How to start a NEMT business in Utah: Modivcare, the ride hierarchy, and Medicaid rules
Utah Medicaid runs NEMT itself, for fee-for-service and health plan members alike, and it sends each member to the least costly option that works. Members with a car get mileage reimbursement, members along the Wasatch Front get a UTA transit card or paratransit, and door-to-door rides go through Modivcare, the statewide broker. Utah Medicaid does not accept applications from new NEMT providers. A transportation company joins by contracting with Modivcare.
Utah NEMT at a glance
- Runs the program
- Utah Department of Health and Human Services (DHHS)
- Program
- Utah Medicaid non-emergency medical transportation (NEMT)
- How rides are arranged
- One statewide broker. DHHS arranges NEMT for all Traditional Medicaid members, including health plan members, through mileage reimbursement, UTA and CATS transit, tribal programs, and Modivcare for door-to-door rides.
- Brokers you will contract with
- Modivcare
- State operating license
- No Medicaid NEMT license or enrollment for new companies. Utah Medicaid contracts only with UTA, CATS, Modivcare, and tribal programs; other providers join through Modivcare.
- EVV for NEMT trips
- Not required
- Medicaid enrollment
- 290,393 (May 2026, Medicaid only)
On this page
How Medicaid NEMT works in Utah
NEMT is available to Traditional Medicaid members for medically necessary appointments with Medicaid providers, and the provider manual counts members enrolled in managed care plans. CHIP, the Medicare savings programs (QMB, SLMB, and QI), and Emergency Medicaid members are not eligible. Trips must go to the nearest appropriate Medicaid provider, and health plan members must use the nearest provider in their plan.
The manual sets a strict order. A member with a working vehicle gets mileage reimbursement, approved by a Department of Workforce Services eligibility worker, at 18 cents a mile up to $300 a month. A member inside the UTA service area (Box Elder, Salt Lake, Weber, Davis, Tooele, and Utah counties) or the Cedar City CATS area uses fixed-route transit, with a UTA Transit Card good for 30 journeys a month. A member who cannot ride fixed routes applies for UTA Paratransit or CATS Dial-A-Ride. Modivcare comes next, for members outside those areas or unable to use them.
Modivcare is the statewide NEMT broker and contracts with local transportation companies. Members qualify if they have no licensed vehicle and live outside the UTA and CATS areas, or if a primary care provider certifies that they cannot use a car or transit for medical reasons. While a certification is pending, Modivcare can transport a member for up to four weeks. American Indian and Alaska Native members in tribal service areas ride with tribal NEMT programs instead.
Governing rule:Utah Medicaid Provider Manual: Medical Transportation Services (July 2026)
Who brokers Medicaid rides in Utah
Modivcare is the only broker. It covers every county, including trips up to 120 miles into border communities in neighboring states.
| Broker | Serves | Provider sign-up |
|---|---|---|
| Modivcare | Door-to-door NEMT statewide for Traditional Medicaid members, fee-for-service and health plan, who live outside the UTA and CATS areas without a vehicle or have a provider's certification that they cannot use a car or transit. | Provider pageMember reservations 855-563-4403 |
Tribal NEMT contracts cover American Indian and Alaska Native members in their service areas: Utah Navajo Health System (UNHS) in San Juan and Kane counties, Sacred Circle for the Confederated Tribes of the Goshute Reservation in Juab and Tooele counties, and Four Points Health for the Paiute Indian Tribe of Utah in Iron, Millard, Sevier, and Washington counties.
UTA runs fixed-route transit and Paratransit on the Wasatch Front, and Cedar Area Transportation Services (CATS) runs buses and Dial-A-Ride in the Cedar City area. Members use these before Modivcare.
How to become a NEMT provider in Utah
The provider manual is direct about it: Medicaid does not accept applications for additional NEMT providers. The path to Utah Medicaid trips runs through Modivcare.
Form the business
Register the company with the state and get a federal EIN. Use the same legal name on your Modivcare application and insurance.
Apply to Modivcare's network
Modivcare contracts with local transportation companies across Utah and takes provider applications online. Utah Medicaid will not enroll you directly for NEMT.
