How to start a NEMT business in Nebraska: Heritage Health, MTM, and PSC authority
Nebraska Medicaid rides run through Heritage Health, the state's managed care program, and all three Heritage Health plans use MTM Health as their broker in 2026. UnitedHealthcare Community Plan moved to MTM on January 1, 2026, joining Nebraska Total Care and Molina Healthcare of Nebraska. Before you enroll with Nebraska Medicaid, you need Public Service Commission (PSC) authority or an exemption. A 2026 law adds a one-year PSC license for Medicaid NEMT, required from January 1, 2027.
Nebraska NEMT at a glance
- Runs the program
- Nebraska Department of Health and Human Services, Division of Medicaid and Long-Term Care (DHHS MLTC)
- Program
- Heritage Health Non-Emergency Transportation (NET) Services
- How rides are arranged
- Health plans each contract a broker. Each Heritage Health plan arranges rides through its broker, and all three use MTM Health. Fee-for-service rides are authorized through the DHHS Customer Service Center.
- Brokers you will contract with
- MTM Health
- State operating license
- PSC carrier authority or an exemption before Medicaid enrollment. From January 1, 2027, a one-year PSC license for Medicaid NEMT.
- EVV for NEMT trips
- Not required
- Medicaid enrollment
- 295,117 (May 2026, Medicaid only)
On this page
How Medicaid NEMT works in Nebraska
The DHHS Division of Medicaid and Long-Term Care runs Nebraska Medicaid. Non-emergency transportation joined the Heritage Health managed care benefit on July 1, 2019. The program rules are in 471 NAC 27, last amended November 12, 2024. Heritage Health members choose one of three statewide plans. Each plan contracts a transportation broker, and ride authorizations go through that broker, which arranges the most appropriate mode for the trip.
Routine rides must be requested at least three business days ahead. Urgent trips are the exception, and hospital discharges and appointments granted within 48 hours count as urgent. Rides go to the nearest Medicaid provider within 20 miles of home unless DHHS approves an exception. Medicaid pays only while the member is in the vehicle, and it does not pay for wait time or no-shows.
Every NEMT provider enrolls with Nebraska Medicaid, whichever program pays for the trip. Enrollment runs through the Provider Data Management System, which the state operates with its contractor, Maximus. The DHHS provider manual tells transportation providers to get PSC certification or an exemption before they apply. Fee-for-service trips for members outside Heritage Health are authorized through the DHHS Customer Service Center and paid at the state fee schedule.
Governing rule:471 NAC 27: Non-Emergency Transportation (NET) Services
Who brokers Medicaid rides in Nebraska
MTM Health brokers rides for all three Heritage Health plans in 2026. Each plan contracts with MTM separately and has its own MTM ride line, so the plan on the member's card still decides who authorizes and pays the trip.
| Broker | Serves | Provider sign-up |
|---|---|---|
| MTM Health | Nebraska Total Care, Molina Healthcare of Nebraska, and UnitedHealthcare Community Plan of Nebraska. All three plans cover the whole state.UnitedHealthcare Community Plan moved its NEMT to MTM on January 1, 2026. MTM began taking its ride requests on December 10, 2025. | Provider pageRide lines: Nebraska Total Care 1-844-261-7834, Molina 888-889-0421, UnitedHealthcare 888-777-6924 |
| Nebraska Medicaid fee-for-service (DHHS) | Members who are not enrolled in a Heritage Health plan. Trips are authorized through the DHHS Customer Service Center and billed to Nebraska Medicaid. | Provider page |
Nebraska requires every provider to enroll with Medicaid before billing, whether a plan's broker or fee-for-service pays for the trip.
Rides for residents of nursing facilities and intermediate care facilities for people with developmental disabilities are not covered as NEMT, except a discharge ride to a private home in Nebraska. Molina notes that nursing homes handle NEMT for their residents within 30 miles.
How to become a NEMT provider in Nebraska
Nebraska puts the Public Service Commission first. Get PSC authority or an exemption, enroll with Nebraska Medicaid, screen every driver, then contract with MTM.
