How to start a NEMT business in Rhode Island: MTM, the DPUC certificate, and EOHHS rules
Rhode Island runs Medicaid rides through one statewide broker, MTM Health, which has held the contract since January 1, 2019. Since 2024 the state has also licensed NEMT companies directly: you need a Division of Public Utilities and Carriers (DPUC) NEMT certificate, $1.5 million in liability coverage, and vehicles that meet EOHHS age and mileage limits. MTM's network is filling from a waitlist, so plan on months between applying and your first trip.
Rhode Island NEMT at a glance
- Runs the program
- Rhode Island Executive Office of Health and Human Services (EOHHS)
- Program
- Rhode Island Non-Emergency Medical Transportation (NEMT) Program
- How rides are arranged
- One statewide broker. EOHHS contracts MTM Health to schedule and pay for rides for Medicaid members, Elderly Transportation Program riders, and RI Works bus passes.
- Brokers you will contract with
- MTM Health
- State operating license
- DPUC NEMT certificate of operating authority under R.I. Gen. Laws chapter 39-14.3: $125 application, public hearing, $100 renewal each December 31. Drivers need a DPUC special license.
- EVV for NEMT trips
- Not required
- Medicaid enrollment
- 251,355 (May 2026, Medicaid only)
On this page
How Medicaid NEMT works in Rhode Island
EOHHS runs one NEMT program for three groups: Medicaid members who have no other way to reach covered care, people 60 and older in the Elderly Transportation Program run by the Office of Healthy Aging, and RI Works families, who get monthly bus passes. Rhode Island has used a broker since 2014. MTM Health replaced the previous broker on January 1, 2019 and won a new contract in 2023.
Members book with MTM at least two business days ahead by phone or through MTM Link, and urgent trips can be booked 24 hours a day. MTM picks the mode: gas mileage reimbursement, a RIPTA bus pass, a sedan or rideshare, or, when a doctor's Level of Need form supports it, a wheelchair van, stretcher van, or non-emergency ambulance. Every trip gets a trip ID from MTM before it runs.
State law now sits on top of the broker contract. Chapter 39-14.3, in effect since August 1, 2024, makes every NEMT operator a common carrier regulated by the DPUC and lets EOHHS set vehicle condition, age, and mileage standards. Most companies need both the DPUC certificate and an MTM contract to carry Medicaid riders.
Governing rule:R.I. Gen. Laws chapter 39-14.3: Non-Emergency Medical Transportation
Who brokers Medicaid rides in Rhode Island
One broker covers the whole state and all three programs. Transportation companies contract with MTM, take trips through the MTM Link portal and driver app, and bill MTM.
| Broker | Serves | Provider sign-up |
|---|---|---|
| MTM Health | Statewide: Medicaid members, Elderly Transportation Program participants age 60 and older, and RI Works (TANF) monthly bus passes.Since January 1, 2019. Re-awarded after a competitive bid in 2023. The network adds providers only as needed, from a waitlist MTM estimates at 8 to 12 months. | Provider pageRide line 1-855-330-9131 |
Taxicab companies certificated by the DPUC under chapter 39-14 can take NEMT trips without a separate NEMT certificate. RIPTA and licensed ambulance companies are exempt, and rideshare companies follow EOHHS policy instead.
Hospital discharge rides that a medical facility arranges itself fall outside the chapter 39-14.3 definition of NEMT.
How to become a NEMT provider in Rhode Island
Rhode Island has two gates: the DPUC certificate, which lets you operate, and the MTM contract, which gets you trips. Start both early, because the certificate needs a public hearing and MTM keeps a waitlist.
Form the business
Register the company and get a federal EIN. The DPUC application asks for the federal ID number, every partner, officer, and director, and a copy of the driver's license of every principal. Incomplete applications are returned unprocessed.
Apply for a DPUC NEMT certificate
File the application with the DPUC Motor Carriers Section with the $125 fee by check or money order. The clerk schedules a public hearing, where you must show you are fit, willing, and able to run the service. If the hearing officer approves, the order usually gives you 180 days to register your vehicles and file proof of insurance before the certificate issues. Renew by December 31 each year for $100.
Register and inspect each vehicle
NEMT vehicles carry Public Service registration plates from the Division of Motor Vehicles, pass a DMV inspection before registration and again each year, and are listed with the DPUC by year, make, model, and plate. Vehicles added after July 31, 2024 must be no more than four model years old and under 150,000 miles at their first inspection.
License your drivers
Every driver needs a Rhode Island operator's license and a DPUC special license, often called a hackney license. MTM also requires drivers to be at least 21 and to pass a Rhode Island BCI criminal check before hire and every year.
Join the MTM waitlist and credential
MTM adds Rhode Island providers as needed and holds virtual information sessions twice a year. Register on the waitlist, then work with an MTM representative on the service agreement, company, driver, and vehicle documents, and training. Upload renewals in MTM Link at least 10 business days before a credential expires. Miss the five-day mark and MTM can pull the affected trips.
