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How to start a NEMT business in Ohio: plan brokers, counties, ambulettes, and SB 315

Updated

Ohio has no statewide NEMT broker. Each Medicaid managed care plan arranges rides through its own transportation vendor, and the county department of job and family services arranges rides for members outside managed care. Wheelchair van (ambulette) companies need a state license and can also bill Ohio Medicaid directly. Senate Bill 315, effective October 6, 2026, requires the Ohio Department of Medicaid to put every NEMT provider except licensed ambulette and ambulance services on a GPS-based trip verification system within 18 months.

Ohio NEMT at a glance

Runs the program
Ohio Department of Medicaid (ODM)
Program
Healthcare-related transportation (Ohio Administrative Code chapter 5160-15)
How rides are arranged
Health plans each contract a broker. Managed care plans arrange rides through their own vendors. County job and family services offices arrange rides for fee-for-service members, and licensed wheelchair van providers can bill ODM directly.
Brokers you will contract with
MTM Health, SafeRide Health, Provide A Ride, plus county job and family services offices
State operating license
Wheelchair van (ambulette) services need a license from the State Board of Emergency Medical, Fire, and Transportation Services (ORC chapter 4766). For-hire passenger carriers need a PUCO certificate (ORC 4921.03).
EVV for NEMT trips
Not required
Medicaid enrollment
2,400,994 (April 2026, Medicaid only)
On this page

How Medicaid NEMT works in Ohio

Most Ohio Medicaid members belong to a managed care plan: AmeriHealth Caritas Ohio, Anthem Blue Cross and Blue Shield, Buckeye Health Plan, CareSource, Humana Healthy Horizons in Ohio, Molina Healthcare, or UnitedHealthcare Community Plan. ODM's July 2026 plan contract requires every plan to arrange a ride whenever a member must travel 30 miles or more each way to a covered service. Plans also offer trips under 30 miles as an added benefit, with their own trip limits, and each plan hires a transportation vendor to run the rides. The same contract holds pickups to 15 minutes either side of the scheduled time and caps shared rides at 60 minutes beyond the direct trip time.

Fee-for-service members get non-emergency transportation from their county department of job and family services (CDJFS) under OAC 5160-15-10. Each county picks the options that fit its area, such as contracted livery service, paid fixed-route or demand-response rides, fuel vouchers, prepaid fares, or mileage reimbursement. A company that drives under a county contract is a private transportation vendor under OAC 5160-15-14.

Apart from ambulance service, wheelchair vans are the one lane where a transportation company enrolls with ODM itself. Under OAC 5160-15-21 and 5160-15-22, a wheelchair van must be a permitted ambulette and the rider must travel with a mobility device. For fee-for-service trips, a practitioner certifies the need on form ODM 03452 (OAC 5160-15-27). Wheelchair van providers can also contract with the plans' vendors.

Governing rule:Ohio Administrative Code chapter 5160-15: Healthcare-related transportation

Who brokers Medicaid rides in Ohio

Which company pays you depends on the member's plan. MTM Health, SafeRide Health, and Provide A Ride are the vendors the plans name, so a fleet that wants trips from most plans contracts with more than one, and many also hold county contracts.

BrokerServesProvider sign-up
MTM HealthAnthem Blue Cross and Blue Shield (800-282-9720), Humana Healthy Horizons in Ohio (855-739-5986), AmeriHealth Caritas Ohio (833-664-6368), and Molina Healthcare of Ohio. Humana and Molina booked through Access2Care in 2025. Access2Care is moving to the MTM Health name and systems, and MTM says it keeps working with the same transportation providers.Provider page
SafeRide HealthBuckeye Health Plan Medicaid, OhioRISE, and MyCare Ohio members.Since July 1, 2024.Provider pageBuckeye transportation line 866-531-0615
Provide A RideCareSource Ohio Medicaid members, who request rides through Provide A Ride. UnitedHealthcare Community Plan's 2026 Ohio provider manual also names Provide A Ride for non-emergency stretcher and ambulance rides, booked at 800-269-4190. Based in Cleveland, with brokerage and NEMT provider services since 1989.CareSource cut its added trips under 30 miles to 15 round trips a year on April 15, 2026.Provider page
County departments of job and family servicesFee-for-service Medicaid members in each of Ohio's 88 counties. Each county contracts its own transportation vendors.

