How to start a NEMT business in New Hampshire: plan brokers, He-W 574, and 2026 mileage limits
New Hampshire Medicaid members get rides through a transportation broker tied to their health plan. MTM Health serves NH Healthy Families and WellSense Health Plan. Coordinated Transportation Solutions (CTS) serves AmeriHealth Caritas New Hampshire, fee-for-service members, and the adult dental program. DHHS rewrote its NEMT rule, He-W 574, effective October 1, 2025, and the MTM plans began applying its round-trip mileage limits in June and August 2026.
New Hampshire NEMT at a glance
- Runs the program
- New Hampshire Department of Health and Human Services (DHHS)
- Program
- New Hampshire Medicaid Non-Emergency Medical Transportation (NEMT)
- How rides are arranged
- Health plans each contract a broker. Each Medicaid health plan has its own transportation broker. Fee-for-service members ride through CTS.
- Brokers you will contract with
- MTM Health, CTS (Coordinated Transportation Solutions)
- State operating license
- No NEMT license in He-W 574. Vehicles must be registered under RSA 261:40 and equipped to 49 CFR 38.23, and drivers participate through a broker.
- EVV for NEMT trips
- Not required
- Medicaid enrollment
- 149,895 (May 2026, Medicaid only)
On this page
How Medicaid NEMT works in New Hampshire
DHHS runs New Hampshire Medicaid, and most members are enrolled in one of three Medicaid Care Management health plans: AmeriHealth Caritas New Hampshire, NH Healthy Families, and WellSense Health Plan. The current plan contracts took effect September 1, 2024. Each plan has a transportation broker that books rides and pays drivers, and members find the broker's number on the back of their Medicaid ID card.
The rules are in He-W 574, which DHHS readopted with extensive changes effective October 1, 2025. A broker must hold an active Medicaid provider number, screen every driver against the OIG exclusion list at hire and every month, and make sure vehicles are registered and equipped to federal accessibility standards. Transportation company drivers must participate with the broker, and the broker keeps a six-year file on each one.
Rides go to the nearest appropriate Medicaid provider by the least costly route, measured with a web-based mapping tool. Wait time is covered only on round trips, up to two hours, rounded to the nearest half hour. Trips beyond the rule's round-trip mileage limits need prior authorization.
Governing rule:He-W 574: Non-Emergency Medical Transportation (effective October 1, 2025)
Who brokers Medicaid rides in New Hampshire
Two brokers cover New Hampshire Medicaid. The member's plan decides which one books the ride, and each broker has its own notice rules.
| Broker | Serves | Provider sign-up |
|---|---|---|
| MTM Health | NH Healthy Families (since September 1, 2020) and WellSense Health Plan members.He-W 574 round-trip mileage limits took effect for NH Healthy Families on June 1, 2026 and for WellSense on August 1, 2026. | Provider pageNH Healthy Families rides 888-597-1192; WellSense 844-909-7433 |
| CTS (Coordinated Transportation Solutions) | AmeriHealth Caritas New Hampshire, NH Medicaid fee-for-service, and the adult dental program (Northeast Delta Dental and DentaQuest). | Provider pageAmeriHealth Caritas 833-301-2264; fee-for-service 844-259-4780; dental 844-304-6630 |
Notice rules differ. The DHHS quick guide lists 48 hours for fee-for-service and AmeriHealth Caritas routine rides and two business days for NH Healthy Families and WellSense. Urgent rides need 2 hours' notice with CTS and 3 hours with MTM.
Members who have a car, or a friend or family member who can drive them, use the Family and Friends Mileage Reimbursement Program. Members who live and get care near a bus route may be required to use public transit.
How to become a NEMT provider in New Hampshire
New Hampshire transportation companies join a broker network. Pick the brokers whose members you want to serve and complete each one's credentialing packet.
Form the business
Register the company with the New Hampshire Secretary of State and get a federal EIN. He-W 574 requires the broker to keep a copy of the IRS document showing your federal tax ID, a W-9, and any nonprofit determination letter.
Register and equip your vehicles
Vehicles must be registered under RSA 261:40 and equipped and supplied to 49 CFR 38.23, the federal ADA vehicle standard for lifts, ramps, and securement. Wheelchair van drivers follow 49 CFR 37 and 38 and keep proof of registration and insurance for the dates they carried Medicaid members.
