How to start a NEMT business in Texas: brokers, rules, and enrollment
Texas moved Medicaid transportation into managed care on June 1, 2021, so most trips come from a health plan's broker rather than from the state. For rides on or after October 1, 2026, two brokers cover every plan: SafeRide Health and MTM Health. Modivcare arranged Blue Cross and Blue Shield of Texas rides through September 30, 2026. Texas has no statewide NEMT license. The credentials that matter are your TMHP enrollment and a contract with each broker whose plans you want to serve.
Texas NEMT at a glance
- Runs the program
- Texas Health and Human Services Commission (HHSC)
- Program
- Medical Transportation Program (MTP)
- How rides are arranged
- Health plans each contract a broker. Medicaid managed care plans arrange rides through contracted brokers. HHSC arranges fee-for-service trips through MTP.
- Brokers you will contract with
- SafeRide Health, MTM Health
- State operating license
- None statewide. HHSC sets vehicle and driver standards in 1 TAC 380. TxDMV registration applies to vehicles designed for more than 15 passengers including the driver.
- EVV for NEMT trips
- Not required
- Medicaid enrollment
- 3,795,527 (June 2026, Medicaid only)
On this page
How Medicaid NEMT works in Texas
HHSC runs the Medical Transportation Program for Medicaid members who have no other way to get to covered care, under Texas Government Code chapter 526. House Bill 1576 (2019) required every Medicaid managed care plan to arrange its own members' rides, and the cutover happened on June 1, 2021. Each plan hires a transportation broker to credential providers, schedule trips, and pay for them.
Members still on fee-for-service Medicaid call MTP at 877-633-8747 and HHSC arranges the trip. Every MTP trip is authorized before it happens, with two business days' notice for routine trips and five for out-of-county trips. Texas Medicaid & Healthcare Partnership (TMHP) enrolls fee-for-service transportation providers and processes their claims.
For a provider that means two paths to trips. Fee-for-service work needs a TMHP enrollment. Managed care work, which is most of the volume, needs a credentialing contract with each broker whose plans operate in your service area. For managed care trips, providers bill the broker, not the plan. Fee-for-service claims go to TMHP.
Governing rule:Texas Medicaid Provider Procedures Manual, chapter 2.14: Medical Transportation Program Handbook
What Medicaid pays:Texas Medicaid NEMT rates
Who brokers Medicaid rides in Texas
For rides on or after October 1, 2026, two brokers hold every Texas Medicaid managed care transportation contract. Which broker pays you depends on which plan the member belongs to, so most fleets contract with both. HHSC publishes the plan-by-plan list with each broker's phone line.
| Broker | Serves | Provider sign-up |
|---|---|---|
| SafeRide Health | Superior HealthPlan (since June 1, 2021), Community First Health Plans (since April 1, 2025), UnitedHealthcare Community Plan (since January 1, 2026), Molina Healthcare of Texas, Driscoll Health Plan, and Texas Children's Health Plan.Since June 1, 2021. | Provider page |
| MTM Health | Aetna Better Health of Texas, Cook Children's Health Plan, Community Health Choice, Dell Children's Health Plan, El Paso Health, Parkland Community Health Plan, and Wellpoint, plus Blue Cross and Blue Shield of Texas Medicaid (STAR and STAR Kids) for rides on or after October 1, 2026. Includes the former Access2Care plans. MTM Health closed that acquisition in October 2024 and moved the trips onto MTM Link on May 14, 2026.Arranges Blue Cross and Blue Shield of Texas Medicaid rides on or after October 1, 2026, in place of Modivcare. Standing trips and rides already scheduled after that date carry over to MTM Health. | Provider page |
Plans switch brokers with a few months' notice. Before you sign, check the plan's own provider notices and HHSC's health plan transportation contact page (under official resources), which lists the broker and phone line for every plan.
Fee-for-service trips are arranged and authorized by HHSC's MTP directly. Enrolled Demand Response Transportation Service providers bill TMHP.
How to become a NEMT provider in Texas
Enrollment runs through TMHP. Broker credentialing runs separately through each broker. Plan on both if you want managed care trips.
