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How to start a NEMT business in North Dakota: zone approvals, BCBSND, and enrollment

Updated

North Dakota has no NEMT broker. For traditional Medicaid, the member's human service zone or tribal office approves each ride on form SFN 1507, and the provider bills ND Medicaid directly. Medicaid Expansion members get rides through Blue Cross Blue Shield of North Dakota (BCBSND), which sends ride requests to providers enrolled with both the state and BCBSND. The July 1, 2026 fee schedule pays $18.05 per wheelchair van trip plus $2.57 a mile and $97.37 per stretcher van trip plus $2.57 a mile.

North Dakota NEMT at a glance

Runs the program
North Dakota Department of Health and Human Services (ND HHS), Medical Services
Program
ND Medicaid Non-Emergency Medical Transportation (NEMT)
How rides are arranged
No broker: providers bill Medicaid directly. Human service zone and tribal offices approve each traditional Medicaid ride, and the provider bills ND Medicaid. Medicaid Expansion rides come through BCBSND, the plan that administers Expansion.
Brokers you will contract with
None. Medicaid Expansion ride requests come from Blue Cross Blue Shield of North Dakota (BCBSND), which administers Expansion.
State operating license
No statewide NEMT license. Taxi providers submit a city taxi license where their city issues one.
EVV for NEMT trips
Not required
Medicaid enrollment
103,256 (May 2026, Medicaid and CHIP)
On this page

How Medicaid NEMT works in North Dakota

ND HHS pays for NEMT as a fee-for-service benefit under North Dakota Administrative Code section 75-02-02-13.1, last amended January 1, 2024. The rule lets the department or the human service zone choose the most efficient, economical, and appropriate way to travel. Individuals, taxis, buses, lodging and meal providers, and airlines can all enroll as transportation providers.

Every trip except a hospital discharge needs prior approval on the Non-Emergency Medical Transportation Authorization, SFN 1507, from the member's human service zone or tribal office, and the provider gets a copy before the ride. Hospitals can arrange a discharge ride with any enrolled provider using the Medical Certificate of Transportation Services, SFN 249. For urgent rides on weekends, evenings, or holidays, the provider asks for a retroactive SFN 1507 within 72 hours, and the zone or tribe answers within five business days.

Medicaid Expansion works differently. BCBSND has administered it since January 1, 2022. Members call BCBSND at 1-833-777-5779 at least two days ahead, and BCBSND sends the ride request to an enrolled provider, who accepts or declines it. Claims go to BCBSND through Availity within 180 days.

Governing rule:N.D. Admin. Code 75-02-02-13.1: Travel expenses for medical purposes

Who brokers Medicaid rides in North Dakota

North Dakota has no broker. Two payers send you trips: ND Medicaid, through zone and tribal approvals, and BCBSND for Medicaid Expansion. You enroll with the state first, then add BCBSND.

BrokerServesProvider sign-up
Human service zone and tribal offices (ND Medicaid fee-for-service)Traditional ND Medicaid members. The zone or tribe picks the mode and approves each trip on SFN 1507, and ND Medicaid pays the enrolled provider. Tribal offices approve in-state trips on their own and need zone approval for out-of-state travel.Provider pageND Medicaid provider enrollment 877-328-7098
Blue Cross Blue Shield of North Dakota (Medicaid Expansion)Medicaid Expansion adults 19 to 64. BCBSND takes the ride request and offers it to a provider enrolled with both ND Medicaid and BCBSND.Since January 1, 2022.Provider pageBCBSND Medicaid Expansion 1-833-777-5779

Out-of-state transportation, meals, and lodging for a provider more than 50 miles past the North Dakota border need a service authorization from ND Medicaid. Without it, the member pays.

Hospitals may arrange discharge rides with any enrolled NEMT provider using SFN 249, with no zone approval needed.

How to become a NEMT provider in North Dakota

Enroll with ND Medicaid through Noridian first. BCBSND accepts only providers already enrolled with the state.

  1. Set up the business and get an NPI

    Form the company, get a federal EIN, and get an organization NPI. The commercial NEMT application asks for the NPI, the IRS CP 575 or 147C letter, and your legal business name exactly as the IRS shows it.

  2. Apply online as provider type 034

    Submit the application on the ND Health Enterprise MMIS portal as provider type 034, Transportation Services, or with specialty 389 for taxis (taxonomy 344600000X). Noridian Healthcare Solutions handles enrollment for ND Medicaid at 877-328-7098.