Apply to MTM
MTM serves NH Healthy Families and WellSense. Its onboarding runs through an application, an interview, contracting, credentialing, and training, and every employee completes fraud, waste, and abuse training and HIPAA training each year.
Apply to CTS
CTS serves AmeriHealth Caritas, fee-for-service, and adult dental members. CTS lists defensive driving, passenger assistance, customer service, and sensitivity training for drivers, plus First Aid and CPR where mandated. Vehicles must be licensed, inspected, and insured to local, state, and federal guidelines.
Build each driver file
For each transportation company driver the broker keeps a signed credentialing packet, proof of a valid license, proof of auto liability insurance and each renewal, background checks, OIG exclusion checks at hire and every month, training records, and proof the vehicle is safe for passengers. The broker holds these records for six years.
Keep dispatch travel logs
The broker's file for each driver must include dispatch travel logs with the driver name, company name, member name, date of service, and a signature log of all parties. Member complaints and the steps taken to resolve them go in the file too, so keep both ready to send.
Vehicle and driver requirements in New Hampshire
He-W 574 puts most provider requirements on the broker, which collects and stores them. The broker contract adds training and operating standards.
Vehicles
| Requirement | State rule | Broker contract |
|---|---|---|
| Registration | Registered under RSA 261:40 (He-W 574.03). | CTS: licensed, inspected, and insured to local, state, and federal guidelines. |
| Accessibility equipment | Equipped and supplied to 49 CFR 38.23. Wheelchair van drivers follow 49 CFR 37 and 38 (He-W 574.04). | Wheelchair ramps, lifts, or securement systems where the service calls for them (CTS). |
| Vehicle safety | Proof the vehicle is safe for passengers, kept in the broker's file for six years. | Maintenance schedules that meet Department of Transportation, DMV, and CTS standards. |
| Mileage and routing | Nearest appropriate provider by the least costly route. Round-trip limits run from 30 miles to a pharmacy up to 400 miles to a specialty provider (He-W 574.10). | Trips over the limits need prior authorization. NH Healthy Families applied the limits from June 1, 2026 and WellSense from August 1, 2026. |
Drivers
| Requirement | State rule | Broker contract |
|---|---|---|
| License | Proof of a valid driver's license on file with the broker (He-W 574.04). | Credentialing packet completed, signed, and dated by the transportation company. |
| Background and exclusion checks | Background checks on file, plus OIG exclusion checks at hire and every month (He-W 574.03 and 574.04). | The broker runs the monthly OIG screening for every driver. |
| Training | Training records kept in the broker's file. | CTS: defensive driving, passenger assistance, customer service, sensitivity, and First Aid and CPR where mandated. MTM: annual fraud, waste, and abuse and HIPAA training. |
Insurance minimums in New Hampshire
He-W 574 requires proof of automobile liability insurance but sets no dollar amount. Each broker sets its minimums in the provider contract.
| Coverage | Minimum | Set by |
|---|---|---|
| Automobile liability | Proof required at enrollment and at every renewal. No dollar amount in the rule. | He-W 574.04(c) |
| Wheelchair vans | Proof of insurance for the dates Medicaid service was delivered | He-W 574.04(d) |
| CTS network | Commercial general liability, commercial automobile, and workers compensation, in the amounts the contract sets | Broker contract (CTS) |
| Coverage amounts | Set in each broker contract | Broker contract |
Does New Hampshire require EVV for NEMT?
No. New Hampshire's EVV requirement went live June 1, 2024 for home care visits under listed Medicaid home and community-based services, recorded in the state's NH AuthentiCare system or a provider's own EVV tool. He-W 574, the NEMT rule, has no EVV requirement.
NEMT relies on records instead. Brokers keep dispatch travel logs with the driver, company, member, date, and a signature log of all parties. Family and friends mileage claims need signatures from the member, the driver, and the Medicaid provider, and they must be filed within 90 days of the trip.
What changed in New Hampshire in 2025 and 2026
New Hampshire Medicaid covered 149,895 people in May 2026, plus 18,787 in CHIP, according to preliminary CMS data that include retroactive enrollments.
He-W 574 spells out how wheelchair van trips are paid. Each one-way leg earns a base rate, mileage is paid on loaded miles only along the most direct route, and round trips add wait time of up to two hours. The commissioner sets the rates under RSA 161:4, VI(a).
