How to start a NEMT business in South Carolina: Modivcare, ORS certificates, and the rebid
Modivcare arranges Medicaid rides in all three of South Carolina's transportation regions, for fee-for-service and health plan members alike. To carry those riders you need a Class C Non-Emergency certificate from the Public Service Commission and the Office of Regulatory Staff (ORS), $1 million in liability coverage, and a Modivcare contract. The state is rebidding the broker contract: proposals are due December 3, 2026, and the new contract is estimated to start March 11, 2027.
South Carolina NEMT at a glance
- Runs the program
- South Carolina Department of Health and Human Services (SCDHHS)
- Program
- Healthy Connections Medicaid non-emergency medical transportation (NEMT)
- How rides are arranged
- One statewide broker. SCDHHS contracts one broker, Modivcare, for fee-for-service and health plan members. Health plans exclude NEMT and send members to the broker.
- Brokers you will contract with
- Modivcare
- State operating license
- Class C Non-Emergency certificate (or Class C Stretcher Van certificate) approved by the Public Service Commission and issued by ORS, with vehicles registered with ORS every year.
- EVV for NEMT trips
- Not required
- Medicaid enrollment
- 957,737 (May 2026, Medicaid and CHIP)
On this page
How Medicaid NEMT works in South Carolina
SCDHHS covers NEMT under section 1902(a)(70) of the Social Security Act and 42 CFR 440.170, through a single transportation coordinator. Modivcare, formerly LogistiCare, has held the job since a competitive contract that ran from May 26, 2011 to May 25, 2016, and has kept it since through non-competitive contracts with SCDHHS.
Health plan members use the same broker as fee-for-service members. The state's managed care contract lists NEMT as an excluded service, so plans help members book through the department's transportation broker instead of arranging rides themselves. Members call their region's reservation line, Monday through Friday from 8 a.m. to 5 p.m., at least three days before the appointment, and facilities book hospital discharges around the clock on a dedicated line.
For a provider, that means one payer for Medicaid trips: you credential with Modivcare, receive trips from it, and bill it. Separately, the state regulates you as a for-hire passenger carrier. The Public Service Commission approves a Class C Non-Emergency or Class C Stretcher Van certificate, and ORS inspects your vehicles and driver files and holds your proof of insurance.
Governing rule:S.C. Code of Regulations 103-133(5): Non-emergency vehicles
Who brokers Medicaid rides in South Carolina
One broker, three regions, fee-for-service and health plan members alike. The contract is being rebid, so the name on the contract may change in 2027.
| Broker | Serves | Provider sign-up |
|---|---|---|
| Modivcare (Region 1) | Abbeville, Anderson, Cherokee, Edgefield, Greenville, Greenwood, Laurens, McCormick, Oconee, Pickens, Saluda, and Spartanburg counties. Fee-for-service and health plan members.Since May 26, 2011. Rebid under solicitation 5400029919. Estimated new contract start March 11, 2027. | Provider pageReservations 866-910-7688 |
| Modivcare (Region 2) | Aiken, Allendale, Bamberg, Barnwell, Calhoun, Chester, Clarendon, Fairfield, Kershaw, Lancaster, Lee, Lexington, Newberry, Orangeburg, Richland, Sumter, Union, and York counties. Fee-for-service and health plan members.Since May 26, 2011. Rebid under solicitation 5400029919. Estimated new contract start March 11, 2027. | Provider pageReservations 866-445-6860 |
| Modivcare (Region 3) | Beaufort, Berkeley, Charleston, Chesterfield, Colleton, Darlington, Dillon, Dorchester, Florence, Georgetown, Hampton, Horry, Jasper, Marion, Marlboro, and Williamsburg counties. Fee-for-service and health plan members.Since May 26, 2011. Rebid under solicitation 5400029919. Estimated new contract start March 11, 2027. | Provider pageReservations 866-445-9954 |
Facilities request standing orders for dialysis, adult day care, and mental health appointments on Modivcare forms, and book hospital discharges around the clock on the facility line, 866-420-6231. On a discharge, the transportation provider has 30 minutes to three hours to pick up the member.
Modivcare books trips anywhere in South Carolina and to facilities within 25 miles of the state line through the standard process. Longer out-of-state trips go through the facility line.
Nursing facilities have arranged and been paid for their Medicaid residents' rides since January 1, 2018, so those trips do not go through the broker. The draft contract for the next broker also leaves out PACE participants and limited-benefit groups such as QMB, SLMB, and Family Planning.
Adult day health care rides have gone through Modivcare since July 1, 2022. Adult day centers that want to keep driving their own members can contract with Modivcare to do it.