OhioRISE youth get rides through their managed care plan, which must arrange transportation for OhioRISE services whichever payer covers the service.

UnitedHealthcare Community Plan members book routine rides through the plan's transportation line, 800-269-4190, and the 2026 provider manual does not name the vendor behind it. Ask UnitedHealthcare which vendor handles those trips before you plan around them.

Plans change vendors from time to time. Check the plan's member transportation page before you sign, and ask the vendor which plans your contract covers.

How to become a NEMT provider in Ohio

Decide which lanes you want first. Ambulatory trips come from plan vendors and county contracts. Wheelchair trips need an ambulette license, and that license also opens direct ODM billing.

  1. Form the business

    Register the company with the Ohio Secretary of State and get a federal EIN. The ambulette license application asks for your organizational structure, tax ID, every trade name you operate under, and any Medicaid provider numbers.

  2. License wheelchair vans as ambulettes

    Apply to the State Board of Emergency Medical, Fire, and Transportation Services through its MTLS online system. Fees are $100 a year for the service license, $50 per vehicle permit, and $50 per vehicle inspection. The application needs a certificate of liability insurance naming the board as certificate holder with 30 days' cancellation notice, each vehicle listed by VIN, and a color photo of the vehicle markings.

    OAC 4766-3-02: Application for ambulette licensure

  3. Check PUCO for passenger service

    Ohio law bars a for-hire motor carrier from operating in intrastate commerce without a PUCO certificate of public convenience and necessity. The definition in ORC 4921.01 leaves out taxicabs in usual taxicab service and ambulances. Ask PUCO whether your service needs a certificate before you run for-hire passenger trips.

    ORC 4921.03: Certificate required

  4. Enroll with ODM for wheelchair van billing

    A wheelchair van provider enrolls with ODM as an eligible provider. Every vehicle must hold its ambulette permit, and each fee-for-service trip needs a practitioner certification (form ODM 03452) valid for up to 90 days or one year.

    OAC 5160-15-21: Conditions of provider participation

  5. Contract with the plan vendors

    MTM Health onboards providers in six steps: application, interview, contracting, credentialing, training, and first trip. Every provider employee completes fraud, waste, and abuse training and HIPAA training each year. SafeRide Health credentials Buckeye providers, and Provide A Ride handles CareSource.

    MTM Health: Transportation providers

  6. Bid on county contracts

    Before a county signs or renews with you, it needs a certified BMV driving record and a BCII criminal background check for each driver, SAM and LEIE exclusion checks on the company and staff, and federal ownership disclosures.

    OAC 5160-15-14: CDJFS program integrity provisions

  7. Plan for SB 315 GPS verification

    Counting from the October 6, 2026 effective date, ODM has six months to set technical standards and an implementation plan, 12 months to start a pilot, and 18 months to require every covered NEMT provider to use an approved verification system. ODM rules will also set GPS intervals, certification criteria, and the exemption process. After full rollout, a claim without the required GPS and timestamp data will not be paid.

    ORC 5164.401: Verification of nonemergency medical transportation services

Vehicle and driver requirements in Ohio

State rules differ by lane. Ambulettes follow OAC 4766-3, county vendors follow OAC 5160-15-14, and ambulatory vehicles on plan trips follow the vendor contract.

Vehicles

RequirementState ruleBroker contract
Wheelchair van configurationAt least 56 inches of overhead clearance at the door (68 inches on vehicles over 22 feet), four-point permanent wheelchair fasteners, occupant restraints, a ramp or hydraulic lift, and secure storage with no bungee cords (OAC 4766-3-08).Vendors check vehicle inspections and credentials before assigning trips.
Ambulette equipmentFire extinguisher, blanket, disinfectants, oxygen equipment, isolation equipment, and first aid equipment.Same, checked at credentialing.
Markings and permitsService name on both sides in letters at least 3 inches tall and on the back at least 1.5 inches, plus the board's permit decal on the right rear window.Vendors may add their own decals.
InspectionsThe board inspects every ambulette each year and may inspect any location unannounced, including nights and weekends.Vendor inspections at credentialing and on the vendor's schedule.
Trip verification technologyWithin 18 months of SB 315 taking effect, a GPS-based system developed or approved by ODM that records pickup arrival, trip start, drop-off arrival, trip end, route, and distance. Licensed ambulette and ambulance services are excluded.Vendor driver apps already capture trip times and locations.

