How to start a NEMT business in North Carolina: plan brokers, NCTracks, and county DSS
North Carolina splits Medicaid transportation two ways. Health plans (Standard Plans, Tailored Plans, and the Children and Families Specialty Plan) arrange rides for their members, and most of them use Modivcare. County departments of social services (DSS) arrange rides for NC Medicaid Direct and EBCI Tribal Option members. Every NEMT provider enrolls in NCTracks, and NC Medicaid requires no separate NEMT license or certification.
North Carolina NEMT at a glance
- Runs the program
- NC Department of Health and Human Services, Division of Health Benefits (NC Medicaid)
- Program
- Non-Emergency Medical Transportation (NEMT)
- How rides are arranged
- Health plans each contract a broker. Health plans arrange rides through transportation brokers. County DSS offices arrange rides for NC Medicaid Direct and EBCI Tribal Option members.
- Brokers you will contract with
- Modivcare, MTM Health, plus county DSS offices
- State operating license
- No NEMT license, certification, or accreditation. Providers enroll in NCTracks and receive a state compliance site visit.
- EVV for NEMT trips
- Not required
- Medicaid enrollment
- 2,486,253 (April 2026, Medicaid only)
On this page
How Medicaid NEMT works in North Carolina
NC Medicaid managed care started July 1, 2021. Today four Standard Plans (AmeriHealth Caritas, Carolina Complete Health, Healthy Blue, and UnitedHealthcare Community Plan), four Tailored Plans (Alliance Health, Partners Health Management, Trillium Health Resources, and Vaya Health), and the statewide Children and Families Specialty Plan each owe their members NEMT. The state NEMT policy requires each plan to pay only for the least expensive suitable mode, to a Medicaid covered service from an NC Medicaid enrolled provider.
The policy also sets trip timing. A member should arrive on time but no more than one hour early, and should not wait more than one hour after treatment ends for the ride home. On shared, long distance, or coordinated trips, both limits stretch to two hours. Urgent trips and hospital discharges need no advance notice.
Members outside managed care, in NC Medicaid Direct or the EBCI Tribal Option, call their local DSS. NC treats transportation arranged and paid by a county DSS as an administrative service: the county authorizes each trip, and the provider bills NCTracks against that authorization. Members with NC Medicaid Direct are asked to request rides at least four days ahead, compared with two days for plan members.
Governing rule:NC Medicaid Managed Care Non-Emergency Medical Transportation Policy
Who brokers Medicaid rides in North Carolina
Modivcare arranges rides for seven of the eight named health plans. Carolina Complete Health, which uses MTM Health, is the exception. Plans and their brokers cannot bar you from contracting with other plans, so one fleet can hold both contracts.
| Broker | Serves | Provider sign-up |
|---|---|---|
| Modivcare | Standard Plans: Healthy Blue, AmeriHealth Caritas North Carolina, and UnitedHealthcare Community Plan. Tailored Plans: Alliance Health, Partners Health Management, Trillium Health Resources, and Vaya Health. | Provider pageNC network team 855-397-3604, ncnetwork@modivcare.com |
| MTM Health | Carolina Complete Health, which absorbed WellCare of North Carolina on April 1, 2026 and now serves all six Medicaid regions. CCH's transportation page and April 2026 member handbook name MTM Health as its transportation provider (member line 844-784-8931).NC Medicaid's May 2026 quick reference still lists 855-397-3601 for Carolina Complete Health rides. CCH's own page lists MTM Health at 844-784-8931. | Provider page |
| County departments of social services | NC Medicaid Direct and EBCI Tribal Option members in each county. The county authorizes every trip. |
The Children and Families Specialty Plan launched December 1, 2025 for children and young adults currently and formerly served by child welfare. Blue Cross NC runs it as Healthy Blue Care Together. Ask the plan which vendor arranges its rides before you count on those trips.
State policy bars plans and their brokers from putting exclusivity or non-compete clauses in transportation provider contracts.
How to become a NEMT provider in North Carolina
NCTracks enrollment comes first for every lane. Broker contracts and county agreements come after.
Form the business
Register the company with the NC Secretary of State and get a federal EIN. An NPI is optional for NEMT: NCTracks lets transportation providers enroll with an NPI or as atypical providers.
Enroll in NCTracks with the right taxonomy
Apply online at NCTracks under a NEMT taxonomy, such as 343900000X for a non-emergency medical transport van, 344600000X for taxi, or 347B00000X for bus. The NC Medicaid application fee is $100, and taxonomies that owe the federal application fee pay $750 in 2026. Online training is required, and NEMT taxonomies are screened as moderate to high risk.
Pass the state site visit
Every NEMT provider type gets a state compliance monitoring visit. Compliant, approved providers appear on NC Medicaid's daily provider directory file.
