How to start a NEMT business in Vermont: VPTA, regional transit, and DVHA rules
Vermont runs Medicaid NEMT through one statewide broker, the Vermont Public Transportation Association (VPTA), under contract with the Department of Vermont Health Access (DVHA). VPTA's member transit agencies schedule and run the rides by town, using buses, vans, volunteer drivers, and subcontracted taxi companies. A private NEMT company gets Medicaid trips by subcontracting with the regional provider for its area and enrolling in Vermont Medicaid.
Vermont NEMT at a glance
- Runs the program
- Department of Vermont Health Access (DVHA), Agency of Human Services
- Program
- Vermont Medicaid Non-Emergency Medical Transportation (NEMT)
- How rides are arranged
- One statewide broker. DVHA contracts VPTA as the statewide NEMT broker. Regional public transit providers schedule and run rides for members in their towns.
- Brokers you will contract with
- Vermont Public Transportation Association (VPTA) and its regional transit providers
- State operating license
- No statewide NEMT license. Only providers subcontracted with the broker and enrolled in Vermont Medicaid are paid (HCAR 4.225).
- EVV for NEMT trips
- Not required
- Medicaid enrollment
- 145,403 (May 2026, Medicaid and CHIP)
On this page
How Medicaid NEMT works in Vermont
Vermont covers NEMT under Health Care Administrative Rule 4.225, effective April 1, 2021. Every ride needs prior authorization, trips go to a provider within 30 miles of home unless none is closer, and Medicaid pays only for the least expensive mode that meets the member's needs. Only transportation providers subcontracted with the broker and enrolled in Vermont Medicaid can be paid.
VPTA is DVHA's NEMT contractor, and its regional member agencies take the calls. Members schedule at least two business days ahead with the provider for their town, and a DMV check of the household confirms there is no other way to get there. Members who live within three quarters of a mile of a bus route ride the bus unless a doctor documents why they cannot.
Trips of 100 miles or more, and commercial air, need DVHA's own prior authorization. The referring provider faxes the Physician Referral Form to DVHA at least two weeks ahead. DVHA pays VPTA a set weekly amount for each unique member served over the prior 365 days. Amendment 8 to VPTA's contract 41132 sets a weekly rate of $45.80 per member, unchanged across state fiscal years 2025 and 2026 (the two years ending June 30, 2026), plus a temporary $83.25 rate for part of June 2026. VPTA decides how to pay its subcontractors and volunteers.
Governing rule:HCAR 4.225: Non-Emergency Medical Transportation
Who brokers Medicaid rides in Vermont
One broker covers the whole state. VPTA assigns each member to a regional transit provider by town, and those regional providers are where subcontracting starts.
| Broker | Serves | Provider sign-up |
|---|---|---|
| Vermont Public Transportation Association (VPTA) | All Vermont Medicaid NEMT statewide, through regional public transit providers assigned by the member's town. | Provider pageVPTA 833-387-7200 |
DVHA's program manual assigns each member to one of eight transportation providers by town of residence. VPTA's area map marks six agencies as Medicaid providers: Special Services Transportation Agency (Chittenden County), Rural Community Transportation (northeastern Vermont, including Caledonia, Orleans, Lamoille, and Franklin counties), Marble Valley Regional Transit District (Rutland), Tri-Valley Transit (separate lines for Addison, Orange and northern Windsor, and Washington), Green Mountain Community Network (Bennington County), and MOOver (Deerfield Valley, Windham, and southern Windsor).
VPTA's updated Grand Isle area service took effect January 1, 2026. Check VPTA's map for the provider that covers your town before you reach out.
Taxi companies work as subcontractors. The broker keeps a list of subcontracted taxi companies and drivers with their background check records, and every subcontracted taxi invoice carries the driver's name and signature.
How to become a NEMT provider in Vermont
The path to Medicaid trips runs through the regional transit provider for your area, plus Vermont Medicaid enrollment.
Find your regional provider
Look up the regional transit provider for your service area on VPTA's map, then contact it about subcontracting. VPTA and its members set up their own subcontracts, so the conversation starts with them.
Enroll in Vermont Medicaid
HCAR 4.225 pays only providers that are subcontracted with the broker and enrolled in Vermont Medicaid. Enrollment and revalidation run through Gainwell Technologies, DVHA's fiscal agent, at vtmedicaid.com (800-925-1706). NEMT is one of the non-medical provider types Vermont allows to enroll without an NPI.
Clear every background check
Before hire and every year, each driver and staff member clears the national and Vermont criminal checks, the child and adult abuse registries, the DMV, the HHS OIG exclusion list, the Social Security Death Master File, and SAM. The exclusion list, SAM, and Death Master File are rechecked monthly.
Set up drug testing
The NEMT contractor must keep a drug-free workplace policy and a substance abuse testing program that follows federal rules at 49 CFR parts 40 and 655. Ask your regional provider how its program covers subcontracted drivers.