    ND HHS: Medicaid provider enrollment

  3. Send the required documents to Noridian

    Send the EFT form (SFN 661), the ownership and conviction form (SFN 1168) listing managing employees and board members, the signed provider agreement (SFN 615), copies of vehicle insurance and registration, and a city taxi license if your city licenses taxis. The owner also signs an attestation that each vehicle is in good operating order and insured for carrying passengers for payment.

    ND Medicaid: Commercial and taxi NEMT group application requirements

  4. Work with the human service zones

    Zones and tribal offices choose the mode and issue SFN 1507 before each ride, so introduce your company to the offices in your area. New providers go on review for a period ND Medicaid sets and must attach SFN 1507 and the SFN 296 trip ticket to each claim until it ends.

    ND Medicaid Billing and Policy Manual: Non-Emergency Medical Transportation

  5. Join the BCBSND Medicaid Expansion network

    After state enrollment, email providercontracting@bcbsnd.com to join the network. BCBSND's Customer Contact Center onboards you on its authorization process, and you register on Availity to check eligibility and submit claims.

    BCBSND: Medicaid Expansion NEMT, meals and lodging providers

  6. Bill within 180 days and revalidate

    ND Medicaid must receive the claim within 180 days of the date of service, through the web portal's Travel, Meals, and Lodging claim page or as a professional claim. BCBSND also uses 180 days. Revalidate your ND Medicaid enrollment at least every five years.

Vehicle and driver requirements in North Dakota

ND Medicaid's NEMT policy sets a short list of provider rules. BCBSND contracts only with providers already enrolled with ND Medicaid, sets rates and codes in its provider contract, and adds documentation rules in its Medicaid Expansion provider manual.

Vehicles

RequirementState ruleBroker contract
Registration and insuranceCurrent registration and proper insurance on every vehicle used for members. The June 2026 group application asks for copies, and ND Medicaid can ask for proof at any time.BCBSND contracts only with providers enrolled with ND Medicaid, so the state rule applies first.
Vehicle conditionThe owner attests at enrollment that each vehicle is in good operating order, including brakes, lights, and tires.BCBSND contracts only with providers enrolled with ND Medicaid, so the state attestation applies first.
Vehicle typesTaxi, minibus (8 to 15 passengers), wheelchair van (any van with a wheelchair lift), and stretcher van (for a person who needs no medical monitoring during the ride).BCBSND uses the same vehicle definitions and pays by your enrolled vehicle type.
Trip recordsProvider Medicaid ID, member name and ID, pickup and drop-off times and addresses, trip date, odometer readings, and mileage, kept seven years. Record the facility name and address, not the doctor's name. The state's NEMT documentation guideline also asks for the member's signature.BCBSND's Medicaid Expansion provider manual adds the vehicle type, the time the member got home, starting and ending mileage, and the member's signature, kept at least seven years.

Drivers

RequirementState ruleBroker contract
Driver's licenseEvery driver, including hired drivers, holds a valid government-issued driver's license. Commercial providers keep a copy in each driver's personnel file.BCBSND contracts only with providers enrolled with ND Medicaid, so the state rule applies first.
Who can driveFriends, family, neighbors, foster and kinship caregivers, and court-appointed guardians may enroll as individual transportation providers (NEMT policy and N.D. Admin. Code 75-02-02-13.1).BCBSND does not cover personal mileage reimbursement for Medicaid Expansion members.

Insurance minimums in North Dakota

ND Medicaid sets no dollar minimum for NEMT. It requires insurance that covers carrying passengers for payment, and the state auto liability floor applies to every vehicle.

CoverageMinimumSet by
NEMT coverageNo dollar amount. Vehicles must carry insurance that covers transporting passengers for payment.ND Medicaid NEMT group application attestation
Auto liability, any vehicle$25,000 per person, $50,000 per accident, $25,000 property damageN.D.C.C. § 39-16.1-11

Does North Dakota require EVV for NEMT?

No. ND Medicaid's EVV policy covers personal care, home health, and listed home and community-based services. The list includes non-medical transportation (T2001) delivered by aging-services providers, but not NEMT billed under codes such as A0100, A0130, or T2005.

NEMT is checked through paperwork instead. Each trip needs an approved SFN 1507 (or SFN 249 for a hospital discharge), vehicle trips need the SFN 296 trip ticket, and trip records with odometer readings are kept for seven years. New providers attach the forms to every claim during their review period.

ND Medicaid Billing and Policy Manual: Electronic Visit Verification

What changed in North Dakota in 2025 and 2026

North Dakota covered 103,256 people in Medicaid and CHIP in May 2026 (CMS preliminary count). Traditional Medicaid rides are approved one at a time by human service zones and tribes. Medicaid Expansion rides come through BCBSND.