Set up driver screening and drug testing
Before you contract, put in place a written driver screening policy, a criminal background check process repeated every three years, yearly driving record reviews, and a random alcohol and drug testing program that meets Federal Transit Administration rules. The provider pays for the testing program.
Contract with the brokers
Apply to Modivcare for its seven plans. Its checklist covers PASS wheelchair certification, First Aid and CPR, defensive driving, a drug screen, a motor vehicle report, and a background check for each driver, plus current registration, state inspection, and insurance for each vehicle. Contract with MTM Health for Carolina Complete Health members.
Contract with county DSS offices
For NC Medicaid Direct trips, reach out to the DSS transportation coordinator in each county you serve. The county issues the prior authorization for each trip, and you bill NCTracks against it.
Vehicle and driver requirements in North Carolina
NC's managed care NEMT policy sets the state floor, and plans must write it into every provider contract. Brokers add training and screening on top.
Vehicles
| Requirement | State rule | Broker contract |
|---|---|---|
| Registration and inspection | Valid North Carolina registration and state inspection for every vehicle used to transport members. | Current registration and state inspection (Modivcare). |
| Vehicle type | Enroll the taxonomy that matches the service: non-emergency medical transport van, taxi, bus, secured medical transport van, or transportation network company. | Vehicle inspection at credentialing on the broker's schedule. |
| Provider files | For every driver and volunteer: license, current vehicle registration and inspection, current driving record, liability insurance, and a signed agreement to report changes. Plans review contractors every year. | Broker credentialing file, updated at each recredentialing. |
Drivers
| Requirement | State rule | Broker contract |
|---|---|---|
| Age and license | At least 18 and properly licensed for the specific vehicle used. | Same. |
| Driving record | A three-year driving record at application, reviewed every 12 months. No more than two chargeable accidents or moving violations in three years and no license suspension or revocation in five years. | Motor vehicle report (Modivcare). |
| Criminal background | A North Carolina criminal record check (NCIC if the driver has lived in NC less than five years) before hire and every three years. Convictions within 10 years for offenses such as murder, rape, kidnapping, serious assault, elder or child abuse, weapons or explosives crimes, or Schedule I or II drug sales disqualify. | Background check (Modivcare). |
| Drug and alcohol testing | A random alcohol and drug testing program meeting FTA requirements, paid for by the provider. | Drug screen at credentialing (Modivcare). |
| Training | NCTracks online training for the enrolled provider. | PASS wheelchair certification, First Aid and CPR, and defensive driving (Modivcare). |
Insurance minimums in North Carolina
The state NEMT policy points to the NC Utilities Commission common carrier limits as the guide for minimum coverage. Brokers set their own limits on top.
| Coverage | Minimum | Set by |
|---|---|---|
| For-hire passenger vehicles, 15 or fewer seats including driver | $1,500,000 liability | NC Medicaid NEMT policy (NCUC common carrier guide) |
| For-hire passenger vehicles, more than 15 seats including driver | $5,000,000 liability | NC Medicaid NEMT policy (NCUC common carrier guide) |
| Commercial vehicles with 16 or more passengers | Plan or broker named as additional insured, with 30 days' notice before coverage drops | NC Medicaid NEMT policy |
| Taxicabs | The local ordinance minimum for the vehicle class | Local ordinance |
| General liability and sexual abuse and molestation (SAM) | Commercial general liability (limits vary by state) plus SAM coverage | Broker contract (Modivcare) |
Does North Carolina require EVV for NEMT?
No. North Carolina requires electronic visit verification for in-home services: personal care services, home health, CAP/C, CAP/DA, and in-home Innovations and TBI waiver services. NEMT is not on the list.
NC tracks trips through encounter data instead. Plans must report every leg as its own encounter, with the trip number, scheduled pickup time, the time the driver arrived, the time the driver left, the drop-off time, actual miles, and whether the member was picked up. Brokers pull those times from the provider, so every leg needs accurate arrival, departure, and drop-off times.
What changed in North Carolina in 2025 and 2026
North Carolina had 2,486,253 people on Medicaid and 349,014 on CHIP in April 2026, according to CMS enrollment data.
The plan map shifted twice in six months. The Children and Families Specialty Plan launched December 1, 2025, and WellCare of North Carolina merged into Carolina Complete Health on April 1, 2026, making CCH the largest Medicaid plan in the state at more than 775,000 members across all six regions.
County rates were cut and then restored. NC Medicaid reduced NC Medicaid Direct NEMT rates to 97 percent of the September 30, 2025 level on October 1, 2025. The state announced the reversal on December 10, 2025. From December 17, 2025, new county prior authorizations use the September 30, 2025 rates again, and earlier authorizations and claims are being adjusted in phases.
Modivcare, which brokers seven NC plans, filed for Chapter 11 on August 20, 2025 and emerged on December 29, 2025.
Tailored Plans launch, and the current managed care NEMT policy changes take effect.
Modivcare files for Chapter 11.