Form the business and get an NPI
Register the company with the Texas Secretary of State, get a federal EIN, and apply for a National Provider Identifier. Use the exact legal name on every enrollment and contract that follows.
Enroll with TMHP through PEMS
Demand Response Transportation Service (DRTS) providers and transportation network companies enroll as Medicaid providers in TMHP's Provider Enrollment and Management System, provider type MT. Individual transportation participants who drive members in personal vehicles register instead and receive an Atypical Provider Identifier. PEMS tells you whether the 2026 application fee of $750 applies to you. Enrollment revalidates at least every five years. The TMHP contact center is 800-925-9126.
Meet the HHSC vehicle and operator standards
Title 1, Texas Administrative Code, sections 380.501 and 380.502 set the vehicle and driver rules every MTP provider follows. The tables below summarize them.
Credential with each broker
SafeRide Health and MTM Health each run their own application, vehicle inspection, and driver file review. SafeRide, for example, checks each driver's national criminal record, sex-offender registry status, and motor vehicle record, requires a pre-hire drug screen plus First Aid or CPR/AED, defensive driving, and wheelchair securement training, and expects 95 percent on-time performance.
Check TxDMV and city rules
TxDMV motor carrier registration applies if a vehicle is designed to carry more than 15 passengers including the driver ($100 application fee per year, $10 per vehicle, and a $100 insurance filing fee). Houston's vehicle-for-hire ordinance lists no NEMT category, and Dallas regulates transportation for hire under Chapter 47A of its code, so ask each city whether your service falls under its permit.
Bill within the filing deadline
File fee-for-service claims with TMHP within 95 days of the service date as an in-state provider, or within 365 days if you are out of state. Broker claims follow each broker's contract, usually through the broker's portal or app.
Vehicle and driver requirements in Texas
HHSC rules set the floor. Broker contracts add to it, most notably drug testing and CPR, which the state rule does not require.
Vehicles
| Requirement | State rule | Broker contract |
|---|---|---|
| Vehicle markings | Provider name and vehicle number in letters at least 6 inches tall, plus posted no-smoking, seat-belt, and no-concealed-weapons signs (1 TAC 380.501). | Brokers may add their own decals or trip-verification devices. |
| Climate control | Working heating and air conditioning. | Same. |
| Accessibility | Wheelchair-accessible vehicles follow the ADA accessibility guidelines (36 CFR 1192). | Brokers inspect lifts, securements, and ramps at credentialing. |
| Safety standards | Federal Motor Vehicle Safety Standards (49 CFR 571) and Texas Transportation Code chapter 547 equipment rules. | Periodic vehicle inspections on the broker's schedule. |
| Operating registration | No NEMT license. TxDMV motor carrier registration for vehicles designed for more than 15 passengers including the driver. | Broker credentialing is the operative approval. |
Drivers
| Requirement | State rule | Broker contract |
|---|---|---|
| Driver license and record | Valid license and a Department of Public Safety driving record check (1 TAC 380.502). | Motor vehicle record rechecks, usually yearly. |
| Criminal history | No conviction in the past seven years for offenses against children, elders, or disabled people, offenses against persons, family, public order, or property, controlled substances, or Medicaid fraud. | National background and sex-offender registry checks. |
| DWI | No DWI or DUI finding within seven years before hire or at any time after. | Same or stricter. |
| Training | Passenger safety, passenger assistance, and assistive device training every year. Defensive driving every two years. | Broker orientation, HIPAA, wheelchair securement, and First Aid or CPR. |
| Drug and alcohol testing | Not required by 1 TAC 380. | Pre-hire drug screen required by the brokers. |
Insurance minimums in Texas
The state NEMT rule sets no dollar minimum. Texas's general auto liability floor applies to every vehicle, TxDMV sets minimums for larger vehicles, and each broker sets its own bar in the provider contract.
| Coverage | Minimum | Set by |
|---|---|---|
| NEMT-specific minimum | None in 1 TAC 380 | Broker contract |
| Auto liability, any vehicle | $30,000 per person, $60,000 per accident, $25,000 property damage | Transportation Code § 601.072 |
| Vehicles designed for 16 to 26 passengers | $500,000 combined single limit | 43 TAC § 218.16 (TxDMV-registered carriers) |
| Vehicles designed for 27 or more passengers | $5,000,000 combined single limit | 43 TAC § 218.16 |
| SafeRide Health contract | $1,000,000 per occurrence and $2,000,000 aggregate general liability; $500,000 auto liability; SafeRide named as additional insured | Broker contract |
| Workers compensation | Optional for private employers under Texas law | Broker contract, often required |
Does Texas require EVV for NEMT?