The July 1, 2026 NEMT fee schedule raised most rates about 2 percent over the April 2026 schedule. It pays $27.06 per taxi trip plus 72 cents a mile, and $18.05 per minibus or wheelchair van trip. Wheelchair van and stretcher van mileage pays $2.57 a mile, and a stretcher van trip pays $97.37. Volunteer and private mileage pays 72 cents a mile, lodging up to $110 a night, and a full day of meals $32.46. Providers bill their usual and customary charge, and ND Medicaid pays the lower of that charge or the fee schedule.

No-shows cannot be billed to ND Medicaid. A provider whose posted policy charges every rider for missed trips may bill Medicaid members the same way. Unloaded miles are not covered unless the NEMT administrator approves them. BCBSND allows unloaded miles only past the first 15 when a provider travels more than 15 miles outside its home town.

ND Medicaid added a commercial-driver section and a section on minibus, wheelchair van, and stretcher van service to its NEMT policy in January 2025, then reissued the policy with clarifications in January 2026.

  1. BCBSND begins administering North Dakota Medicaid Expansion, including its NEMT benefit.

    Notice

  2. Travel expense rule N.D. Admin. Code 75-02-02-13.1 amended.

    Notice

  3. NEMT policy adds a commercial-driver section and a minibus, wheelchair van, and stretcher van section.

    Notice

  4. NEMT policy reissued with format updates and clarifications.

    Notice

  5. Commercial and taxi NEMT group application requirements revised.

    Notice

  6. New NEMT fee schedule takes effect, raising most rates about 2 percent (taxi base rate from $26.53 to $27.06).

    Notice

Frequently asked questions

Does North Dakota have a NEMT broker?
No. For traditional Medicaid, human service zone and tribal offices approve each ride and ND Medicaid pays the enrolled provider directly. Medicaid Expansion members get rides through Blue Cross Blue Shield of North Dakota, which sends ride requests to providers in its network.
How does a ride get approved in North Dakota?
The member contacts their human service zone or tribal office, which picks the most appropriate and economical mode and issues the Non-Emergency Medical Transportation Authorization, SFN 1507. The provider needs a copy before the ride. Hospital discharges use SFN 249 instead, and urgent after-hours rides can get a retroactive SFN 1507 if the provider asks within 72 hours.
How do I become a Medicaid transportation provider in North Dakota?
Apply on the ND Health Enterprise MMIS portal as provider type 034 (Transportation Services), or specialty 389 for taxis, then send the required documents to Noridian: IRS EIN letter, EFT form, ownership form, provider agreement, vehicle insurance and registration, and a city taxi license where one applies. To serve Medicaid Expansion members, join the BCBSND network after state enrollment.
How much does North Dakota Medicaid pay for NEMT?
From July 1, 2026: taxi $27.06 per trip plus 72 cents a mile, wheelchair van $18.05 per trip plus $2.57 a mile, stretcher van $97.37 per trip plus $2.57 a mile, and volunteer mileage 72 cents a mile. ND Medicaid pays the lower of your usual and customary charge or the fee schedule. BCBSND pays under its provider contract.
Can I bill North Dakota Medicaid for no-shows or empty miles?
No-shows are not billable to ND Medicaid. If your written or posted policy bills every rider for missed trips, you may bill Medicaid members the same way. Unloaded miles are not covered unless the NEMT administrator approves them in advance of billing.
Do I need a license to run a NEMT business in North Dakota?
North Dakota has no statewide NEMT license. ND Medicaid requires enrollment, current registration and passenger-for-hire insurance on each vehicle, and a valid license for every driver. Taxi companies also submit a city taxi license if their city issues one.
How long do I have to file North Dakota NEMT claims?
ND Medicaid must receive the original claim within 180 days of the date of service. BCBSND also requires Medicaid Expansion claims within 180 days, with the BCBSND authorization number on the claim.
Does North Dakota require EVV for NEMT?
No. ND Medicaid's EVV policy covers personal care, home health, and listed home and community-based services, including non-medical transportation for aging-services programs. Medicaid NEMT uses SFN 1507 approvals, trip tickets, and trip records instead.

Running NEMT in North Dakota with HealthRide

North Dakota providers answer to two payers with different paperwork: zone-approved trips billed to ND Medicaid and BCBSND ride requests billed through Availity. HealthRide puts both on one dispatch board and records every payment, from either payer or a private-pay rider, in one ledger.

The driver app records GPS-recorded miles, pickup and drop-off times, and signatures on every leg, which supports the seven-year trip records ND Medicaid expects.

See pricing

Official resources

HealthRide plans the whole day in one click and bills every ride.

$59 per vehicle per month. No contracts.

NEMT in other states

Comparing brokers across states?See who arranges Medicaid rides in every state