What Certifications are Needed to Start an NEMT Business?

Complete-your-company-with-NEMT-routing-software

03/05/2021

Last updated: 01/09/2026

5 mins read

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The NEMT industry is constantly growing, so there’s never been a better time to think about starting your own NEMT company. Medical transportation businesses are responsible for providing transportation to elderly and low-income citizens who can’t drive themselves to medical appointments. The job is an important one, and as American citizens continue to age, the need for reliable transportation increases. So, if you’re thinking about becoming part of the NEMT industry, you’ve come to the right place. Here, we’ve outlined what you need to do to qualify as a business, what legal documents and certifications you need, and more.

What Certifications do NEMT Owners Need?

Since NEMT providers aren’t medical professionals, they don’t actually need mandated certifications like those of their emergency transportation counterparts. However, this doesn’t mean certifications aren’t helpful in bettering your business and building a more experienced staff.

Recommended training programs include:

Defensive driving courses
Emergency response and first aid training
Passenger assistance techniques for disabled or mobility-challenged riders
CPR and basic life support certification
Sensitivity training for working with elderly and special needs passengers

You never know when your employees and passengers could end up in an emergency situation, so having the knowledge and background of how to respond is crucial. Research different class options in your area, and require all current and incoming drivers to complete them. Not only will this benefit your employees—it will also set your business ahead of competitors.

What Licenses do NEMT Owners Need?

Like any other business owner, NEMT providers need a business license. This license varies depending on what state you’re operating in, so it’s good to check with your state requirements on what you need to obtain this license. In some states, you may also need additional permits or certifications to contract with Medicaid or Medicare Advantage plans. Besides this, no formal licensing is required to operate an NEMT company, aside from the obvious driver’s license for you and your employees, and routine NEMT vehicle inspections as a part of your NEMT vehicle maintenance schedule. While laws vary by state, here are some specific requirements that most providers will need before signing on an NEMT driver employee:

Clean driving record with minimal points
Valid driver's license (appropriate class for vehicle type)
Negative drug test results
Background check clearance
Current vehicle registration and inspection
Proof of adequate transport insurance
Medical clearance or physical exam

It’s important to be transparent to applicants that they’ll need to complete these things before working, so you don’t run into problems during the hiring process.

Why NEMTAC Accreditation Matters for the Long Haul

While not legally required, NEMTAC (Non-Emergency Medical Transportation Accreditation Commission) accreditation represents the gold standard in the NEMT industry and demonstrates your commitment to operational excellence and safety standards.

Once your medical transportation business gains momentum, it is advisable to pursue NEMTAC accreditation. Accredited providers often gain preferred status with hospitals and health plans when negotiating contracts—particularly for higher-margin services like stretcher transports. Many facilities prioritize working with accredited providers because it reduces their risk and demonstrates a measurable commitment to quality care. However, achieving accreditation requires robust operational systems including centralized compliance tracking, standardized dispatch procedures, and comprehensive documentation capabilities

How to Choose the Right Insurance for Your Company

While certification is not a mandatory requirement, insurance is and it should be one of your top priorities when starting an NEMT business. You’ll need insurance for both the company and the individual driver, so everyone and everything is covered. At a minimum, you'll need commercial auto insurance and general liability coverage. Depending on your service mix, you may also need wheelchair lift coverage, stretcher transport coverage, and workers' compensation insurance.

While searching for the right insurance provider for your operation, it’s important to compare options. Don’t settle on the first one you find. Insurance won’t be cheap finance for your business, but it’s crucial to have all-encompassing coverage to keep all employees and passengers safe. When evaluating providers, ask about coverage limits, claims response times, experience with NEMT operations, fleet discounts, and options for scaling coverage as you grow.

Figure out what you want to spend, what added coverage you might be interested in, and make sure you ask companies questions. If you end up with insurance you aren’t happy with, you could run the risk of having to pause your work until you find a new one. By doing your research and asking the right questions, you’ll be able to avoid this situation.

Complete Your Company With NEMT Routing Software

As you can tell, there are plenty of initial documents you’ll need to gather in order to operate your business. Once you have your legal papers in line, you can start looking at other assets that will improve your business, including NEMT software. Software helps you manage, schedule, and follow your trips to completion, all through an automated process. If you’re interested in seeing how NEMT dispatch and billing software could improve your business, get in touch with our RouteGenie team today!