Document every trip
Each trip record shows the member and the appointment, the driver's name and signature, odometer readings, the actual pickup and drop-off times, when billing started and stopped, whether the ride took place, and any delay or incident. Records stay available for seven years.
Vehicle and driver requirements in Vermont
HCAR 4.225 sets coverage rules. DVHA's program manual sets the provider standards, and it binds VPTA and every subcontractor through the broker contract.
Vehicles
| Requirement | State rule | Broker contract |
|---|---|---|
| Registration and insurance | Vermont registration and at least the 23 V.S.A. § 800 liability minimums on every vehicle. Vehicles that routinely take paying riders count as jitneys and carry the higher 23 V.S.A. § 843 limits. | Drivers must show valid registration and current insurance at the DMV check. |
| Modes the broker uses | Least expensive appropriate mode, with prior authorization for every ride (HCAR 4.225). | Free fixed-route transit, volunteer drivers, taxis, demand response transit vans, bus fare, hardship mileage, and commercial air. |
| Trip records | Not specified in HCAR 4.225. | Driver name and signature, odometer miles, actual pickup and drop-off times, billing start and stop times, and any delays or incidents, kept seven years. |
Drivers
| Requirement | State rule | Broker contract |
|---|---|---|
| Driving record | A valid driver's license. | Valid license, registration, and insurance, and at least two years of continuous US driving experience. A suspension must be reported by the end of the next business day. |
| Criminal history | Federal Medicaid screening rules (42 CFR 455.434 and 455.436). | National and Vermont criminal checks before hire and yearly, with no convictions for bodily injury, abuse of a vulnerable person, felony drugs, or crimes of trust. No fingerprinting. |
| Abuse registries and exclusions | Federal rule 42 CFR 455.436 has the state check providers and their owners against the OIG exclusion list, SAM, and the Death Master File. | Child and adult abuse registries yearly. OIG exclusion list, SAM, and the Death Master File at hire and monthly after. |
| Drug testing | Not set in HCAR 4.225. | Drug-free workplace policy and testing program under 49 CFR parts 40 and 655. |
Insurance minimums in Vermont
Vermont sets no NEMT-specific insurance amount. The state liability minimum applies to every vehicle. Jitney limits apply once a vehicle routinely takes paying riders, and the broker checks each driver's coverage.
| Coverage | Minimum | Set by |
|---|---|---|
| Auto liability, any vehicle | $25,000 per person, $50,000 per crash, $10,000 property damage | 23 V.S.A. § 800 |
| Vehicles carrying passengers for hire (jitneys) | $50,000 per person; per crash, $100,000 for seating of 7 passengers or fewer, $250,000 for 8 to 12, $300,000 for 13 to 20; $50,000 property damage | 23 V.S.A. §§ 4(15) and 843 |
| NEMT drivers | Current vehicle insurance, checked with the DMV record | Broker contract (DVHA NEMT Program Manual) |
Does Vermont require EVV for NEMT?
No. Vermont has required EVV since January 1, 2021 for in-home services funded by Medicaid, such as personal care. NEMT is not an in-home service.
NEMT runs on the broker's own checks: household DMV reviews, verification of at least 20 percent of appointments with the provider's office, detailed trip records, incident reports to DVHA within 24 hours, and yearly DVHA site audits of VPTA and its subcontractors.
What changed in Vermont in 2025 and 2026
Vermont Medicaid and CHIP covered 145,403 people in May 2026 (CMS preliminary count).
Rides are coordinated to fill vehicles. The broker can ask members to be ready up to an hour before a local appointment, members cannot arrive more than 45 minutes early, and the monthly average wait after a scheduled pickup must stay at 15 minutes or less. After a third no-show, members must call by noon the business day before to confirm, or no driver is sent.
The payment model may change. In GCR 26-057 (June 30, 2026), the state proposes dropping the weekly per-member payment and paying by HCPCS code instead, with a proposed effective date of July 1, 2026. The draft schedule prices taxi rides (A0100) at $30.75, wheelchair van rides (A0130) at $77.98, and volunteer driver miles (A0080) at $2.11 each. The comment period ended July 30, 2026. The change remains a proposal, not a final policy.
Provider screening is tightening. Vermont's June 4, 2026 revalidation strategy, written at the request of CMS, names NEMT among the provider types allowed to enroll without an NPI. Starting in early 2027 the state plans to score those providers for fraud risk and revalidate any it moves to high risk off-cycle. Off-cycle revalidation of high-risk types such as home health agencies began July 1, 2026.
HCAR 4.225, Non-Emergency Medical Transportation, takes effect.
DVHA sets the weekly per-member payment method for its NEMT contractor.
DVHA updates the Medicaid NEMT Program Manual.
Updated NEMT Rules and Guidelines and Hardship Mileage Waiver forms.
VPTA's updated Grand Isle area service takes effect.
Amendment 8 to VPTA contract 41132, dated May 29 and signed in September 2026, holds the SFY 2026 weekly rate at $45.80 per member and adds a temporary $83.25 rate for part of June 2026.