The 2025 attempt to replace Modivcare failed. The state posted an intent to award the contract to MTM Health on July 3, 2025, the Chief Procurement Officer overturned it on October 2, 2025 after finding MTM's proposal nonresponsive, and the Procurement Review Panel upheld the ruling on January 16, 2026.
How to become a NEMT provider in South Carolina
South Carolina regulates you twice: as a passenger carrier through the Public Service Commission and ORS, and as a Medicaid transportation provider through the broker's credentialing.
Form the business and get an NPI
Register the company with the South Carolina Secretary of State, then get a federal EIN. Get a National Provider Identifier as well: the draft contract for the next broker lists an NPI, a business license, a W-9, and an ownership disclosure among the credentialing documents for every transportation provider.
Apply to the Public Service Commission for a Class C certificate
Ambulatory and wheelchair service needs a Class C Non-Emergency certificate, and stretcher service needs a Class C Stretcher Van certificate. The commission posts your application for 15 days. If no one objects, it decides whether you are fit, willing, and able; an objection triggers a hearing. Approval comes as a directive, followed by a written order in one to two weeks.
Finish the ORS compliance steps within 90 days
After the order, ORS emails a compliance letter. You then pass an ORS inspection of your vehicles and driver files, register each vehicle with ORS, and have your insurer send a Form E showing the required coverage in the exact company name on the commission's order. ORS then issues the certificate. You have 90 days from the order date to finish.
Build compliant driver files
Keep a file for every driver at your place of business: license, CPR and first aid card, a certified three-year driving record updated every year, a DOT medical examiner's certificate, drug test records, a SLED criminal records check, and a sex offender registry search. The ORS inspector will ask for them.
ORS: Non-emergency and stretcher van driver file and vehicle requirements
Credential with Modivcare
Modivcare is the only NEMT broker in the state, so its network is the route to Medicaid volume. Modivcare's provider requirements include PASS wheelchair training, First Aid and CPR, defensive driving, a drug screen, a motor vehicle report, and a background check for drivers, plus registration, inspection, and insurance proof for vehicles.
Plan for the 2027 broker change
Proposals for the next NEMT coordinator are due December 3, 2026, the award is scheduled to post March 1, 2027, and the contract is estimated to start March 11, 2027. If the contract changes hands, you will need to credential with the new coordinator. The draft contract pays the broker a capitated rate instead of fee-for-service, requires GPS in every vehicle, and gives preference to atypical providers such as adult day care centers. It also has the broker send trip manifests at least 48 hours before the day of the trip and pay undisputed provider invoices within 30 days.
Vehicle and driver requirements in South Carolina
State rules come from the commission's regulation 103-133(5) and ORS inspection standards. The broker column shows Modivcare's requirements and, where noted, the draft contract SCDHHS published for the next broker.
Vehicles
| Requirement | State rule | Broker contract |
|---|---|---|
| Operating authority | Class C Non-Emergency certificate for ambulatory and wheelchair service, or Class C Stretcher Van certificate. Vehicles are registered with ORS every year; renewal opens November 15. | Modivcare checks current registration and state inspection at credentialing. |
| Markings | Business name on both sides and the rear in contrasting letters at least 3 inches high, readable from 20 feet (Reg. 103-133(5)). ORS also asks for the certificate number. | Same. |
| Required equipment | Seat belts at every seat, door locks, a foot stool or extra step, sanitary seat covers, spare tire and jack, a 4 lb ABC extinguisher inspected yearly, two-way radio or phone, working heat and air, emergency warning devices, and a "No Smoking" sign when oxygen is carried. | Draft next-broker contract: GPS in every vehicle that records driver activity on NEMT trips, and removal of any vehicle with two cleanliness or temperature complaints in five days until it is fixed. |
| First aid kit | ORS list: CPR face cover, scissors, two isolation kits, gloves, gauze pads and rolls, tape, a spill kit, a blanket, bandages, two flashlights, and three emergency triangles. | Same. |
| Wheelchair vehicles | A lift or ramp that meets state and federal standards, and securement strong enough to keep the chair from rotating or lifting and to hold it in a rollover. A lift defect fails inspection. | Draft next-broker contract: an interior mirror for watching the passenger area, anti-skid flooring that does not block wheelchair movement, and a seat belt cutter within the driver's reach. |
| Stretcher vans | Separate Class C Stretcher Van certificate. Every trip carries a driver and an assistant, who rides in the passenger compartment, and the passenger is never left unattended. Both hold first aid (renewed every three years) and adult CPR (renewed yearly) certifications. | The draft next-broker contract adds an allowance for stretcher van service and CDC-based cleaning standards for stretcher vehicles. |