No. Texas requires electronic visit verification for personal care services and home health services (1 TAC 354.4005 and 354.4006). NEMT trips are outside EVV scope.
Brokers check trips on their own terms instead: GPS from a driver app, pickup and drop-off timestamps, and signatures or trip logs. Keep those records for every trip. A September 2025 HHSC Office of Inspector General audit of SafeRide's Superior contract found SafeRide did not obtain required prior authorizations for 38 of 58 sampled services. Keep authorization numbers and trip records for every trip.
HHSC EVV Policy Handbook, section 3000: Programs and services required to use EVV
What changed in Texas in 2025 and 2026
Texas had 3,795,527 people on Medicaid and 166,563 on CHIP in June 2026 (HHSC monthly caseload). Managed care plans cover most of them, which is why the broker table above decides who pays you.
SafeRide Health picked up Community First in April 2025 and UnitedHealthcare in January 2026. MTM Health moved Access2Care's Texas plans onto its own platform in May 2026, and it arranges Blue Cross and Blue Shield of Texas rides on or after October 1, 2026. BCBSTX was the only Texas Medicaid plan on HHSC's transportation list that used Modivcare.
Modivcare filed for Chapter 11 on August 20, 2025 and left bankruptcy on December 29, 2025 with its funded debt cut by more than 85 percent. Providers holding Modivcare receivables for BCBSTX trips run through September 30, 2026 should watch those payments.
Managed care rates are set in each broker contract. HHSC's February 2021 Rider 12b report put the preliminary average fee-for-service trip cost at $50.57 for fiscal 2020.
NEMT moves into Medicaid managed care under House Bill 1576. SafeRide Health begins serving Superior HealthPlan.
Community First Health Plans switches from MTM to SafeRide Health.
Modivcare files for Chapter 11 in the Southern District of Texas.
HHSC Office of Inspector General publishes its audit of SafeRide's Superior STAR+PLUS transportation contract.
UnitedHealthcare announces SafeRide Health as its Texas NEMT vendor effective January 1, 2026.
Modivcare emerges from Chapter 11 with its funded debt cut by more than 85 percent.
SafeRide Health goes live for UnitedHealthcare. TMHP's enrollment application fee rises to $750.
Access2Care trips for Texas plans move onto MTM Link.
Blue Cross and Blue Shield of Texas Medicaid rides on or after this date go through MTM Health instead of Modivcare.
Frequently asked questions
- Who is the NEMT broker in Texas?
- There is no single Texas broker. Each Medicaid managed care plan hires its own. SafeRide Health serves Superior, Community First, UnitedHealthcare, Molina, Driscoll, and Texas Children's. MTM Health serves Aetna, Cook Children's, Community Health Choice, Dell Children's, El Paso Health, Parkland, and Wellpoint, plus Blue Cross and Blue Shield of Texas for rides on or after October 1, 2026 (Modivcare arranged BCBSTX rides through September 30). Fee-for-service members use HHSC's Medical Transportation Program line, 877-633-8747.
- Do I need a license to run a NEMT business in Texas?
- Texas has no statewide NEMT license. You need a business entity, an NPI, a TMHP enrollment for fee-for-service work, and a credentialing contract with each broker for managed care work. TxDMV registration applies to vehicles designed for more than 15 passengers including the driver, and some cities regulate vehicles for hire.
- How do I become a Medicaid transportation provider in Texas?
- Enroll with TMHP through the Provider Enrollment and Management System as a Demand Response Transportation Service provider, pay the $750 application fee if PEMS says it applies, then apply to the brokers whose plans cover your area. Each broker inspects vehicles and reviews driver files before assigning trips. Revalidate at least every five years.
- Does Texas require EVV for NEMT?