Put up the EOHHS door signs
Each vehicle carries a white sign with black text on the middle of each side door, showing your NEMT number, "RI EOHHS Non-Emergency Medical Transportation", and your MTM provider code. No company name or logo goes on the sign.
Bill MTM within 90 days
Submit each completed trip in MTM Link within 90 days with an electronic trip log: trip ID, scheduled and actual pickup time, departure and arrival times, and the member's signature. Denied claims can be appealed in MTM Link before the appeal deadline shown on each claim.
MTM Health: Rhode Island transportation provider handbook (July 2026)
Vehicle and driver requirements in Rhode Island
In Rhode Island the state rules carry as much weight as the broker contract. Chapter 39-14.3 and EOHHS policy set the certificate, plate, age, and insurance rules. MTM adds driver screening and trip documentation.
Vehicles
| Requirement | State rule | Broker contract |
|---|---|---|
| Operating authority | DPUC NEMT certificate after a public hearing, renewed every December 31. DPUC-certificated taxicab companies are exempt (§ 39-14.3-3). | Certificate uploaded to MTM Link, with the yearly renewal receipt. |
| Registration and plates | Public Service plates from the DMV, and each vehicle listed with the DPUC before carrying passengers (§ 39-14.3-6). | Each vehicle credentialed in MTM Link before it gets trips. |
| Inspection | DMV inspection before registration and periodically after, with an annual inspection fee (§ 39-14.3-5). EOHHS requires a yearly inspection with mileage recorded. | Field audits check the door signs. |
| Age and mileage | Vehicles added after July 31, 2024: no more than four model years old and under 150,000 miles at first inspection, retired at 250,000 miles. Older fleet vehicles retire at 300,000 miles. | Enforced through MTM credentialing. |
| Markings | Exterior markings showing the DPUC NEMT certificate number, in the EOHHS door sign format. | Providers send receipts for every sign ordered. |
| Dedicated fleet | Vehicles under an NEMT certificate carry only NEMT members (EOHHS policy, October 31, 2024). | No private-pay passengers mixed with Medicaid or Elderly Transportation Program riders. |
Drivers
| Requirement | State rule | Broker contract |
|---|---|---|
| License | Rhode Island operator's license plus a DPUC special (hackney) license (§ 39-14.3-7). | At least 21, with no license suspension or revocation for moving violations in the past five years. |
| Criminal history | Chapter 39-14.3 sets no criminal history rule of its own. EOHHS may require more vetting. | Rhode Island BCI check before hire and yearly, or NCIC for drivers who have lived in the state under five years. No felony in 10 years, no sex offender registry listing in 10 years, and no health care fraud or abuse convictions. |
| Drug testing | Not set in chapter 39-14.3. | Five-panel program: pre-employment, post-accident, and random tests covering more than 25 percent of drivers each year. |
| Training and ID | EOHHS may require additional training. | CPR, defensive driving, and passenger assistance training, fraud, waste, and abuse training before the first trip and every year, and a visible photo name tag and DPUC ID. |
Insurance minimums in Rhode Island
Rhode Island writes a high insurance floor into the NEMT statute itself, and MTM matches it on general liability.
| Coverage | Minimum | Set by |
|---|---|---|
| NEMT certificate holders, vehicle liability | $1,500,000 personal injury and $100,000 property damage, refiled with the DPUC at each annual renewal | R.I. Gen. Laws § 39-14.3-8 |
| General liability and auto liability | $1,500,000 each, with MTM listed as certificate holder and additional insured | Broker contract (MTM Health) |
| Workers compensation | Coverage that meets Rhode Island requirements | Broker contract (MTM Health) |
Does Rhode Island require EVV for NEMT?
No. Rhode Island's EVV system, run by Sandata for EOHHS, covers home-based services such as personal care and home health visits. NEMT is not an EVV service.
MTM checks trips instead. Every claim needs an electronic trip log with the trip ID, scheduled and actual pickup times, departure and arrival times, and the member's signature, and MTM scores providers on GPS compliance from its driver app, with more than 90 percent needed to stay in the green.
What changed in Rhode Island in 2025 and 2026
Rhode Island Medicaid covered 251,355 people in May 2026, according to CMS monthly enrollment data. When MTM won its new contract in 2023, it described the program as about 2.4 million trips a year across Medicaid, the Elderly Transportation Program, and RI Works.
MTM's Rhode Island rate schedule, effective July 1, 2023, pays per one-way trip. During business hours a pickup within 40 miles of your vehicle base pays $17.75 for ambulatory, $28.50 for wheelchair, and $175 for stretcher for the first 5 miles, plus $1.75, $2.50, and $4.50 per mile after that. Trips with appointments between 5 p.m. and 5 a.m. pay a higher base, and MTM does not pay for no-shows. Members who drive themselves get 32 cents per mile.