Vermont sends CMS its two-year provider revalidation strategy, which names NEMT among the provider types that may enroll without an NPI.
GCR 26-057 proposes paying NEMT by HCPCS code instead of a weekly amount per member. Comments close July 30, 2026.
DVHA posts updated NEMT forms, including the Physician Referral Form for trips over 100 miles.
Vermont plans to begin risk scoring for providers that enroll without an NPI, including NEMT.
Frequently asked questions
- Who is the NEMT broker in Vermont?
- The Vermont Public Transportation Association (VPTA), under contract with DVHA. VPTA's regional member transit agencies schedule and run the rides, using buses, vans, volunteer drivers, and subcontracted taxis. The statewide line is 833-387-7200.
- How can a private NEMT company get Medicaid trips in Vermont?
- Subcontract with the regional transit provider that serves your area and enroll in Vermont Medicaid. Under HCAR 4.225, payment goes only to providers that hold a broker subcontract and are enrolled in Vermont Medicaid. Every driver must clear the background checks in DVHA's program manual before starting.
- What background checks do Vermont NEMT drivers need?
- Before hire and every year: national and state criminal record checks, a DMV record check, the child and adult abuse registries, SAM, the HHS OIG exclusion list, and the Social Security Death Master File. The exclusion list, SAM, and Death Master File are rechecked monthly. Drivers also need two years of continuous US driving experience.
- How far will Vermont Medicaid transport a member?
- Routine trips go to a provider within 30 miles of home, or the nearest one if none is closer. Trips of 100 miles or more, and commercial air, need DVHA prior authorization through a Physician Referral Form faxed at least two weeks ahead.
- How does Vermont pay for NEMT?
- DVHA pays VPTA a set weekly amount for each unique member served over the prior 365 days: $45.80 a week per member in both state fiscal year 2025 and 2026, under amendment 8 of contract 41132. VPTA can set any method to pay subcontractors and volunteers that follows tax and employment law, so your rate comes from your subcontract with the regional provider. GCR 26-057, proposed June 30, 2026, would replace the weekly amount with per-trip and per-mile rates; it is not final.
- What happens when a Vermont member no-shows?
- The first no-show gets a warning notice. After the third, the member must call by noon on the business day before each ride to confirm, or no driver is sent. Late cancellations by the member's doctor do not count as no-shows.
- What insurance does a Vermont NEMT provider need?
- Every vehicle needs at least $25,000 per person, $50,000 per crash, and $10,000 property damage (23 V.S.A. § 800). Once a vehicle routinely takes paying riders it counts as a jitney, and the floor rises to $50,000 per person, $100,000 per crash for seating of seven passengers or fewer, and $50,000 property damage (23 V.S.A. § 843). The jitney definition leaves out vehicles in state and federally funded transportation programs for elders and people with disabilities run through public and private nonprofit social service agencies, so confirm the limit with your insurer and regional provider.
- Does Vermont require EVV for NEMT?
- No. Vermont requires EVV for Medicaid-funded in-home services such as personal care. NEMT relies on trip records, appointment checks, and DVHA audits instead.
Running NEMT in Vermont with HealthRide
Vermont's broker is held to a 15-minute average pickup wait and a full trip record for every ride, and those standards pass down to subcontractors. HealthRide's live map and late warnings show dispatch which rides are slipping before the member waits, and the driver app records pickup and drop-off times, GPS-recorded miles, and signatures on every leg.
Credential expiry reminders warn you before a driver's credentials lapse, and the trip log exports as CSV or PDF for your regional provider and DVHA site audits.
Official resources
- DVHA: Non-Emergency Medical Transportation
- DVHA: Medicaid NEMT Program Manual (July 28, 2025)
- HCAR 4.225: Non-Emergency Medical Transportation
- Vermont Agency of Human Services: Adopted Health Care Administrative Rules
- DVHA: NEMT per member payment methodology (April 14, 2021)
- DVHA: VPTA contract 41132, amendment 8 (May 29, 2026)
- GCR 26-069: NEMT temporary rate increase, correction (June 11, 2026)
- GCR 26-057: NEMT transition to fee-for-service payment, proposed (June 30, 2026)
- DVHA: NEMT Rules and Guidelines (August 12, 2025)
- DVHA: Physician Referral Form, over 100 miles (July 2, 2026)
- VPTA: Vermont Medicaid NEMT transportation
- VPTA: My area provider
- Rural Community Transportation: Service map
- Green Mountain Community Network
- DVHA: Medicaid provider revalidation strategy
- Vermont Medicaid two-year provider revalidation strategy (June 2026)
- 23 V.S.A. § 800: Maintenance of financial responsibility
- 23 V.S.A. § 4: Definitions (jitney, subdivision 15)
- 23 V.S.A. § 843: Amount of insurance or bond for jitneys
- DVHA: Electronic Visit Verification
- CMS: Medicaid and CHIP monthly enrollment data
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