Form the business and get an NPI
Register the company with the Nebraska Secretary of State and get a federal EIN. Nebraska Medicaid requires an NPI before enrollment. A transportation company applies with a Type 2 NPI, the kind issued to organizations.
Get PSC authority or an exemption
Apply to the PSC for common carrier or contract carrier authority. The application fee is $300, and the packet includes your business entity papers and a Nebraska fingerprint-based criminal background check. The PSC publishes the application for 30 days so other carriers can protest, and unprotested applications can be decided on affidavits instead of a hearing. Before operating you need PSC-approved rates ($100 rate filing), PSC plates ($50 per vehicle), and a Form E insurance filing from your insurer. Carrying passengers under a DHHS contract or subcontract also needs specific authorization from the Commission (291 NAC 3-003.02(C)). Some carriers are exempt under Neb. Rev. Stat. 75-303, including certain nonprofit and government operators.
Plan for the 2027 Medicaid NEMT license
LB1126, signed April 14, 2026, creates a PSC license for intrastate Medicaid NEMT. From January 1, 2027, you need it before providing Medicaid NEMT for DHHS, a Heritage Health plan, or an agent working for DHHS. The license lasts one year and renews annually, and the fee cannot exceed $250. The PSC may approve an applicant that is fit, willing, and able to provide the service and can follow its rules. The license test has no public-need showing, unlike a certificate. Transportation network companies can apply.
Neb. Rev. Stat. 75-311: Certificates, permits, and Medicaid NEMT licenses
Enroll with Nebraska Medicaid
Start in the Provider Data Management System run by Maximus. You accept the MC-19 Service Provider Agreement, an ownership disclosure, a felony and misdemeanor release, a citizenship attestation, and the MS-84 ACH/EFT form. Agency providers pay the federal application fee that CMS sets each year, unless Medicare or another state already collected it. Provider types screened at high risk submit fingerprints for owners with 5 percent or more, and every agreement revalidates every five years.
DHHS: Medicaid provider screening and enrollment requirements
Screen every driver before the first ride
471 NAC 27 requires three checks before a driver's first Medicaid ride and every year after: the Nebraska State Patrol sex offender registry, a criminal history check, and the Nebraska Adult and Child Abuse and Neglect Central Registry. Keep the results on file, because DHHS can ask for them at any time.
Contract with MTM
MTM onboarding runs through an application, an interview, contracting, credentialing, and training before your first trip. MTM monitors licensure, background checks, certifications, insurance, and vehicle inspections, and its system stops assigning trips when a credential is not current. Every employee completes fraud, waste, and abuse training and HIPAA training each year.
Vehicle and driver requirements in Nebraska
Two state agencies write Nebraska's rules. DHHS sets driver screening standards in 471 NAC 27, and the PSC sets authority, equipment, driver fitness, and insurance rules in 291 NAC 3. MTM credentials providers against both.
Vehicles
| Requirement | State rule | Broker contract |
|---|---|---|
| Operating authority | PSC common or contract carrier authority with specific authorization for DHHS work, or an exemption under Neb. Rev. Stat. 75-303. From January 1, 2027, a PSC Medicaid NEMT license. | MTM monitors licensure and stops assigning trips when it lapses. |
| Plates and inspection | PSC plates on each vehicle ($50). The PSC inspects vehicles at least annually and can place an unsafe vehicle out of service until it is repaired and re-inspected (291 NAC 3-005.07 and 005.08). | Vehicle inspections are a credential MTM monitors. |
| Rates | Regulated carriers charge only PSC-approved rates. Medicaid NEMT rates paid under a PSC designation or license are exempt from PSC rate regulation (Neb. Rev. Stat. 75-303.03). | Set in the MTM provider agreement. |
| Trip rules | Three business days' notice for routine trips, the nearest provider within 20 miles, no payment for wait time or no-shows, and children under 13 ride with an adult (471 NAC 27). | For UnitedHealthcare members, MTM sets pickup within 180 minutes for discharges and 60 minutes for will-call returns. |
Drivers
| Requirement | State rule | Broker contract |
|---|---|---|
| Age and license | At least 19, with a valid license, no more than three points in the past two years, and no revocation in the past three years (471 NAC 27-007.01). The PSC adds a license suited to the vehicle and the ability to read, speak, and understand English. | MTM monitors licensure as a credential. |
| Background checks | Sex offender registry, criminal history, and abuse and neglect central registry checks before the first ride and every year. A protection order, crimes against a child or vulnerable adult, or drug crimes disqualify a driver (471 NAC 27-008). PSC carriers also submit driver background checks to the Commission. | Background checks are a credential MTM monitors. |
| Training | No training course named in 471 NAC 27. | Fraud, waste, and abuse training and HIPAA training for every employee, every year. |
Insurance minimums in Nebraska
Nebraska's minimums come from the PSC and depend on the vehicle's rated seating capacity. Every passenger carrier also carries uninsured and underinsured motorist coverage, and the policy must be filed with the PSC.