The regulatory change is the bigger shift. The 2024 law moved NEMT companies off general public motor vehicle certificates and onto a dedicated NEMT certificate, and EOHHS used its new authority to cap vehicle age and mileage and to require one standard door sign.
MTM Health begins running Rhode Island's statewide NEMT program.
MTM announces a notice of intent to award for a new EOHHS contract after a competitive bid.
MTM's current Rhode Island transportation provider rate schedule takes effect.
Vehicles added to NEMT fleets after this date must meet the four-model-year and 150,000-mile limits.
R.I. Gen. Laws chapter 39-14.3 takes effect, creating the DPUC NEMT certificate and the $1.5 million insurance floor.
Every MTM transportation provider must hold an NEMT certificate and display the new EOHHS door signs.
MTM issues an updated Rhode Island transportation provider handbook with its credential deadlines and performance measures.
Frequently asked questions
- Who is the NEMT broker in Rhode Island?
- MTM Health, statewide, for Medicaid, the Elderly Transportation Program, and RI Works bus passes. MTM has run the program since January 1, 2019 and was re-awarded the contract in 2023. Members book at 1-855-330-9131 or through MTM Link.
- Do I need a license to run a NEMT business in Rhode Island?
- Yes. Since August 1, 2024, anyone operating a vehicle for NEMT needs a DPUC NEMT certificate of operating authority. The application costs $125, requires a public hearing, and renews every December 31 for $100. DPUC-certificated taxicab companies, RIPTA, and licensed ambulances are exempt.
- How much insurance does a Rhode Island NEMT company need?
- State law requires $1,500,000 for personal injury and $100,000 for property damage on NEMT vehicles, filed with the DPUC every year. MTM requires $1,500,000 each in general and auto liability with MTM as additional insured, plus workers compensation.
- How old can my NEMT vehicle be in Rhode Island?
- Vehicles added after July 31, 2024 must be no more than four model years old and under 150,000 miles at their first inspection, and they age out at 250,000 miles. Vehicles already in a fleet before that date can run to 300,000 miles. Every vehicle is inspected yearly.
- Is MTM accepting new transportation providers in Rhode Island?
- Only as needed. MTM keeps a Rhode Island waitlist and estimates 8 to 12 months before a new provider gets the chance to contract. Join the waitlist early and get your DPUC certificate in the meantime.
- How much does MTM pay in Rhode Island?
- Under the schedule effective July 1, 2023, a business-hours trip within 40 miles of your base pays $17.75 ambulatory, $28.50 wheelchair, or $175 stretcher for the first 5 miles, plus $1.75, $2.50, or $4.50 per mile after that. After-hours trips, and pickups more than 40 miles from your base, pay more.
- Can I use my Rhode Island NEMT vans for private-pay rides?
- Not under the NEMT certificate. EOHHS policy requires certificate holders to keep a separate fleet that carries only NEMT members, and MTM bars mixing private-pay passengers with Medicaid or Elderly Transportation Program riders.
- Does Rhode Island require EVV for NEMT?
- No. Rhode Island EVV covers home-based personal care and home health services. MTM verifies trips with electronic trip logs, member signatures, and GPS data from its driver app.
Running NEMT in Rhode Island with HealthRide
Rhode Island stacks a state certificate, EOHHS vehicle limits, and MTM credentials on every van. HealthRide sends credential expiration reminders, tracks vehicle inspections, and blocks assignments when a driver or vehicle falls out of date.
Signatures are captured on screen in the driver app, and the trip log exports as CSV or PDF when MTM or EOHHS asks for records.
Official resources
- R.I. Gen. Laws chapter 39-14.3: Non-Emergency Medical Transportation
- R.I. Gen. Laws § 39-14.3-3: Certificate required for NEMT operations
- R.I. Gen. Laws § 39-14.3-5: Vehicle inspection and suitability
- R.I. Gen. Laws § 39-14.3-6: Registration and vehicle markings
- R.I. Gen. Laws § 39-14.3-8: Proof of financial responsibility
- DPUC Motor Carriers: Application for NEMT operating authority
- EOHHS: Non-Emergency Medical Transportation (NEMT) manual
- EOHHS: NEMT certificate and vehicle signage policy (September 2024)
- EOHHS: NEMT incident and accident management policy (April 2024)
- EOHHS: Medicaid NEMT frequently asked questions
- EOHHS: Electronic Visit Verification (EVV)
- MTM Health: Rhode Island NEMT
- MTM Health: Rhode Island transportation providers
- MTM Health: Rhode Island transportation provider handbook (July 2026)
- MTM Health: Rhode Island transportation provider rates, Schedule A
- MTM Health: Join the transportation provider network
- MTM Health: Statewide NEMT services in Rhode Island begin January 1, 2019
- MTM Health: Awarded new contract for Rhode Island NEMT services (2023)
- CMS: Medicaid and CHIP monthly enrollment data
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