Drivers

RequirementState ruleBroker contract
Age and experienceAmbulette drivers: at least 18 with two years of driving experience (OAC 4766-3-13).Set by each vendor.
Driving recordAmbulette drivers: BMV abstract at hire and every year, and six or more points disqualifies. County vendor drivers: valid license and a certified BMV driving record.Motor vehicle report (SafeRide).
Background checksBCII check under ORC 109.572, or FBI if the driver has not lived in Ohio for five years. County vendors also run SAM and LEIE exclusion checks.National background and sex-offender registry checks (SafeRide).
Drug and alcohol testingAmbulette drivers: CLIA-lab alcohol and drug test on file, repeated after any accident they were driving in.Pre-hire drug screen (SafeRide).
Training and medicalAmbulette drivers: current CPR and first aid with hands-on training, passenger assistance training every three years including wheelchair securement, and a physician or DOT physical statement.First aid or CPR, defensive driving, and wheelchair securement (SafeRide). Annual fraud, waste, and abuse and HIPAA training (MTM Health).

Insurance minimums in Ohio

Ohio sets insurance by license type. Ambulette services follow ORC 4766.06, PUCO-certified passenger carriers follow OAC 4901:2-13-03, and vendors add their own limits.

CoverageMinimumSet by
Ambulette service liability$500,000 per occurrence and $500,000 aggregateORC 4766.06(A)
Ambulette vehicle bodily injury and property damage$100,000 per person, $300,000 per accident, $50,000 property damage, per vehicleORC 4766.06(B)
For-hire passenger carrier, 15 or fewer seats including driver$1,500,000 public liabilityOAC 4901:2-13-03
For-hire passenger carrier, 16 or more seats including driver$5,000,000 public liabilityOAC 4901:2-13-03
SafeRide Health contract$1,000,000 per occurrence and $2,000,000 aggregate general liability, $500,000 auto, SafeRide named as additional insuredBroker contract

Does Ohio require EVV for NEMT?

No. Ohio's electronic visit verification law (ORC 5164.42, as enacted by Senate Bill 315 effective October 6, 2026) covers in-home care such as personal care and home health, and it expressly excludes transportation services.

NEMT gets its own system instead. SB 315 directs ODM to build or certify a GPS-based verification system that tracks pickup arrival, trip start, drop-off arrival, and trip end, and records timestamps, route, and total distance. Once it is fully in place, ODM pays an NEMT claim only when that data is present and no discrepancy is open. ODM can grant exemptions for equipment failure or rural connectivity problems, emergencies, and rider safety, and it will monitor how often each provider asks for one.

ORC 5164.402: Use of electronic verification system by NEMT providers

What changed in Ohio in 2025 and 2026

Ohio counted 2,400,994 people on Medicaid and 232,871 on CHIP in April 2026, according to CMS enrollment data. Ohio reports everyone enrolled at any point in the month.

The vendor map moved in the last two years. Buckeye switched to SafeRide Health on July 1, 2024. Access2Care, which booked Humana and Molina rides in 2025, is moving to the MTM Health name and systems, and four plans now name MTM Health. CareSource, through Provide A Ride, cut its added trips under 30 miles from 30 round trips to 15 round trips a year on April 15, 2026, while keeping unlimited rides for dialysis, prenatal care, wheelchair members, and hospital discharges.

Fee-for-service wheelchair van rates have held since January 1, 2024: $31.00 per trip (A0130), $1.30 per mile (S0209), and $15.00 for an attendant (T2001). ODM revised its transportation documentation and payment rules on August 1, 2026. Plan trips pay whatever your vendor contract says.

SB 315 is the change to plan around. The governor signed it on July 7, 2026, and it takes effect October 6, 2026. Within five years ODM must also cross-check NEMT GPS data against other Medicaid claims to confirm each rider went to a covered appointment with an enrolled provider.