NC Medicaid Direct NEMT rates drop to 97 percent of the rates in effect September 30, 2025.
The Children and Families Specialty Plan, run by Healthy Blue Care Together, launches statewide.
New NEMT prior authorizations from counties return to the September 30, 2025 rates.
Modivcare emerges from Chapter 11.
The federal provider enrollment application fee rises to $750. The NC fee stays at $100.
WellCare of North Carolina members move to Carolina Complete Health, which expands to all six regions.
Frequently asked questions
- Who is the NEMT broker in North Carolina?
- There is no single broker. Modivcare arranges rides for Healthy Blue, AmeriHealth Caritas, UnitedHealthcare Community Plan, and all four Tailored Plans (Alliance, Partners, Trillium, and Vaya). Carolina Complete Health uses MTM Health. NC Medicaid Direct and EBCI Tribal Option members get rides through their county DSS.
- Do NEMT providers have to enroll in NCTracks?
- Yes. The state NEMT policy requires every NEMT provider, and every plan's broker, to enroll as an NC Medicaid provider through NCTracks. You pay the $100 NC application fee (plus the $750 federal fee in 2026 if your taxonomy owes it), complete online training, and pass a state site visit.
- Do I need an NPI or a license to run NEMT in North Carolina?
- No NPI is required: NEMT providers can enroll in NCTracks as atypical providers. NC Medicaid also requires no NEMT certification, accreditation, or license. Taxis follow local ordinances, and brokers set their own credentialing checklists.
- What insurance do North Carolina NEMT providers need?
- The state policy uses the NC Utilities Commission common carrier limits as the guide: $1.5 million liability for vehicles seating 15 or fewer including the driver, and $5 million above that. Taxis carry their local ordinance minimum. Brokers add general liability and sexual abuse and molestation coverage.
- What are the driver requirements for NEMT in North Carolina?
- Drivers must be at least 18, licensed for the vehicle, and have no more than two chargeable accidents or moving violations in three years and no suspension or revocation in five years. They need a state criminal check before hire and every three years, and the provider must run an FTA-compliant random drug and alcohol testing program.
- Does North Carolina require EVV for NEMT?
- No. NC EVV covers personal care, home health, CAP/C, CAP/DA, and in-home Innovations and TBI waiver services. NEMT trips are reported as encounter data with arrival, departure, and drop-off times for each leg.
- How do NC Medicaid Direct NEMT trips work?
- The member calls the local DSS, ideally at least four days ahead. The county arranges the ride, submits a prior authorization with the rate, and the provider bills NCTracks against that authorization.
- Did North Carolina cut NEMT rates in 2025?
- Yes, briefly. NC Medicaid Direct NEMT rates fell to 97 percent of the September 30, 2025 level on October 1, 2025. The state reversed the cut, and from December 17, 2025 new county authorizations use the September 30 rates again. Authorizations issued between October 1 and December 16, and the claims billed against them, are being adjusted.
Running NEMT in North Carolina with HealthRide
North Carolina fleets often run Modivcare, MTM Health, and county DSS trips in the same week. HealthRide keeps them on one dispatch board and records every payment, whichever payer it came from, in one ledger.
The driver app records timestamps, GPS-recorded miles, and signatures on every leg, so the per-leg times brokers report to the state are already on record. The trip log exports as CSV or PDF.
Official resources
- NC Medicaid: Non-Emergency Medical Transportation
- NC Medicaid: NEMT policy page
- NC Medicaid Managed Care Non-Emergency Medical Transportation Policy (amended January 1, 2025)
- NC Medicaid: Medicaid transportation (county DSS)
- NC Medicaid County Playbook: NEMT
- NC Medicaid: NEMT quick reference guide (May 2026)
- NCTracks: Provider enrollment
- NCTracks: Federal and NC enrollment fees by year
- NC Medicaid: Rate reductions effective October 1, 2025
- NC Medicaid: NEMT rate reduction update (December 19, 2025)
- NC Medicaid: Children and Families Specialty Plan
- NC Medicaid: Tailored Plans
- NC Medicaid: Electronic Visit Verification
- Carolina Complete Health: Merger with WellCare of North Carolina
- Carolina Complete Health: Non-emergency medical transportation
- Carolina Complete Health: Member handbook (April 2026)
- Healthy Blue NC: Transportation
- AmeriHealth Caritas North Carolina: Transportation
- UnitedHealthcare Community Plan of NC: Transportation services for providers
- Alliance Health: Transportation services
- Partners Health Management: Tailored Plan transportation services
- Trillium Health Resources: Transportation
- Vaya Health: Transportation assistance
- Modivcare: Transportation providers
- MTM Health: Transportation providers
- FTA: Drug and alcohol program
- CMS: Medicaid and CHIP monthly enrollment data
- SEC: Modivcare Form 8-K, August 2025
- SEC: Modivcare Form 8-K, December 2025
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