Reviewing nemt companies: strengths, gaps and a verdict

What to take away

Who actually moves the trips

Brokered NEMT in the United States runs through a handful of companies. Knowing which one holds your state contract tells you who signs your check.

MTM, based in Lake Saint Louis, Missouri, administers state Medicaid transportation programs and facility discharge work. Southeastrans, in Atlanta, brokers Medicaid trips across several Southern states. Medical Answering Services runs New York's Medicaid transportation program.

Modivcare, formed when Providence Service Corporation merged with LogistiCare, is the largest broker by trip volume. Its brands include LogistiCare and Veyo. Access2Care, part of Modivcare but credentialed separately, brokers health-plan and regional work. SafeRide Health does the same for Medicare Advantage and managed care.

A second group contracts with hospitals and payers rather than state Medicaid. Ride Health, in New York, links health plans to local providers. Roundtrip, in Philadelphia, books rides for hospitals and payers. Kaizen Health, in Chicago, coordinates transport for health systems. American Logistics Company, in Utah, handles health-plan and school transportation.

Those names cover most of the trips a small operator will bid on.

MTM: strong on compliance, slow on will-calls

MTM's strength is process. Credentialing is documented, driver files are audited, and the trip assignment system is predictable once you learn it. If you run wheelchair-accessible vehicles and keep paperwork clean, MTM work is steady.

The gap is flexibility. Will-call returns and same-day additions route through a call center. A driver at a dialysis clinic at 11:40 waiting on an authorization is a driver not earning.

MTM suits operators with scheduled standing orders and a dispatcher who can work the portal.

Modivcare: volume, and the rate conversation

Modivcare, based in Denver, Colorado, is the broker most small operators meet first. It holds contracts in more states than anyone else, so trip volume is real and the payment cycle is predictable. The gap is rate.

Modivcare sets per-trip rates by state contract. As of 2026, brokered ambulatory one-way trips typically pay $25 to $45 in most markets, and wheelchair trips run $55 to $90. Dense metros sit at the top of those ranges.

A rural operator with twenty-minute deadhead legs will find the math tight, because the rate is built for high trip density. Run your own cost per trip before signing, not after. A one-way sedan trip of about a mile and a half typically costs $25 to $40 to deliver, driven by driver wages, insurance and deadhead miles.

Access2Care and SafeRide: the entry point

Access2Care and SafeRide Health broker health-plan and Medicare Advantage work. Contract sizes are smaller, credentialing is lighter, and a fleet with three to ten vehicles can usually get approved. SafeRide Health concentrates on Medicare Advantage and managed care plans.

The gap is trip predictability. Health-plan trips cluster around appointments and cancel late. Build no-show and cancellation terms into the agreement, and read the section on contract terms that hide cost before you sign anything. The NEMT pricing and profit guide walks through the arithmetic.

Facility contracts: where the margin sits

Hospitals, dialysis centers and skilled nursing facilities contract directly with operators for discharge and recurring trips. Dialysis chains such as Fresenius Medical Care and DaVita buy recurring runs; hospital systems buy discharges. These contracts pay better than broker work, because the facility is buying reliability, not the lowest bid.

The gap is relationship risk. One discharge coordinator leaves and the contract goes to bid. Treat facility accounts as sales work, not operations work, and keep two contacts at every site. The NEMT sales and proposal guide covers how to structure the pitch.

The verdict

A fleet under ten vehicles should start with Access2Care or SafeRide Health to build trip history, add one facility contract for margin, and treat MTM and Modivcare as volume fill. That sequence is the same one covered in the NEMT expansion and market guide.

What to check before you sign

Building the fleet behind the contract

A broker contract is only as good as the drivers who run it. Turnover shows up as late loads and missed will-calls, which is what gets a contract pulled. The NEMT hiring and training guide covers the checklist.

Wage data for your market from the Bureau of Labor Statistics wage tables tells you what a driver costs before you bid. Driver pay in most metros sits in the mid teens per hour, and large cities run higher. The Small Business Administration's business guide covers the general planning side.

Common questions

Why name these companies and not others?

MTM, Modivcare, Access2Care and SafeRide Health hold the largest share of state and health-plan NEMT contracts. Southeastrans and Medical Answering Services hold state contracts in the South and New York. Smaller regional brokers exist, and your state Medicaid agency publishes the current list.

Which one pays best?

Facility contracts pay best per trip. Among brokers, rates vary by state contract, so the only useful comparison is against your own cost per trip.

Can I work for more than one broker?

Yes, and most small fleets do. Two brokers smooth out volume gaps, provided you can meet both credentialing standards without duplicating driver files.

What if my state has no broker?

Some states run transportation through regional entities or direct provider enrollment. The state Medicaid agency is the authority on which model applies where you operate.