| Coverage | Minimum | Set by |
|---|---|---|
| Vehicles seating 7 or fewer passengers | $500,000 liability | 291 NAC 3-003.03(D) |
| Vehicles seating 8 to 15 passengers | $1,500,000 liability | 291 NAC 3-003.03(C) |
| Vehicles seating 16 or more passengers | $5,000,000 liability | 291 NAC 3-003.03(B) |
| Uninsured and underinsured motorist | $100,000 per person, $300,000 per accident | 291 NAC 3-006.02 |
| Proof of coverage | Continuous policy filed on Form E. Policies written for a fixed term are not accepted. | 291 NAC 3-006 |
| Broker review | Insurance is a credential MTM monitors | Broker contract |
Does Nebraska require EVV for NEMT?
No. Nebraska uses EVV for personal assistance services and home and community-based waiver services, which have billed through EVV since January 2021, and for home health services, phased in from January 1, 2024. Non-emergency transportation under 471 NAC 27 is not one of them.
NEMT is checked a different way. The plan's broker authorizes each trip in advance, Medicaid pays only while the member is in the vehicle, and 471 NAC 27 bars payment for wait time and no-shows. Keep trip records, driver screening results, and PSC filings ready, because DHHS can ask for screening records at any time.
What changed in Nebraska in 2025 and 2026
Nebraska Medicaid covered 295,117 people in May 2026, plus 37,115 in CHIP, according to preliminary CMS data. Heritage Health members choose among three plans, and each plan covers the whole state.
The fee-for-service schedule did not rise on July 1, 2026, because the Legislature appropriated no rate increase. It pays $19.69 per trip at the base rate, $46.12 for a wheelchair van trip, and $1.85 per loaded mile. The base rate includes the first five loaded miles, unloaded miles, and usual waiting time. Individuals with a vested interest in the trip, such as a family member, a neighbor, or the member, get 76 cents per mile. The attendant or escort code (T2001) pays $2.87.
Two 2026 changes matter most for providers. UnitedHealthcare moved its rides to MTM on January 1, and LB1126 sets up the PSC's Medicaid NEMT license for January 1, 2027. Nebraska also began enforcing Medicaid work requirements on May 1, 2026 for adults 19 to 64 in the expansion group.
Non-emergency transportation joins the Heritage Health managed care benefit.
DHHS amends 471 NAC 27, the NEMT chapter.
The PSC's revised motor carrier rules, 291 NAC 3, take effect.
MTM starts taking ride requests for UnitedHealthcare Community Plan of Nebraska members.
MTM becomes the NEMT broker for UnitedHealthcare Community Plan of Nebraska.
The Governor signs LB1126, which creates a PSC license for Medicaid NEMT.
Nebraska Medicaid begins enforcing work requirements for the expansion group.
A new NET fee schedule takes effect with no rate increase.
The NEMT sections of LB1126 take effect.
A PSC Medicaid NEMT license is required to serve DHHS, a Heritage Health plan, or an agent of DHHS.
Frequently asked questions
- Who is the NEMT broker in Nebraska?
- MTM Health, for all three Heritage Health plans in 2026: Nebraska Total Care, Molina Healthcare of Nebraska, and UnitedHealthcare Community Plan of Nebraska, which moved to MTM on January 1, 2026. Each plan has its own MTM ride line. Members outside Heritage Health get fee-for-service rides authorized through the DHHS Customer Service Center.
