Starting a NEMT Company – Profitable Business Plan

Medical and healthcare services remain always in demand and any business related to medical healthcare is always lucrative and full of opportunities. If you start with an effective business plan then there are chances of success and profit. 

Though, medical healthcare is a noble profession but profit is also one such aspect that cannot be ignored. Medical transportation is one such avenue in healthcare services that has its own market.

There are two types of medical transportation. The first is emergency medical transportation which we generally call as emergency ambulance service while the other is non-emergency medical transportation or NEMT services.

In contrast to emergency transportation, NEMT services have easier norms and regulation and is also a sector that has huge potential and scope for growth. Some stats will reveal the same.

NEMT Business Opportunity

  • The Global NEMT market size was estimated at USD 7 billion in 2020 and expected to reach USD 7.5 billion in 2021.
  • A worrying trend that has been recorded in the United States where close to 3.6 million either delayed or dismissed their important medical care treatment due to lack of NEMT services.
  • The scope of NEMT services can be realised from the fact that the elder population in the USA which is presently at 50 million will reach 70 million by 2030 which implies more NEMT service requirements.
  • The US medical system suffers a loss of $150 billion due to lack of NEMT services or medical transport.
  • A report from 32 states of the United States reported a total of 59 million trips of non-emergency medical transportation services from 2015-2018. 

The above stats are a testimony to the fact that there’s a lot of scope in the NEMT business and also that there’s huge demand in this sector which can be fulfilled through a right and comprehensive business plan.

Non-Emergency Medical Transportation Business in Brief

NEMT services are for those people who require transportation from his premise to the hospital, clinic, pathology centre or any other place based on requirement.

Unlike an emergency ambulance service, a NEMT service is essentially of non-emergency nature meaning that the patient isn’t in an emergency situation but generally has a prior booking with the medical institution for general diagnosis, OPD, consultation, therapy, etc.

Since the patient is not in a medical emergency so he does not require an ambulance but certainly requires a special transportation vehicle that is comfortable and has general medical facilities until he reaches the destination.

US medical laws and policies dealing with such cases has laid down several guidelines and rules for this purpose. It defines what NEMT, what a NEM transport should be like and the facilities that it must have in order to qualify as non-emergency medical transport.

Some Facilities that NEMT Offers

The core services that non-emergency medical transportation offers are:

  • Comfortable travel in the vehicle for a disabled person who requires certain facilities in this regard.
  • Wheelchair for those who cannot walk on their own.
  • Oxygen cylinder for those who have breathing issues and are on oxygen.
  • It must have a ramp using which the patient can be seating inside the vehicle on his wheelchair.
  • Dialysis machine facilities.
  • Toilet facility inside the vehicle.
  • Shock control and jerk control system to avoid any uncomfortable experience when the vehicle is moving.
  • Stretchers for those who require to lay down or cannot sit.
  • Air conditioner for temperature control and much more.

How to Start a NEMT Business

What exactly is required to start your business in NEMT? 

There are various answers to it which you can find here and there but a business is a serious work which requires serious research, analysis, feasibility analysis, planning and strategy. 

It would be advisable for you to first write a thorough business plan about the details of your business and how you will proceed to make it a reality step by step. This will help you in sorting out your priorities, the correct steps, its impact and the final conclusion.

To give you an insight about the basic requirements. You need:

  • ADA Compliant NEMT Vehicle either one or more in number
  • Drivers with proper training, license to drive NEMT vehicle
  • Medical staff 
  • Office attendants receiving customer service call
  • Supporting staff and helpers
  • Space to park your vehicle
  • Office space and office staff

You necessarily don’t need to own all the vehicles for your business. You can also rent it for your usage making it compliant with the NEMT norms. As and when you are able to make good returns, you can easily go about purchasing your vehicle. It can be either first hand or used.

Medical staff generally include certified nurses or their likes who know the basics of medicine. Those who can give basic aid, know how to use medical oxygen, attend a patient requiring dialysis, etc. 

Your driver needs to have an impeccable record in driving with an approved NEMT driving license as per law of your state.

Office staff should be trained enough to politely and smartly deal with your customers. They should be prompt in receiving calls and setting things in motion. Your staff need to be smart and quick to ensure that your customer is fully satisfied.

Office space is something from where you will do the office work, accountancy, manage regular business affairs, from where your staff will deal with your customers, etc. 

It doesn’t need to be huge or at a prime location since you will be only dealing with customers mostly through phone, website or email. You can make your home office as well and can allow your staff to work from home as per the COVID norms.

Vehicle parking space is something that you can get allotted by paying the requisite amount for parking.

Economy of the whole NEMT Service Business

A feasibility analysis report based on which you will write your business plan will give you the actual details of the expenditure which is likely to be incurred by you while starting your business.

The cost of office, furnishing, vehicles, gasoline, general maintenance, employee salary, taxes, fees, etc. 

In general, you may end up spending close to $350000 as overall expenditure. A smart and strategic business plan with proper execution will reduce the expense. 

