How to start a NEMT business in Montana: the Modivcare transition, rates, and rules
Montana is switching models this fall. Through September 30, 2026, transportation companies enroll with Montana Medicaid and bill the state directly for trips that Mountain-Pacific Quality Health authorizes. From October 1, 2026, Modivcare becomes the state's NEMT broker and takes over the reservation line, provider enrollment, and billing. Since September 1, 2026, members can book with Modivcare for rides on or after October 1. If you run rides in Montana, your next contract is with Modivcare.
Montana NEMT at a glance
- Runs the program
- Montana Department of Public Health and Human Services (DPHHS), Health Resources Division
- Program
- Montana Healthcare Programs Non-Emergency Medical Transportation (NEMT)
- How rides are arranged
- Statewide broker, phasing in. Until September 30, 2026, providers bill Montana Medicaid directly for trips Mountain-Pacific authorizes. From October 1, 2026, Modivcare runs enrollment and billing statewide.
- Brokers you will contract with
- Modivcare (from October 1, 2026)
- State operating license
- No NEMT license. The Medicaid rule still ties wheelchair and stretcher vans to a PSC class B license, a class state motor carrier law no longer lists.
- EVV for NEMT trips
- Not required
- Medicaid enrollment
- 182,556 (May 2026, Medicaid only)
On this page
How Medicaid NEMT works in Montana
DPHHS covers non-emergency rides for Montana Medicaid members who have no other way to reach covered care. There are three kinds: personal transportation, where the member or a friend drives and gets mileage; commercial transportation by taxi, bus, or air; and specialized non-emergency transportation in wheelchair or stretcher vans for members who are wheelchair-bound or need a stretcher. Healthy Montana Kids (CHIP) and Mental Health Services Plan members do not get these transportation benefits.
Today every trip needs prior authorization from the Mountain Pacific Medicaid Transportation Center, which faxes providers a list of approved transports with a prior authorization number. Providers enroll with Montana Healthcare Programs as provider type 23 (commercial) or 24 (specialized), bill electronically or on a CMS-1500 claim with that number, and file within 12 months. Trips under 16 miles pay a flat one-way fee. Longer trips pay per loaded mile.
On October 1, 2026 the program moves to a broker. DPHHS signed Modivcare to run NEMT for Montana Healthcare Programs, and Mountain-Pacific's administrative and operational work shifts to Modivcare. Enrollment and claims move from the state's contractor, Conduent, to Modivcare, which will contact current providers with the steps to stay enrolled and will enroll new ones. The new program also brings an app for phones, tablets, and computers that handles scheduling, billing, documentation, and ride tracking.
Governing rule:Montana Healthcare Programs: Commercial and Specialized Non-Emergency Transportation Services manual
Who brokers Medicaid rides in Montana
Montana has no broker until October 1, 2026, and one statewide broker after that. The table shows both sides of the switch.
| Broker | Serves | Provider sign-up |
|---|---|---|
| Modivcare | All Montana Medicaid NEMT statewide, including provider enrollment, trip management, and billing.Since October 1, 2026 (anticipated start). Soft go-live on September 1, 2026, when members could start booking rides for October 1 and later. DPHHS added a transportation provider line and a facility line, and the member reservation line keeps its number with 24-hour service. | Provider pageTransportation provider line 866-726-1471 |
| Montana Medicaid direct billing (Mountain-Pacific authorizations) | All NEMT through September 30, 2026. Mountain-Pacific authorizes each trip, and enrolled providers bill Montana Medicaid through Conduent.Ends when Modivcare takes over enrollment and billing on October 1, 2026. | Provider pageMember reservation line 800-292-7114 |
The Medicaid rule lets Indian Health Service and tribal carriers that meet class B standards enroll without a PSC license. The provider manual also exempts organizations funded under the federal 5310 and 5311 transit programs.
For questions about enrolling in the new program, DPHHS lists its NEMT program officer at 406-444-3337. Montana Provider Relations (800-624-3958) handles claims under the current program.
How to become a NEMT provider in Montana
Timing matters in Montana. A company starting in late 2026 should plan to enroll through Modivcare, since Modivcare assumes all provider enrollment when the broker model starts.