Drivers
| Requirement | State rule | Broker contract |
|---|---|---|
| Age and license | At least 18, with a valid license from South Carolina or the state of residence. | Draft next-broker contract: no license suspension or revocation for a moving violation in the past five years. |
| Driving record | Certified three-year DMV driving record, updated every year. | Modivcare requires a clean motor vehicle report. Draft contract: no more than two chargeable accidents or moving violations and no DUI in three years. |
| Medical fitness | Current DOT medical examiner's certificate (Reg. 103-133(5)). | Same. |
| Background checks | National criminal history check (ORS asks for a SLED check), and no driver who is or must be on a sex offender registry. Since December 15, 2021, SCDHHS also bars drivers excluded by the HHS Inspector General. | Draft contract adds a 10-year lookback for felonies and listed misdemeanors and bars health care fraud and abuse convictions. |
| Drug testing | Pre-employment, random, and post-accident drug testing (Reg. 103-133(5)). | Modivcare requires a drug screen. Draft contract: 5-panel drug and alcohol tests on random, suspicion, request, and accident triggers. |
| Training and appearance | Current First Aid and CPR, 12 hours of in-service training every year (6 CPR and first aid, 6 safety), equipment training, and a uniform with a photo ID badge. | Modivcare adds PASS wheelchair training and defensive driving. |
Insurance minimums in South Carolina
South Carolina sets a specific floor for non-emergency vehicles, above the general passenger-carrier schedule. ORS accepts only a Form E sent directly by your insurer.
| Coverage | Minimum | Set by |
|---|---|---|
| Liability, combined each occurrence | $1,000,000 | S.C. Code Regs. 103-133(5)(E) |
| Medical payments | $1,000 per person | S.C. Code Regs. 103-133(5)(E) |
| Proof of coverage | Form E from the insurer, in the company name on the commission's order | ORS certificate process |
| Modivcare network | General liability, sexual abuse and molestation, auto liability, and workers compensation where required, at limits set by state | Broker contract |
Does South Carolina require EVV for NEMT?
No. South Carolina uses EVV for in-home services in its community long-term care and children's waivers. NEMT is not included, and the draft contract for the next broker does not add it.
Trip proof runs through the broker. The draft next-broker contract requires GPS in every vehicle, a real-time electronic system for tracking vehicles and trip assignments that can use electronic signatures to record members getting in and out, and annual reporting on how many rides come from providers that track and report fully digitally. Since December 15, 2021, SCDHHS has also required that no provider or driver be on the federal exclusion list and that providers be able to disclose each driver's driving history.
SCDHHS: Update on continued postponement of EVV launch for SCDDSN-operated waiver program
What changed in South Carolina in 2025 and 2026
South Carolina had 957,737 people on Medicaid and CHIP in May 2026 (CMS preliminary data). The state's rebid documents count about 3.79 million NEMT rides in state fiscal year 2025. Adult day care was the largest category at 1,288,159 rides, followed by dialysis at 731,143, mental health at 248,959, and methadone treatment at 230,866.
That mix favors standing orders. Modivcare accepts a standing order for a member who attends a program at least three days a week for at least three months, and the draft contract for the next broker asks it to give preference to atypical providers such as adult day care centers. The draft also moves the broker from fee-for-service to a risk-based capitated rate.
The broker contract has been in play since January 2025. The state tried to replace Modivcare with MTM Health in July 2025, lost that award on a protest, and started over with solicitation 5400029919 on June 26, 2026. A new Modivcare protest suspended it on July 14. The Chief Procurement Officer denied that protest on August 5, 2026, and Amendment 1 on September 11 reset the dates: proposals December 3, 2026, award March 1, 2027, and an estimated start of March 11, 2027 for a three-year term with two one-year renewals.
Modivcare went through Chapter 11 after the 2025 evaluation and emerged as a privately held company. The Chief Procurement Officer cited that change when explaining why the state could test the market again.
The state issues its first NEMT coordinator solicitation since 2014 (5400027781).
That solicitation is cancelled and replaced by solicitation 5400028336. Seven proposals arrive on May 14.
The state posts an intent to award the NEMT contract to MTM Health. Modivcare protests.
The Chief Procurement Officer grants Modivcare's protest in part, finding MTM's proposal nonresponsive.
The Procurement Review Panel affirms, and the award to MTM is vacated.
A new solicitation, 5400029919, is issued with a revised scope, including an allowance for stretcher van service.
The solicitation is suspended pending review of a Modivcare protest.
The Chief Procurement Officer denies Modivcare's protest and formally cancels the second 2025 solicitation (5400028336).
