How to start a NEMT business in Nevada: MTM Health, SafeRide, and the state rules
Nevada Medicaid runs NEMT through one statewide broker, MTM Health, which authorizes every ride for fee-for-service members anywhere in the state and for health plan members in Clark and Washoe counties. Since January 1, 2026, the two rural health plans, CareSource and SilverSummit, arrange rides for their own members in the other 15 counties through SafeRide Health. Nevada has no NEMT license, but every vehicle needs $1.5 million in combined single limit insurance under the state manual.
Nevada NEMT at a glance
- Runs the program
- Nevada Medicaid (Division of Health Care Financing and Policy), part of the Nevada Health Authority
- Program
- Non-Emergency Medical Transportation (NEMT), Medicaid Services Manual chapter 1900
- How rides are arranged
- One statewide broker. MTM Health authorizes all urban and all fee-for-service rides. Rural members of CareSource and SilverSummit book through their plan, which uses SafeRide Health.
- Brokers you will contract with
- MTM Health, SafeRide Health
- State operating license
- No NEMT license. Nevada Medicaid issues a letter of exemption from Nevada Transportation Authority certificate rules to providers the broker certifies (NRS 706.745).
- EVV for NEMT trips
- Not required
- Medicaid enrollment
- 668,617 (May 2026)
On this page
How Medicaid NEMT works in Nevada
Nevada Medicaid, the Division of Health Care Financing and Policy, has been part of the new Nevada Health Authority since July 1, 2025. Its Medicaid Services Manual chapter 1900 sets the NEMT rules. The manual splits the state into urban areas (Clark and Washoe counties) and rural areas (the other 15 counties), and that split decides who authorizes a ride.
MTM Health holds the statewide broker contract. It authorizes rides for every fee-for-service member in the state and for every health plan member in an urban county. MTM has run Nevada's program since 2016. The contract term it won in the 2021 re-award began July 1, 2021, with a four-year base and two optional one-year extensions. At that re-award MTM reported nearly two million trips a year, with public transit carrying about 75 percent of trip volume.
On January 1, 2026, Nevada Medicaid moved most rural members into managed care, and the manual now makes the rural plans responsible for their members' rides. CareSource and SilverSummit route those trips to SafeRide Health. Every NEMT ride needs prior authorization, members give at least three business days' notice, and hospital discharges and urgent care can be booked the same day.
Governing rule:Nevada Medicaid Services Manual, chapter 1900: Transportation Services (January 1, 2026)
Who brokers Medicaid rides in Nevada
Two brokers arrange Nevada Medicaid rides. Where the member lives and whether they have a health plan decides which one.
| Broker | Serves | Provider sign-up |
|---|---|---|
| MTM Health | All fee-for-service members statewide, and members of all five health plans (Anthem, CareSource, Health Plan of Nevada, Molina, SilverSummit) who live in Clark or Washoe County.Since 2016 (contract term began July 1, 2021). | Provider pageMTM Health Nevada program office 702-323-7700 |
| SafeRide Health | Rural members of CareSource and SilverSummit in the 15 counties outside Clark and Washoe. Members call their plan first and are routed to SafeRide.Since January 1, 2026. | Provider page |
SilverSummit's rural list also includes outlying towns inside Clark and Washoe, such as Mesquite, Laughlin, and Incline Village. Check the member's ZIP code before you assume which broker a trip belongs to.
Health Plan of Nevada serves urban Clark County only since January 1, 2026. Its Washoe and rural Clark members moved to other plans, but urban NEMT for every plan still runs through MTM Health.
MSM chapter 1900, effective January 1, 2026, lists Nevada Check Up (CHIP) members as eligible for NEMT. Nevada Medicaid's transportation services page still says Check Up members are not eligible and sends them to transportation@nvha.nv.gov, so confirm with the broker before you schedule a Check Up member.
How to become a NEMT provider in Nevada
Nevada providers contract with a broker rather than billing Medicaid directly. Pick the broker that covers the area you want to serve, then meet the chapter 1900 standards the broker enforces.