Form the business and get an NPI
Register the company, get a federal EIN, and apply for a National Provider Identifier. Montana enrolls organizations under an NPI and a tax ID.
Choose your service type
Commercial transportation covers taxi, bus, and air trips for members with no special needs. Specialized non-emergency transportation covers wheelchair and stretcher vans. Members must be wheelchair-bound or need a stretcher to qualify for specialized trips, and Medicaid will not pay for them when a less costly mode works.
Montana Healthcare Programs: Specialized Non-Emergency Transportation
Settle your operating authority
ARM 37.86.2501 still defines specialized NEMT providers by a PSC class B license. Montana's motor carrier law now lists only Class A, D, and E carriers, so ask DPHHS and Modivcare what operating authority they accept before you buy vans.
Enroll and credential with Modivcare
Use the transportation provider line (866-726-1471) or Modivcare's provider form. Modivcare's standard checklist covers a PASS wheelchair certificate, First Aid and CPR, defensive driving, a drug screen, a motor vehicle report, and a background check for each driver, plus current registration, a state inspection where one applies, and proof of insurance for each vehicle.
Keep dispatch records for every trip
Montana requires commercial providers to keep original dispatch records for Medicaid trips, including the authorized units and the authorization number. Under the current program, bill only loaded miles and only up to what the Transportation Center approved.
Vehicle and driver requirements in Montana
Montana's Medicaid rules are short. They define who qualifies and what records to keep. Most driver and vehicle standards will come from Modivcare's credentialing.
Vehicles
| Requirement | State rule | Broker contract |
|---|---|---|
| Operating authority | ARM 37.86.2501 defines specialized NEMT as service by a provider with a class B public service commission license. IHS and tribal carriers that meet class B standards need no license. State motor carrier law (MCA 69-12-301) now lists only Class A, D, and E carriers, so confirm with DPHHS and Modivcare. | Modivcare credentialing from October 1, 2026. |
| Vehicle type | Specialized vans must be equipped to carry people with disabilities, such as wheelchair or stretcher vans. | Current registration, a state inspection where one applies, and proof of insurance for each vehicle. |
| Trip records | Original dispatch records with authorized units and the authorization number (ARM 37.86.2502). | Modivcare app for scheduling, billing, documentation, and ride tracking. |
Drivers
| Requirement | State rule | Broker contract |
|---|---|---|
| Driving record and background | No Medicaid-specific driver rule in ARM 37.86.2501 to 2505. | Motor vehicle report and background check for each driver. |
| Drug testing | Not required by the Medicaid transportation rules. | Drug screen for each driver. |
| Training | Not set by the Medicaid transportation rules. | PASS wheelchair certificate, current First Aid and CPR, and defensive driving. |
Insurance minimums in Montana
The Medicaid transportation rules set no insurance amount. Montana's auto law sets the floor, and Modivcare sets its own limits in the provider agreement.
| Coverage | Minimum | Set by |
|---|---|---|
| Auto liability, any vehicle | $25,000 per person and $50,000 per accident bodily injury, $20,000 property damage | MCA 61-6-103 |
| Commercial general liability, sexual abuse and molestation, and auto liability | Required, with limits that vary by state | Broker contract (Modivcare) |
| Workers compensation | Required for employers with employees, with limited exemptions | MCA 39-71-401 |
Does Montana require EVV for NEMT?
No. Montana's EVV requirement covers personal care, home health, and other applicable home and community-based services, with full compliance required since July 1, 2024. Non-emergency transportation is not an EVV service.
Trips are checked through authorization instead. Every current claim carries the prior authorization number from the Transportation Center, providers keep original dispatch records, and Modivcare's app adds ride tracking and documentation from October 2026.
What changed in Montana in 2025 and 2026
Montana Medicaid covered 182,556 people in May 2026, according to CMS monthly enrollment data. Modivcare's July 2026 Montana presentation lists about 15 state Medicaid contracts, Montana included.
The fee schedule in effect since July 1, 2025 pays $15.30 for a one-way trip under 16 miles and $1.18 per loaded mile for longer trips. Members who drive get 36 cents per mile, $6.43 per meal, and $46.71 per night of lodging when approved. DPHHS said on May 29, 2026 that projected budget shortfalls mean no provider rate adjustments for state fiscal year 2027, outside a few categories required by law. Ask Modivcare for the rates it will pay under the new program.