Amendment 1 sets proposals due December 3, 2026, an award posting on March 1, 2027, and an estimated contract start of March 11, 2027.
Estimated start of the next NEMT coordinator contract.
Frequently asked questions
- Who is the NEMT broker in South Carolina?
- Modivcare runs all three Medicaid transportation regions and serves both fee-for-service and health plan members. Member reservation lines are 866-910-7688 (Region 1), 866-445-6860 (Region 2), and 866-445-9954 (Region 3). Facilities use 866-420-6231.
- Is South Carolina changing its NEMT broker?
- Possibly in 2027. SCDHHS is rebidding the contract under solicitation 5400029919. Proposals are due December 3, 2026, the award is scheduled to post March 1, 2027, and the contract is estimated to start March 11, 2027. A 2025 award to MTM Health was overturned on protest, so Modivcare remains the broker until then.
- Do I need a license to run a NEMT business in South Carolina?
- Yes. For-hire transport to medical appointments needs a Class C Non-Emergency certificate, or a Class C Stretcher Van certificate for stretcher service. The Public Service Commission approves the application and ORS issues the certificate after inspecting your vehicles and driver files and receiving your Form E insurance filing.
- Do health plan members use a different broker in South Carolina?
- No. NEMT is an excluded service in the state's managed care contract. Plans help their members book through the department's broker, so managed care and fee-for-service trips both come from Modivcare. The exception is nursing facility residents, whose facility arranges their rides.
- What insurance does a South Carolina NEMT provider need?
- Regulation 103-133(5) requires $1,000,000 combined liability per occurrence and $1,000 medical payments per person for non-emergency vehicles, filed with ORS on a Form E sent by your insurer. Modivcare also asks for general liability, sexual abuse and molestation coverage, and workers compensation where required.
- What are the driver requirements for NEMT in South Carolina?
- Drivers must be at least 18 with a valid license, a certified three-year driving record updated yearly, a DOT medical card, current First Aid and CPR, 12 hours of in-service training a year, a criminal background check, and a clear sex offender registry search. Pre-employment, random, and post-accident drug tests are mandatory. Drivers wear a uniform and photo ID.
- What are the rules for stretcher vans in South Carolina?
- Stretcher service needs its own Class C Stretcher Van certificate. Each trip is staffed by a driver and an assistant, the assistant rides in the passenger compartment, and the passenger is never left alone. Both staff meet the same age, license, driving record, background, and sex offender rules as other drivers.
- Does South Carolina require EVV for NEMT?
- No. South Carolina's EVV covers in-home services in its community long-term care and children's waivers. For NEMT, the draft contract for the next broker requires GPS in every vehicle and real-time trip tracking instead.
- What kinds of trips make up South Carolina Medicaid transportation?
- Adult day care is the largest category, with 1,288,159 rides in state fiscal year 2025 out of about 3.79 million. Dialysis followed with 731,143 rides, then mental health and methadone treatment. Most of that volume repeats on standing orders.
Running NEMT in South Carolina with HealthRide
South Carolina's Medicaid trips come from one broker today, and that contract is being rebid for a 2027 start. HealthRide keeps broker, facility, and private-pay trips on one dispatch board and one ledger, so a broker change is a payer change, not a new system.
Recurring trips cover the adult day care and dialysis schedules that make up most of the state's volume. Credential expiry reminders track yearly driving records, CPR and first aid cards, and the annual ORS vehicle registration.
Official resources
- SCDHHS: Transportation beneficiary information
- SCDHHS: Non-emergency medical transportation provider requirements (MB 21-015)
- SCDHHS: Final action on NEMT for nursing facility residents (December 29, 2017)
- SCDHHS: Updates to adult day health care transportation (MB 22-010)
- SCDHHS: MCO contract, 2024 Amendment VI
- SCDHHS: Update on continued postponement of EVV launch for SCDDSN-operated waiver program
- SC Procurement Services: Protest decision, File 2026-104 (October 2, 2025)
- SC Procurement Review Panel: Appeal by Medical Transportation Management, Inc., Case 2025-4
- SC Procurement Services: Protest decision, File 2027-201 (August 5, 2026)
- SCEIS: Solicitation 5400029919, NEMT coordinator services
- ORS: Transportation
- ORS: Class C non-emergency
- ORS: Becoming a Class C certificate passenger carrier
- ORS: Non-emergency and stretcher van driver file and vehicle requirements
- S.C. Code of Regulations, Chapter 103: Public Service Commission
- S.C. Code Title 58, Chapter 23: Motor vehicle carriers
- Modivcare: South Carolina facility site
- Modivcare: Become a transportation provider
- CMS: State Medicaid and CHIP applications, eligibility determinations, and enrollment data
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