Form the business
Register the company with the Nevada Secretary of State and get a federal EIN. Use the same legal name on your insurance, broker contract, and any Nevada Medicaid enrollment.
Choose your service area
Clark and Washoe county work runs through MTM Health. Rural health plan members run through SafeRide Health, while rural fee-for-service members still go to MTM. The broker authorizes every ride, so a contract with the right broker is the only way to get Medicaid trips.
Apply to the broker
Apply through MTM Health's service provider network page or SafeRide's provider page. MTM sets rates with each provider individually. The manual lists a current Nevada Medicaid provider agreement among the items the broker checks, so ask the broker whether it needs your Nevada Medicaid enrollment. Enrollment runs through the Provider Flex tool, and the Gainwell contact center is 877-638-3472.
Buy the required insurance
Every vehicle needs at least $1,500,000 combined single limit coverage. MTM Health also requires $1,500,000 in general liability, workers compensation that meets state law, and MTM listed as certificate holder and additional insured on both liability policies.
Set up driver files and a drug testing program
The broker confirms each provider keeps a drug and alcohol testing program that meets 49 CFR Part 382, periodic criminal background checks under MSM chapter 100, and classroom and behind-the-wheel training for every driver within 30 days of starting service.
Get your NTA letter of exemption
Carriers working under the Medicaid contract are exempt from Nevada Transportation Authority certificate and permit rules under NRS 706.745. Nevada Medicaid issues the letter of exemption only after the broker certifies your insurance, vehicle safety, and driver background and drug tests. Keep the letter in each vehicle and mark the vehicle as operating under the exemption. The exemption covers service under the Medicaid contract, so ask the NTA whether any other work, such as private-pay rides, needs a certificate.
Vehicle and driver requirements in Nevada
In Nevada the Medicaid manual itself sets detailed driver and vehicle standards, and the broker must enforce them. MTM Health adds its own insurance and reporting terms.
Vehicles
| Requirement | State rule | Broker contract |
|---|---|---|
| Operating authority | No NEMT license. NTA certificate rules do not apply to carriers under the Medicaid contract once Nevada Medicaid issues a letter of exemption; exemption signage and documents stay in each vehicle (NRS 706.745, MSM 1903.3C). | The broker certifies insurance, vehicle safety, and driver checks before the exemption is issued. |
| Inspection | The broker runs an annual inspection on top of any state inspection, covering brakes, tires, signals, horn, seat belts, and heating and air conditioning. | Run by the broker for every vehicle in its network. |
| Equipment | Two-way communication with your base (pagers do not count), heat and air conditioning, working seat belts and child seats under NRS 484B.157, speedometer and odometer, two side mirrors and an interior mirror, first aid kit, and a current state map. | Same, checked at inspection. |
| Signs and paperwork | Provider name, vehicle number, and the broker's phone numbers posted inside; "NO SMOKING" and "ALL PASSENGERS MUST USE SEAT BELTS" signs; a packet with registration, insurance card, and accident forms. | Written complaint procedures available to riders on request. |
| Accessibility | Vehicles comply with ADA regulations. Any vehicle out of compliance is removed from service until the broker confirms the fix. | Accident and incident forms go to MTM Health by the end of the next business day, and injuries are reported by phone within three hours. |
Drivers
| Requirement | State rule | Broker contract |
|---|---|---|
| Age and license | At least 18 with a current, valid Nevada driver's license for the assigned vehicle. | Same. |
| Driving record | No more than one chargeable accident and two moving violations in the last three years, and no suspension or revocation in the last five years. | Same, enforced by the broker. |
| Criminal history | No convictions for substance abuse, sexual abuse, or a crime of violence. Any other felony needs Nevada Medicaid's approval before hire. Background checks repeat periodically under MSM chapter 100. | Same, enforced by the broker. |
| Drug and alcohol testing | A testing program that meets 49 CFR Part 382, and no alcohol or impairing drugs on duty. | Same. |
| Training | Classroom and behind-the-wheel training within 30 days: defensive driving, wheelchair securement and lift operation, cultural and disability sensitivity, passenger assistance, first aid, and customer service. | MTM Health provides training resources and requires its own credentialing elements. |
| Conduct | Visible company ID, no smoking, no headphones, and no phone use while driving. | Same. |
Insurance minimums in Nevada
Nevada sets a real dollar minimum for NEMT vehicles in the Medicaid manual, tied to the Nevada Transportation Authority's carrier rule. MTM Health matches it with general liability.