Montana's current personal, commercial, and specialized transportation fee schedules take effect.
DPHHS announces no provider rate adjustments for state fiscal year 2027.
DPHHS notifies providers that Modivcare will be the NEMT broker and will take over enrollment and billing.
DPHHS and Modivcare present the new program's member, caregiver, and facility tools.
Soft go-live: members can book Modivcare rides for October 1 and later, and the transportation provider line (866-726-1471) and facility line (866-726-1469) open.
Anticipated start of the Modivcare broker model. Enrollment and claims move from Conduent to Modivcare.
Frequently asked questions
- Who is the NEMT broker in Montana?
- Modivcare, starting October 1, 2026. Until then Montana has no broker: Mountain-Pacific Quality Health authorizes each trip and providers bill Montana Medicaid directly. Modivcare's transportation provider line is 866-726-1471.
- I am already a Montana Medicaid transportation provider. What do I need to do?
- Watch for outreach from Modivcare and DPHHS. Modivcare takes over all provider enrollment and will send current providers the steps to continue in the new program. Questions about claims under the current program go to Montana Provider Relations at 800-624-3958.
- Can a new company enroll with Montana Medicaid for NEMT right now?
- Enrollment is moving to Modivcare with the October 1, 2026 start, so a new company should plan on enrolling through Modivcare. For questions about enrolling in the new program, call the DPHHS NEMT program officer at 406-444-3337.
- Do I need a PSC license for NEMT in Montana?
- The Medicaid rule for wheelchair and stretcher vans (ARM 37.86.2501) still refers to a PSC class B license, but current state motor carrier law lists only Class A, D, and E carriers. Ask DPHHS and Modivcare what operating authority they accept. Indian Health Service and tribal carriers that meet class B standards are exempt.
- How much does Montana Medicaid pay for NEMT?
- The July 1, 2025 fee schedule pays $15.30 per one-way trip under 16 miles and $1.18 per loaded mile over 16 miles, and member mileage is 36 cents per mile. DPHHS is making no provider rate adjustments for state fiscal year 2027. Ask Modivcare for the rates it will pay once the broker model starts.
- Are Healthy Montana Kids members covered for NEMT?
- No. Montana's commercial, specialized, and personal transportation services are not available to Healthy Montana Kids (CHIP) or Mental Health Services Plan members.
- Does Montana require EVV for NEMT?
- No. Montana EVV covers personal care, home health, and similar in-home services. NEMT trips rely on prior authorization numbers and dispatch records instead.
Running NEMT in Montana with HealthRide
Montana providers are changing payers mid-year: direct Medicaid billing through September, Modivcare from October. HealthRide keeps every trip on one dispatch board and records every payment in one ledger, so the switch is a payer change, not a new system.
Driver credential expiration reminders and vehicle inspection tracking help you walk into Modivcare credentialing with a clean roster, and the trip log exports as CSV or PDF when you need records.
Official resources
- DPHHS provider notice: Changes to NEMT, enrollment, billing, and accessibility (July 9, 2026)
- Montana Healthcare Programs Claim Jumper, August 2026
- DPHHS and Modivcare: Montana NEMT partnership presentation (July 2026)
- Montana Healthcare Programs: Personal and Commercial Transportation
- Montana Healthcare Programs: Specialized Non-Emergency Transportation
- Commercial and Specialized Non-Emergency Transportation Services manual
- July 2025 Personal and Commercial Transportation fee schedule
- July 2025 Non-Emergency Specialized Transportation fee schedule
- DPHHS provider notice: State fiscal year 2027 provider rate update
- Montana Healthcare Programs: Provider enrollment
- ARM 37.86.2501: Specialized NEMT, definitions
- ARM 37.86.2502: Specialized NEMT, requirements
- MCA 69-12-301: Classification of motor carriers
- MCA 61-6-103: Motor vehicle liability policy minimum limits
- Montana DPHHS: Electronic Visit Verification
- Modivcare: Montana facility resources
- Modivcare: Become a transportation provider
- MCA 39-71-401: Employments covered by workers compensation
- CMS: Medicaid and CHIP monthly enrollment data
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