the company name in 2-inch letters. |
Drivers
| Requirement | State rule | Broker contract |
|---|---|---|
| Background checks | Written references and a CORI check before any contact with members, repeated every year (130 CMR 407.405). | CORI and SORI checks every year; a positive SORI result bars the driver. |
| License and driving record | Valid driver's license and a process to disclose each driver's driving history to MassHealth. | Seven-year driving history from every state lived in, reviewed yearly: no DUI, reckless driving, leaving the scene, unlicensed or uninsured driving, or driving while suspended. |
| Age and experience | Not set in 130 CMR 407.405. | At least 19, with three years of driving experience including multi-passenger vehicles. |
| Drugs and alcohol | A process to address violations of state drug law by employees and contractors. | Tests at an independent NLCP-certified lab before first contact, after qualifying accidents, and on reasonable suspicion. |
| Exclusion screening | Check every employee and contractor against the OIG exclusion list at hire and every month. | Same. |
| Training | Not set in 130 CMR 407.405. | Annual in-service training, plus hands-on wheelchair securement training every year from a CTAA or University of Wisconsin certified trainer and a broker check every six months. |
Insurance minimums in Massachusetts
The HST performance standards set the insurance for every broker subcontract, with the broker named as additional insured on each policy.
| Coverage | Minimum | Set by |
|---|---|---|
| Vehicle liability, all HST vehicles | $250,000 per person and $500,000 per occurrence bodily injury; $50,000 property damage | HST Transportation Provider Performance Standards (FY25) |
| Program-based vehicles seating 6 to 8, driver included | $500,000 combined single limit | HST Transportation Provider Performance Standards (FY25) |
| Program-based vehicles seating 9 to 15 | $1,000,000 combined single limit | HST Transportation Provider Performance Standards (FY25) |
| Program-based vehicles seating 16 or more | $5,000,000 combined single limit | HST Transportation Provider Performance Standards (FY25) |
| Workers compensation | Required on all drivers and monitors, with a certificate to the broker before the first trip | HST Transportation Provider Performance Standards (FY25) |
Does Massachusetts require EVV for NEMT?
No. MassHealth uses EVV for personal care attendant services, rolled out starting January 2024, because federal law requires it for in-home personal care and home health. NEMT is not included.
HST trips are checked through the broker. Vehicle GPS must report actual arrival times at pickup and drop-off to the broker and EOHHS, broker staff inspect vehicles and audit records, and members can file complaints about any trip through MART or GATRA. Fee-for-service wheelchair van providers keep a trip log for every service they bill.
What changed in Massachusetts in 2025 and 2026
Massachusetts had 1,362,386 people on Medicaid and 173,535 on CHIP in May 2026.
MART is the larger broker. It manages HST trips for 286 of the state's 351 communities and brokers for MassHealth, DDS, DPH Early Intervention, DMH, the Massachusetts Rehabilitation Commission, and the Massachusetts Commission for the Blind.
Brokered trips pay under the broker's contract. MART posts a quarterly vendor rate sheet by origin town, destination, and vehicle type (taxi, dial-a-ride, and chair car); the current sheet covers July 1 through September 30, 2026.
Booking keeps moving online. MART opened a new facility booking portal on August 5, 2025 and 24-hour phone self-service on February 18, 2026, and members of both brokers can book in the QRyde app.
The FY25 HST Transportation Provider Performance Standards take effect, with $250,000 and $500,000 vehicle liability minimums.
MART launches its new facility booking portal, with same-day and Enhanced Chair Car booking.
MART adds 24-hour phone self-service for booking, checking, and canceling trips.
MART stops taking new provider applications from May through July each year.
MART's quarterly vendor rate sheet for July 1 through September 30, 2026 takes effect.
MART reopens new provider applications.
Frequently asked questions
- Who is the NEMT broker in Massachusetts?
- Two regional transit authorities broker MassHealth rides for the HST Office. MART covers Western Mass, Central Mass, Metro Boston, and Northeastern Mass (866-834-9991). GATRA covers Southeastern Mass, Cape Cod, and the Islands (800-431-1713). The member's town decides which one.
- What is a PT-1 form?
- The Provider Request for Transportation. A MassHealth member's medical provider submits it online to request brokered rides, and MassHealth approves it in up to three business days. Recurring PT-1s can cover up to six months for an acute illness and a year for a chronic one.
- Do I need a license to do MassHealth transportation?
- There is no NEMT license. HST brokers require a Registry of Motor Vehicles inspection, registration in Massachusetts or a bordering state, and a Massachusetts or bordering-state license for drivers. Fee-for-service wheelchair van and ambulance providers must meet the DPH, MassHealth, or RMV licensure rules for their mode.
- How do I become an HST transportation provider?
- Run your own passenger service for at least a year, register with the Secretary of the Commonwealth, and apply to the broker for your region. MART takes online applications from August 1 to April 30 and GATRA sends its application by email. Both require you to meet the HST Transportation Provider Performance Standards.
- What insurance does an HST provider need?
- Vehicle liability of $250,000 per person and $500,000 per occurrence plus $50,000 property damage, with the broker as additional insured, and workers compensation on all drivers and monitors. Program-based vehicles need $500,000 to $5,000,000 combined single limits depending on seating.
- What are the driver requirements for MassHealth rides?
- Drivers must be at least 19 with three years of experience, pass CORI and SORI checks yearly, have a clean seven-year driving record, pass drug tests at a certified lab, be enrolled in the RMV Driver Verification System, and complete annual training, including hands-on wheelchair securement for wheelchair van drivers.
- How old can an HST vehicle be?
- Demand-response vehicles cannot be 15 or more years past their date of manufacture. The broker can grant waivers in six-month steps for up to two more years, each after a fresh Massachusetts state inspection.
- Does Massachusetts require EVV for NEMT?
- No. MassHealth EVV covers personal care attendant services. HST trips are tracked through vehicle GPS that reports actual arrival times to the broker and EOHHS.
Running NEMT in Massachusetts with HealthRide
MART assigns trips through a low-cost bid, so every empty mile counts. HealthRide puts every trip on one dispatch board, and Ryder Go plans the whole day in one click.
The live map shows every vehicle and its ETA, and the trip log exports as CSV or PDF when a broker asks for trip records.
Official resources
- EOHHS: Human Service Transportation Office
- Mass.gov: Get a ride to MassHealth medical appointments
- Mass.gov: Providing rides through the HST Brokerage
- MassHealth: Electronic Visit Verification (EVV)
- 130 CMR 407.000: Transportation services
- 130 CMR 407.405: Provider eligibility, in-state
- 130 CMR 407.407: Selective contracting
- 130 CMR 407.421: Authorization for transportation (PT-1)
- 130 CMR 407.471: Nonemergency wheelchair van
- HST Transportation Provider Performance Standards (FY25, effective July 1, 2024)
- MART: About the brokerage
- MART: Brokerage service area
- MART: Become a transportation provider
- MART: Application FAQs
- MART: Member news
- MART: Vendor rates, July 1 to September 30, 2026
- GATRA: MassHealth and PT-1 trips
- GATRA: Becoming a transportation provider
- CMS: State Medicaid and CHIP enrollment data
HealthRide plans the whole day in one click and bills every ride.
$59 per vehicle per month. No contracts.