Credential drivers and vehicles
Modivcare requires a PASS wheelchair certificate, First Aid and CPR, a defensive driving certificate, a passed drug screen, a clean motor vehicle report, and a background check for each driver. Vehicles need current registration, a state inspection if one is required, and insurance.
Insure at the 2025 state minimums or higher
Auto policies issued or renewed on or after January 1, 2025 must carry at least $30,000 per person, $65,000 per accident, and $25,000 property damage, or a $90,000 single limit. Modivcare adds commercial general liability, sexual abuse and molestation coverage, and workers compensation if you have employees.
Utah Code 31A-22-304: Motor vehicle liability policy minimum limits
Plan around the trip rules
Members schedule at least three business days ahead, trips over 75 miles one way need a medical necessity form, and Modivcare vehicles carry members up to a combined member and wheelchair weight of 600 pounds. Children under 16 ride with a parent, guardian, or authorized adult.
Utah Medicaid Provider Manual: Medical Transportation Services
Border-area providers: call Modivcare first
Transportation providers within 120 miles of the Utah border must contact Modivcare before bringing a member back to Utah. Out-of-state transportation that Modivcare cannot provide must be approved, and out-of-state providers enroll as Utah Medicaid providers to be paid.
Utah Medicaid Provider Manual: Medical Transportation Services
Vehicle and driver requirements in Utah
Utah's Medicaid manual controls who rides and where. It sets no driver or vehicle credentials of its own, so Modivcare's credentialing is the standard in practice.
Vehicles
| Requirement | State rule | Broker contract |
|---|---|---|
| Who may provide NEMT | Medicaid contracts only with UTA, CATS, Modivcare, and tribal transportation, and does not accept applications for additional NEMT providers (manual 8-2.8). | Modivcare network credentialing and contract. |
| Weight capacity | Modivcare trips are limited to 600 pounds of combined member and wheelchair weight, and UTA and CATS vehicles to 800. A member over the limit who cannot use a manual wheelchair can be scheduled for NEMT ambulance. | Vehicle matched to the member's level of service. |
| Registration and inspection | Not set in the Medicaid manual. | Current registration, a state inspection if required, and valid insurance. |
Drivers
| Requirement | State rule | Broker contract |
|---|---|---|
| Screening | Not set in the Medicaid manual. | Background check, drug screen, and a clean motor vehicle report. |
| Training | Not set in the Medicaid manual. | PASS wheelchair certificate, First Aid and CPR, and defensive driving. |
| Minors and attendants | Children under 16 must travel with a parent, guardian, or authorized adult. Members aged 16 or 17 may ride alone with written consent. One travel attendant may be authorized for an adult. | Modivcare holds the consent and attendant authorization forms on file before rides are scheduled. |
Insurance minimums in Utah
Utah raised its auto liability floor for policies issued or renewed from January 1, 2025. The Medicaid manual sets no NEMT-specific amount, and Modivcare adds commercial coverage.
| Coverage | Minimum | Set by |
|---|---|---|
| Auto liability, policies from January 1, 2025 | $30,000 per person, $65,000 per accident, $25,000 property damage, or $90,000 single limit | Utah Code 31A-22-304 |
| NEMT-specific minimum | None in the Medicaid manual | Broker contract |
| Modivcare network | Commercial general liability, sexual abuse and molestation coverage, and auto liability; limits vary by state | Broker contract |
| Workers compensation | Required by Modivcare in most states if you have employees | Broker contract |
Does Utah require EVV for NEMT?
No. Utah requires electronic visit verification for Medicaid personal care and home health services, and its EVV code list includes no transportation codes.
Modivcare checks trips instead. It confirms appointments with Medicaid providers, can cancel a ride when the appointment cannot be confirmed, and denies trips to providers not enrolled in Medicaid. NEMT claims billed to Medicaid carry a two-letter modifier showing the origin and destination of each trip.
What changed in Utah in 2025 and 2026
Utah had 290,393 people on Medicaid and 34,067 on CHIP in May 2026, according to CMS's preliminary monthly data. CHIP members have no NEMT benefit.
The hierarchy shapes the market. Members inside the UTA and CATS areas must use transit or paratransit first, so Modivcare's door-to-door work centers on members outside those areas and members with a doctor's certification. Weekend and holiday service is limited to dialysis, urgent care, and hospital discharges, and urgent care trips run from 7 a.m. to 11 p.m. every day.