Regarding profitability, the general charge as per market trend is close to $30-50 for an hour of service. Generally, your customer will require you to pick him up from his home and then take him to hospital, wait till he’s done with his medical treatment and then pick him up from there and drop him back home. 

You can easily attend 3-5 customers a day at the beginning and for 5 days a week in general making your every week income to 240*5 = $1200 a week and $4800-5000 a month which is pretty decent.

Legal Requirements, Licensing and Registration

NEMT services being a medical service is governed by law and is regulated to ensure safety and comfort of patients traveling in it. There are some basic guidelines and rules that are incorporated by the US government including the various state governments. Some of them are:

Rules for Drivers: A driver driving a NEMT vehicle must be properly trained in driving, especially smooth driving to ensure that the patient inside is comfortable during the journey. 

He should be more than just a driver with proper license, least number of negative points against his license, no record of drunk driving, negative drug test, and having basic knowledge about medical first aid.

Rules for NEMT Vehicle: US Government’s law known as Americans with Disabilities Act lays down certain norms to be followed for those having a business of more than 15 employees dealing in NEMT business.

Some of them are:

  • Proper condition of vehicle with proper vehicle documents, pollution control check, safety protocol in case of accident, GPS control, airbags, etc. 
  • Interior of the vehicle must be properly furnished with seat belts, proper lights, ventilation or air conditioning.
  • Wheelchair support that can easily handle 2500 pressure per leg
  • Proper ramp to lift the patient to the vehicle on wheelchair or stretcher
  • Lift door height of 56 inches door opening height
  • Handicap lift should be 30*40 inches with wide clear platform
  • Proper shock handling mechanism with evacuation facilities and much more.

Medical Staff Rules: Medical Staff should be trained and certified in handling patients in non-emergency conditions. They should be knowledgeable enough to give medical care like CPR, vital medical care, emergency aid, first aid, defibrillator operation, vital assessment, immediate panic response, etc.

Registration of Business and Permits: Permits and license to operate a NEMT service is dealt by local laws of different states and for this you need to contact a legal expert operating in this field.

Other formalities like registration of business, taxation registration, enrolment of employees, tax account, general expenditure account, etc. needs to be maintained. 

Business Growth and Marketing

The final chapter of this article is the growth and marketing strategy. It is advisable for you to work in this industry for a while to know about all the details of this business. It makes you more informed and experienced, making your work easier.

Secondly, service sector businesses like this grow based on customer service and their satisfaction. People generally recommend your service to their known ones. Obviously, in the starting you need to advertise in order to get new clients but the growth of business always remains entrenched based on the customer satisfaction.

A medical service business requires lots of dedication, hard work and punctuality. The onus not only lies with you but all the people working for you. Facilities and services rendered by your business should be satiating for your customer.

Behavior of employees, their response, hard work and professional conduct is what will make your business grow. Be careful and vigilant in dealing with all these issues. The success of your business will depend on small and consistent endeavors of you and your staff.


1. What is a Non-Emergency Medical Transportation (NEMT) company?

A NEMT company is a business that provides safe, reliable and comfortable transportation of patients to and from medical appointments.

2. What are the requirements for operating a NEMT company?

Depending on the jurisdiction, the requirements can vary. Most areas require a valid business license, proof of insurance and a valid driver’s license.

3. How much does it cost to start a NEMT company?

The start-up costs depend on the type of business you plan to operate – whether it be a taxi, shuttle or a transport service. Generally, the cost to start a business range anywhere from $5,000 to $50,000.

4. How do I market my NEMT company?

There are a variety of marketing techniques that you can use to promote your NEMT company. Focus on creating a strong online presence using social media and digital advertising. Additionally, don’t forget about traditional methods such as print advertising and word of mouth.

5. What type of vehicles should I use for my NEMT company?

It depends on the type of business you plan to operate. You may need to purchase or lease medical transport or ambulance vehicles for medical transport services, or smaller shuttle and taxi vehicles for transportation services.

6. Do I need special training to operate a NEMT company?

Many jurisdictions require special training and certification to operate a NEMT business. Be sure to research the requirements in your area to make sure you meet all of the necessary regulations.

7. How do I find business partners or investors for my NEMT company?

Reaching out to industry experts and other NEMT operators is a great place to start. Develop a strong business plan and connect with local professionals to discuss potential partnerships and investments in your business

8. What are the legal considerations for starting a NEMT company?

You will need to make sure that you follow all of the local laws and regulations for your particular jurisdiction. This includes obtaining the necessary licenses and permits, providing the appropriate insurance, and understanding any zoning restrictions

9. What type of insurance should I purchase for my NEMT company?

It is important to understand the type of insurance coverage you will need for your business. Consider commercial auto insurance, as well as workers’ compensation insurance for your employees.

10. How do I stay compliant with NEMT regulations?

Research and familiarize yourself with the applicable laws and regulations. Each state or local jurisdiction will have its own set of regulations related to NEMT businesses. Further, regularly track and audit your business to ensure compliance.

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