| Coverage | Minimum | Set by |
|---|---|---|
| NEMT vehicles, combined single limit | $1,500,000 on every vehicle at all times; if NAC 706.191 rises, the higher amount applies | MSM 1903.3C and NAC 706.191 |
| Vehicles seating 16 or more passengers, including the driver | $5,000,000 combined single limit | NAC 706.191 |
| Policy standard | Meets 49 CFR 387 subpart B, with notice to Nevada Medicaid on expiration or cancellation | MSM 1903.3C |
| MTM Health auto and general liability | $1,500,000 each, with MTM Health as certificate holder and additional insured | Broker contract |
| Workers compensation | Coverage that meets Nevada requirements | Broker contract |
| SafeRide Health (rural plan trips) | $1,000,000 per occurrence and $2,000,000 aggregate general liability, $500,000 auto liability, SafeRide as additional insured; the state $1,500,000 vehicle minimum still applies | Broker contract |
Does Nevada require EVV for NEMT?
No. Nevada EVV covers home health care (provider type 29), personal care services (provider types 30 and 83), and attendant care, homemaker, chore, respite, and companion services (provider types 48 and 58). NEMT is not on the list.
The broker verifies instead. MTM Health checks eligibility and confirms each appointment is a covered service before it authorizes a ride, and Nevada Medicaid reviews rides to confirm members went to the nearest appropriate provider. Drivers wait at least 15 minutes past the scheduled pickup before marking a no-show, and riders are never charged for rides or no-shows. MTM Health does not pay providers for no-shows, so confirm each ride with the member the day before.
What changed in Nevada in 2025 and 2026
Nevada Medicaid covered 668,617 people in May 2026, plus 45,454 children in Nevada Check Up, according to CMS preliminary monthly data.
Public transit carries a large share of Nevada trips. The manual requires the broker to use the least expensive mode that fits the member, including bus passes, paratransit, and mileage reimbursement, before it assigns a commercial vehicle. Community drivers who contract with MTM are paid twice the IRS business mileage rate, and MTM reimburses members' gas mileage at 23.5 cents per mile.
The big change is rural managed care. Since January 1, 2026, CareSource and SilverSummit cover most rural members and send their rides to SafeRide Health, while MTM keeps urban and fee-for-service work. Five plans now serve Nevada, and Health Plan of Nevada has narrowed to urban Clark County.
MTM's current statewide NEMT contract begins, with a four-year base term and two optional one-year extensions.
The Nevada Health Authority launches under Senate Bill 494, and the Division of Health Care Financing and Policy becomes Nevada Medicaid.
Nevada Medicaid announces that its transportation broker, Medical Transportation Management, is now MTM Health.
Managed care expands to rural Nevada. CareSource and SilverSummit take over rides for their rural members through SafeRide Health, the updated MSM chapter 1900 lists Nevada Check Up members as eligible for NEMT, and Health Plan of Nevada narrows to urban Clark County.
Nevada Medicaid publishes its scheduling flyer: rural plan members call their plan, and urban and all fee-for-service members call MTM Health.
Frequently asked questions
- Who is the NEMT broker in Nevada?
- MTM Health is Nevada Medicaid's statewide broker. It handles every fee-for-service member and every health plan member in Clark and Washoe counties (844-879-7341). Since January 1, 2026, rural members of CareSource and SilverSummit book through their plan, which uses SafeRide Health.