- Do I need a Public Service Commission permit for NEMT in Nebraska?
- Yes, unless you are exempt. Today you need PSC common or contract carrier authority, with specific authorization to carry passengers under DHHS contracts. From January 1, 2027, LB1126 requires a PSC license for Medicaid NEMT, valid one year, with a fee of no more than $250.
- How do I become a Medicaid transportation provider in Nebraska?
- Get PSC authority or an exemption, get an NPI, and enroll with Nebraska Medicaid through the Maximus Provider Data Management System. Screen every driver against the three registries 471 NAC 27 requires. Then apply to MTM, which runs application, contracting, credentialing, and training before your first trip.
- What insurance does a Nebraska NEMT company need?
- PSC rules set liability by seating capacity: $500,000 for vehicles seating 7 or fewer, $1,500,000 for 8 to 15, and $5,000,000 for 16 or more. Passenger carriers also carry uninsured and underinsured motorist coverage of $100,000 per person and $300,000 per accident, filed with the PSC on Form E.
- What are the driver requirements for Nebraska Medicaid NEMT?
- Drivers must be at least 19, with no more than three license points in two years and no revocation in three years. They clear sex offender registry, criminal history, and abuse and neglect registry checks before the first ride and every year. PSC rules add a physician or physician assistant certificate renewed at least every two years and limit driving to 12 hours after 10 hours off duty.
- How much does Nebraska Medicaid pay for NEMT?
- The July 1, 2026 fee-for-service schedule pays $19.69 per trip at the base rate, $46.12 per wheelchair van trip, and $1.85 per loaded mile after the first five miles, which the base rate includes. Family members, neighbors, and members who drive themselves get 76 cents per mile. MTM pays plan trips at the rate in your MTM agreement.
- Does Nebraska Medicaid pay for wait time or no-shows?
- No. 471 NAC 27 lists wait time and no-shows as non-covered, and the base rate already includes usual waiting or standby time. Medicaid pays only while the member is actually in the vehicle.
- Does Nebraska require EVV for NEMT?
- No. Nebraska EVV covers personal assistance services, home and community-based waiver services, and home health services. NEMT trips are authorized by the broker and documented through trip records instead.
Running NEMT in Nebraska with HealthRide
Nebraska fleets run MTM trips for three plans, plus the occasional fee-for-service ride, under driver checks that repeat every year. HealthRide keeps every trip on one dispatch board and tracks credential expirations, so an expired check is flagged before the driver is assigned.
The driver app records GPS-recorded miles, timestamps, and signatures on every leg, and the trip log exports as CSV or PDF when MTM or DHHS asks for records.
Official resources
- DHHS: Title 471, Nebraska Medical Assistance Program Services
- Nebraska Secretary of State: Title 471 rules, including chapter 27
- DHHS: Nebraska Medicaid Provider Manual
- DHHS: Medicaid provider screening and enrollment requirements
- DHHS: Heritage Health (managed care)
- DHHS: Heritage Health member FAQs
- DHHS: NET fee schedule 471-000-503 (July 1, 2026)
- DHHS: NET fee schedule rates spreadsheet (July 1, 2026)
- DHHS: Medicaid fee schedules
- DHHS: Electronic Visit Verification
- DHHS: Provider Bulletin 26-02, Medicaid work requirements
- Nebraska PSC: Passenger carriers
- Nebraska PSC: 291 NAC 3, Motor carrier rules (effective June 23, 2025)
- Nebraska PSC: Fee schedule (July 1, 2026)
- Nebraska PSC: Transportation forms
- Neb. Rev. Stat. 75-311: Certificates, permits, and Medicaid NEMT licenses
- Neb. Rev. Stat. 75-303.01: Medicaid NEMT contracts
- Neb. Rev. Stat. 75-303.03: Reimbursement and rate regulation
- Nebraska Legislature: LB1126 (2026)
- UnitedHealthcare: MTM Health to manage Nebraska Medicaid NEMT
- Nebraska Total Care: Non-emergency medical transportation
- Molina Healthcare of Nebraska: Transportation
- MTM Health: Provider onboarding
- CMS: State Medicaid and CHIP enrollment data
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