Health plan members use the same state ride program, because the manual counts them as members. Four plans (Health Choice Utah, Healthy U, Molina Healthcare, and SelectHealth Community Care) serve Medicaid members, and enrollment is required in 13 counties, but members still use the state's transportation program. When a plan sends a member to an out-of-state provider, the plan pays for that transportation.
Modivcare filed for Chapter 11 on August 20, 2025 and emerged on December 29, 2025 with its funded debt cut by more than 85 percent. As Utah's only broker, its payment terms decide how Utah providers are paid.
Utah's minimum auto liability limits rise to $30,000 per person (from $25,000) and $25,000 property damage (from $15,000) for new and renewed policies. The $65,000 per accident limit is unchanged.
Modivcare, Utah's statewide NEMT broker, files for Chapter 11.
Modivcare emerges from Chapter 11.
DHHS issues the current Medical Transportation Services provider manual, with the ride hierarchy, Modivcare weight limits, and rules for minors traveling alone.
Frequently asked questions
- Who is the NEMT broker in Utah?
- Modivcare. It is DHHS's statewide broker for door-to-door rides and contracts local transportation companies to run them. Members reach it at 855-563-4403. Many members use UTA transit, Paratransit, CATS, or mileage reimbursement instead, and tribal programs serve American Indian and Alaska Native members in their areas.
- Can I enroll directly with Utah Medicaid as a NEMT provider?
- No. The Medical Transportation provider manual says Medicaid contracts with UTA, CATS, Modivcare, and tribal transportation, and does not accept applications for additional NEMT providers. You join by contracting with Modivcare.
- Which Utah Medicaid members can ride with Modivcare?
- Traditional Medicaid members who have no licensed vehicle and live outside the UTA and CATS service areas, or whose primary care provider certifies they cannot use a car or public transit for medical reasons. Modivcare can transport a member for up to four weeks while that certification is pending.
- Do Utah health plan members use the same NEMT program?
- Yes. The manual includes members enrolled in managed care plans. They must go to the nearest provider in their plan. When a plan sends a member out of state for care, the plan pays for that trip.
- Does Utah require EVV for NEMT?
- No. Utah's EVV covers personal care and home health services, and its code list includes no transportation codes. Modivcare confirms appointments with medical providers instead.
- What insurance does a Utah NEMT company need?
- At minimum, the state auto floor for policies issued or renewed since January 1, 2025: $30,000 per person, $65,000 per accident, and $25,000 property damage, or a $90,000 single limit. Modivcare adds commercial general liability, sexual abuse and molestation coverage, and workers compensation if you have employees.
- Can a child ride alone on a Utah Medicaid trip?
- Children under 16 must travel with a parent, legal guardian, or adult the guardian authorizes. Members aged 16 or 17 can ride alone with a signed consent form filed with Modivcare. Some minors, such as pregnant, married, or emancipated minors, are exempt.
- How far can a Modivcare trip go in Utah?
- Trips must go to the nearest appropriate Medicaid provider. Trips over 75 miles one way need a medical necessity form from the referring provider, and Modivcare covers up to 120 miles one way into border communities in neighboring states.
Running NEMT in Utah with HealthRide
Utah door-to-door trips come through one broker with firm rules on notice, distance, weight, and who rides along. HealthRide tracks seat and wheelchair capacity and escorts on every trip, and wheelchair, stretcher, and oxygen needs are matched to the right vehicle.
Recurring trips such as dialysis runs are set up one time. Schedule it once, and HealthRide keeps it going.
Official resources
- Utah Medicaid Provider Manual: Medical Transportation Services (July 2026)
- Utah Medicaid: Non-emergency medical transportation
- Utah Medicaid: Member guide
- Utah Medicaid: Managed care
- Utah Medicaid: Become a Medicaid provider
- Utah Medicaid: Electronic Visit Verification
- Utah Code 31A-22-304: Motor vehicle liability policy minimum limits
- Modivcare: Transportation providers
- 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)
- CMS: Medicaid and CHIP monthly enrollment data
HealthRide plans the whole day in one click and bills every ride.
$59 per vehicle per month. No contracts.