- Do I need a license to run a NEMT business in Nevada?
- There is no NEMT license. Carriers working under the Medicaid broker contract are exempt from Nevada Transportation Authority certificate and permit rules under NRS 706.745, once Nevada Medicaid issues a letter of exemption after the broker certifies your insurance, vehicles, and drivers. The exemption covers service under the Medicaid contract, so ask the NTA about private-pay or other work.
- How much insurance does a Nevada NEMT provider need?
- At least $1,500,000 combined single limit on every vehicle, under MSM chapter 1900 and NAC 706.191. Vehicles seating 16 or more need $5,000,000. MTM Health also requires $1,500,000 in general liability, workers compensation, and MTM named as additional insured.
- What are the NEMT driver requirements in Nevada?
- Drivers must be at least 18 with a valid Nevada license, have no more than one chargeable accident and two moving violations in three years, have no license suspension in five years, and have no convictions for substance abuse, sexual abuse, or violent crime. They need a 49 CFR Part 382 drug and alcohol program and training within 30 days that includes defensive driving, wheelchair securement, passenger assistance, and first aid.
- Does Nevada require EVV for NEMT?
- No. Nevada EVV applies to home health, personal care, and attendant, homemaker, chore, respite, and companion services. NEMT rides are authorized and checked by the broker instead.
- What changed for Nevada NEMT in 2026?
- On January 1, 2026, managed care expanded into the 15 rural counties. CareSource and SilverSummit now arrange rides for their rural members through SafeRide Health, while MTM Health keeps urban and fee-for-service rides. The same manual update lists Nevada Check Up members as eligible for NEMT, though the state's transportation page still says they are not, so confirm with the broker first.
- How far ahead do Nevada Medicaid members book rides?
- At least three business days before the appointment. Hospital discharges and medically necessary urgent care can be booked the same day. Every ride needs prior authorization from the broker.
- Can family members or neighbors drive Nevada Medicaid members?
- Yes. Family and friends can get gas mileage reimbursement with prior authorization, which MTM Health pays at 23.5 cents per mile. Private citizens can also contract with MTM Health as community non-professional drivers, paid twice the IRS business mileage rate. Current Medicaid members cannot sign up as community drivers.
Running NEMT in Nevada with HealthRide
Nevada fleets often run MTM Health trips in Las Vegas or Reno alongside SafeRide trips from rural plans. HealthRide puts both on one dispatch board and records every payment in one ledger, so a second broker does not mean a second system.
Credential and inspection reminders flag expiring licenses and annual inspections before a driver or van gets assigned, and the driver app records GPS-recorded miles, timestamps, signatures, and no-show wait times on every leg.
Official resources
- Nevada Medicaid: Transportation services
- Nevada Medicaid Services Manual, chapter 1900: Transportation Services (January 1, 2026)
- Nevada Medicaid Web Announcement 3882: Transportation support flyer (April 2026)
- Nevada Medicaid Web Announcement 3674: Broker name changes to MTM Health
- Nevada Medicaid Web Announcement 3661: Nevada Health Authority launches
- Nevada Medicaid: Provider enrollment
- Nevada Medicaid: Electronic Visit Verification
- NRS chapter 706: Motor carriers (see NRS 706.745)
- NRS chapter 422: Medicaid transportation contracts (see NRS 422.27495)
- NAC chapter 706: Carrier insurance minimums (see NAC 706.191)
- MTM Health: Nevada
- MTM Health: Nevada transportation provider network
- MTM Health: Join the service provider network
- MTM Health: Transportation provider training and forms
- MTM Health: Nevada re-awards NEMT program to MTM
- SafeRide Health: What to expect as a NEMT provider
- SilverSummit Healthplan: Transportation services in rural areas
- CareSource Nevada: Transportation
- Health Plan of Nevada: Changes coming to Medicaid plans
- CMS: State Medicaid and CHIP enrollment data
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