The MTM plans began enforcing the rule's mileage limits in 2026. NH Healthy Families began applying the He-W 574 round-trip limits on June 1, 2026 and WellSense on August 1, 2026: 30 miles to a pharmacy, 50 to a physician or behavioral health provider, 90 to a hospital, therapist, or dialysis provider, 300 to a dentist, and 400 to a specialty provider. Longer trips need prior authorization.
NH Healthy Families moves its NEMT program to MTM.
The current Medicaid Care Management contracts take effect with AmeriHealth Caritas, NH Healthy Families, and WellSense.
DHHS readopts He-W 574 with extensive changes to the NEMT rules.
The current DHHS NEMT quick summary guide takes effect, listing each plan's broker, ride line, and notice rules.
NH Healthy Families begins applying He-W 574 round-trip mileage limits.
WellSense begins applying the same distance limits.
Frequently asked questions
- Who is the NEMT broker in New Hampshire?
- It depends on the member's plan. MTM Health serves NH Healthy Families and WellSense Health Plan. CTS serves AmeriHealth Caritas New Hampshire, fee-for-service members, and the adult dental program. The member's broker number is on the back of the Medicaid ID card.
- How do I become a NEMT provider in New Hampshire?
- Contract with the brokers whose members you want to serve. He-W 574 requires transportation company drivers to participate with the broker, and the broker collects your credentialing packet, tax documents, insurance proof, background checks, training records, and vehicle safety proof. MTM and CTS each run their own onboarding.
- What are the New Hampshire Medicaid mileage limits for NEMT?
- He-W 574 caps round-trip mileage at 30 miles to a pharmacy, 50 to a physician or behavioral health provider, 90 to a hospital, therapist, or dialysis provider, 300 to a dentist, and 400 to a specialty provider. Longer trips need prior authorization. NH Healthy Families applied the limits on June 1, 2026 and WellSense on August 1, 2026.
- Does New Hampshire Medicaid pay for wait time?
- Only on round trips, up to two hours, rounded to the nearest half hour. Wait time on one-way trips and wait time beyond two hours are not covered under He-W 574.
- What insurance does a New Hampshire NEMT provider need?
- He-W 574 requires proof of automobile liability insurance at enrollment and at every renewal, but it sets no dollar amount. Each broker sets its minimums in the provider contract, so ask MTM and CTS for their current figures.
- How far ahead do New Hampshire Medicaid members book rides?
- The DHHS quick guide lists 48 hours for fee-for-service and AmeriHealth Caritas routine rides, and two business days for NH Healthy Families and WellSense. Urgent rides need 2 hours' notice with CTS and 3 hours with MTM.
- Does New Hampshire require EVV for NEMT?
- No. New Hampshire EVV, live since June 1, 2024, covers home care visits for listed home and community-based services. NEMT relies on dispatch travel logs with signatures instead.
- What changed in He-W 574 in 2025?
- DHHS readopted He-W 574 with extensive changes effective October 1, 2025. The current rule adds a broker participation section that requires monthly OIG screening of every driver. It also lists the six-year file the broker keeps for each transportation company driver, spells out wheelchair van payment, and sets round-trip mileage limits that need prior authorization to exceed.
Running NEMT in New Hampshire with HealthRide
New Hampshire fleets often work for two brokers with different notice rules and mileage limits. HealthRide keeps MTM and CTS trips on one dispatch board, and the driver app records GPS-recorded miles and timestamps on every leg.
Signatures are captured on screen at each pickup, and the trip log exports as CSV or PDF when a broker asks for the dispatch travel logs He-W 574 requires.
Official resources
- NH DHHS: Medicaid transportation
- NH DHHS: NEMT quick summary guide (October 2025)
- NH DHHS: Medicaid Care Management
- NH Code of Administrative Rules: He-W 500, including He-W 574
- NH DHHS: Electronic Visit Verification
- NH Healthy Families: MTM member mileage limits (April 2026)
- NH Healthy Families: MTM mileage limitation letter to providers
- NH Healthy Families: MTM effective September 1, 2020
- WellSense: New Hampshire provider transportation
- WellSense: New Hampshire Medicaid member transportation
- AmeriHealth Caritas New Hampshire: Transportation
- CTS: AmeriHealth Caritas New Hampshire resources
- CTS: Transportation providers
- CTS: Driver requirements
- CTS: Vehicle requirements
- MTM Health: Provider onboarding
- 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.