- No. Texas EVV covers personal care and home health services only. Brokers still require trip verification, usually GPS timestamps from a driver app plus a signature or trip log.
- What insurance does a Texas NEMT provider need?
- The state NEMT rule sets no minimum, and the general Texas auto floor is $30,000 per person, $60,000 per accident, and $25,000 property damage. Brokers set the real bar. SafeRide, for example, requires $1 million per occurrence and $2 million aggregate general liability plus $500,000 auto liability with SafeRide as additional insured.
- What are the driver requirements for NEMT in Texas?
- Under 1 TAC 380.502, drivers need a valid license, a DPS driving record check, no disqualifying conviction in the past seven years, no DWI within seven years, passenger safety and assistance training every year, and defensive driving every two years. Brokers add drug screens, national background checks, First Aid or CPR, and wheelchair securement training.
- How much does Texas Medicaid pay for NEMT trips?
- Managed care rates are set in each broker's contract. HHSC's February 2021 Rider 12b report put the preliminary average fee-for-service trip cost at $50.57 for fiscal 2020.
- Who arranges Blue Cross and Blue Shield of Texas Medicaid rides?
- MTM Health, for rides on or after October 1, 2026. Modivcare arranged them through September 30, 2026. Recurring rides and rides already scheduled after October 1 move to MTM Health without members rebooking, so providers who serve BCBSTX members need an MTM Health contract to keep receiving those trips.
- How long do I have to file a Texas Medicaid transportation claim?
- File fee-for-service claims with TMHP within 95 days of the service date as an in-state provider, or within 365 days if you are out of state. Broker claims follow the broker contract and are usually submitted through the broker's portal or app.
Running NEMT in Texas with HealthRide
Texas fleets juggle two broker portals, two sets of trip rules, and a state that pays fee-for-service through TMHP. HealthRide runs every trip on one dispatch board and records every payment, whichever payer it came from, in one ledger.
The driver app records GPS-recorded miles, timestamps, signatures, and wait times on every leg, and the trip log exports as CSV or PDF, so broker audits and HHSC reviews get the records they ask for.
Official resources
- TMHP: Medical Transportation Program
- TMHP: Provider enrollment (PEMS)
- TMHP: 2026 provider enrollment application fee set at $750
- Texas Medicaid Provider Procedures Manual, chapter 2.14 (September 2026)
- HHSC: Nonemergency Medical Transportation program
- HHSC: Health plan transportation contact information
- HHSC Provider Finance: Medical Transportation Program (MTP)
- HHSC: Medicaid and CHIP enrollment and revalidation
- HHSC: Healthcare statistics (monthly enrollment by risk group)
- HHSC Office of Inspector General: SafeRide audit (AUD-26-002)
- HHSC: Medical Transportation Program average cost per trip (Rider 12b, February 2021)
- Texas Government Code § 526.0351: Medical transportation program definitions
- Texas Legislature Online: HB 1576 (86R), delivery of Medicaid transportation services
- 1 TAC 380.501: Standards for motor vehicles
- 1 TAC 380.502: Standards for motor vehicle operators
- Texas Transportation Code § 601.072: Minimum coverage amounts
- TxDMV: Motor carrier registration (TxDMV Number)
- 43 TAC § 218.16: Insurance requirements for registered carriers
- HHSC EVV Policy Handbook, section 3000
- City of Houston: Vehicle-for-hire permitting
- SafeRide Health: What to expect as a NEMT provider
- SafeRide Health: Texas
- MTM Health: Transportation providers
- MTM Health: Texas
- MTM: Access2Care trips move to MTM Link
- Modivcare: Texas
- UnitedHealthcare: Texas Medicaid NEMT transportation vendor change
- Community First Health Plans: SafeRide Health begins April 1, 2025
- Blue Cross and Blue Shield of Texas: MTM Health to provide medical transportation
- Blue Cross and Blue Shield of Texas: New medical transportation provider for Medicaid members, effective October 1, 2026
- SEC: Modivcare Form 8-K, August 2025
- SEC: Modivcare Form 8-K, December 2025
- SEC: Modivcare press release on completing its restructuring (8-K exhibit 99.1)
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