  1. SafeRide Health begins arranging NEMT for Buckeye Health Plan Medicaid and MyCare Ohio members.

    Notice

  2. Senate Bill 315, the Medicaid program integrity bill that includes NEMT GPS verification, is introduced.

    Notice

  3. CareSource notifies Ohio providers that its added NEMT trips will drop to 15 round trips a year.

    Notice

  4. CareSource's new trip limit takes effect. Trips of 30 miles or more for covered care do not count against it.

    Notice

  5. The governor signs Senate Bill 315.

    Notice

  6. Revised ODM transportation documentation and payment rules (OAC 5160-15-27 and 5160-15-28) take effect.

    Notice

  7. SB 315 takes effect, including the NEMT GPS verification sections (ORC 5164.40 to 5164.406).

    Notice

  8. Six months after SB 315 takes effect: the deadline for ODM's NEMT GPS technical standards and implementation plan.

    Notice

  9. Twelve months after the effective date: the deadline for ODM to start a pilot with selected providers.

    Notice

  10. Eighteen months after the effective date: the deadline for ODM to require every covered NEMT provider to use a verification system.

    Notice

Frequently asked questions

Who is the NEMT broker in Ohio?
Ohio has no single broker. MTM Health arranges rides for Anthem, Humana, AmeriHealth Caritas, and Molina members. SafeRide Health serves Buckeye, and Provide A Ride serves CareSource and handles UnitedHealthcare stretcher and ambulance rides. UnitedHealthcare members book routine rides at 800-269-4190. Fee-for-service members get rides from their county department of job and family services.
How do I become a Medicaid transportation provider in Ohio?
For ambulatory trips, contract with the plan vendors (MTM Health, SafeRide Health, Provide A Ride) and bid on county job and family services contracts. For wheelchair trips, license your vans as ambulettes with the State Board of Emergency Medical, Fire, and Transportation Services, then enroll with ODM as a wheelchair van provider and contract with the vendors too.
Do I need an ambulette license in Ohio?
Yes, if you transport people who ride in a wheelchair or other mobility device for a fee. The license costs $100 a year, plus $50 per vehicle permit and $50 per vehicle inspection each year. Ohio Medicaid only pays wheelchair van trips run in licensed ambulettes.
What is Ohio SB 315 and does it apply to my NEMT company?
Senate Bill 315, effective October 6, 2026, requires ODM to put NEMT providers on a GPS-based trip verification system. It covers NEMT paid by Medicaid except trips run by licensed ambulance or ambulette services. ODM must require it for all covered providers within 18 months of that date, and after full rollout claims without GPS and timestamp data will not be paid.
Does Ohio require EVV for NEMT?
No. Ohio's EVV law covers in-home care such as personal care and home health and excludes transportation. NEMT gets a separate GPS verification requirement under SB 315 instead.
What insurance does an Ohio NEMT provider need?
Licensed ambulette services need $500,000 per occurrence liability plus $100,000/$300,000/$50,000 auto coverage per vehicle. PUCO-certified for-hire passenger carriers need $1.5 million public liability for vehicles with 15 or fewer seats. Vendors add their own limits: SafeRide asks for $1 million per occurrence and $2 million aggregate general liability and $500,000 auto.
What are the driver requirements for an Ohio ambulette?
At least 18 with two years of driving experience, a clean BMV abstract (under six points) checked yearly, a BCII or FBI background check, CPR and first aid with hands-on training, passenger assistance training every three years, a medical fitness statement, and a drug and alcohol test on file.
How much does Ohio Medicaid pay for wheelchair van trips?
The fee-for-service maximums are $31.00 per trip (A0130), $1.30 per mile (S0209), and $15.00 for an attendant (T2001), unchanged since January 1, 2024. Managed care trips pay the rate in your vendor contract.
How many rides do Ohio Medicaid managed care members get?
Every plan must cover rides of 30 miles or more each way to covered care, with no count limit. Trips under 30 miles are an added benefit that varies: CareSource and UnitedHealthcare offer 15 round trips a year, Buckeye 20 round trips, AmeriHealth Caritas 60 one-way trips, and Humana 60 one-way trips split between medical and non-medical rides. Plans cannot require more than 48 hours of notice.

Running NEMT in Ohio with HealthRide

An Ohio fleet can run plan vendor trips, county contract trips, and direct wheelchair van claims on the same day. HealthRide puts them on one dispatch board and records every payment, whichever payer sent it, in one ledger.

The driver app records GPS-recorded miles, pickup and drop-off timestamps, and signatures on every leg, and the trip log exports as CSV or PDF for vendor and county reviews.

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