Broker programs
Many states contract a broker, chosen through competitive bidding, to arrange rides, often under a capitated payment. Transportation providers then follow the broker's trip, documentation, and payment rules.
Every ride bills through a broker, plan, or state
Medicaid must make sure beneficiaries with no other way to reach covered care have transportation. States deliver that through brokers, managed care plans, or fee-for-service, so who pays for a trip depends on the state and the rider's plan.
Book a demoWhere an NEMT trip gets paid
CMS's 2023 Medicaid transportation coverage guide and MACPAC describe how states run the benefit.
Fee-for-service and managed care
Some states approve and pay each trip themselves, some mix models, and some fold transportation into managed care contracts. Prior approval, trip limits, and copays vary by state.
Provider and driver screening
States enroll and screen transportation providers, may enroll individual drivers, and must attest that providers and drivers meet minimum requirements on exclusions, licensure, and drug law violations.
Keep dispatch, hand off the receivables
Scheduling and driving decide whether a trip happened. Billing turns the trip record into payment.
What the provider keeps
Dispatch, drivers, vehicles, trip logs, signatures, and broker or state enrollment stay with your company.
What Taiga takes on
If the work fits, Taiga checks eligibility, scrubs and submits claims, works every denial and appeal, and follows up on small balances that are easy to let go.
Where a decision is needed
Broker portal submissions, trip reconciliation, and rules for no-shows and cancelled trips need an owner, since they differ by contract.
Questions for an NEMT fit call
Bring de-identified examples of a paid trip, a rejected trip, and your broker's billing instructions. Keep rider details out of the booking form.
Who do you bill?
List each broker, managed care plan, and state program, with rough monthly trip counts.
What trip types do you run?
Separate ambulatory, wheelchair, and stretcher trips, and any mileage reimbursement work.
How are trips verified?
Describe how trip logs, pickup times, and signatures reach whoever submits claims.
For transportation providers buried in trip-level denials
Worth a conversation if your company runs Medicaid trips and the back office can't keep up with rejected or unpaid rides.
NEMT is its own billing world
Taiga has not published support for NEMT claims. Emergency ambulance billing is a separate topic, and this page is not guidance on your state's program rules.
Questions about NEMT billing
Is NEMT a required Medicaid benefit?
States must ensure necessary transportation for beneficiaries who have no other way to reach covered care. CMS describes this as an access assurance, not a promise that the state pays for every ride.
Do NEMT drivers have to be enrolled in Medicaid?
It depends on the state. States can enroll at the organization or driver level, and if drivers are an enrollable provider type, each driver must be enrolled.
Can rideshare companies provide Medicaid trips?
Yes, states can use transportation network companies. The ride still has to be the least costly appropriate option that meets the rider's medical needs.
Is emergency ambulance billing the same as NEMT?
No. Emergency transport follows different coverage and claim rules, covered on the ambulance services page.
Bring your broker and trip mix
Show Taiga who you bill, how many trips you run, and where payment stalls. You'll get a plain answer on fit.
System guides show possible billing handoffs, not proven specialty compatibility.