How much does a Non-Emergency Medical Transport (NEMT) cost to buy?

A typical Non-Emergency Medical Transport (NEMT) sells for 1.5x to 2.5x seller's discretionary earnings. With estimated SDE of $80K, expect to pay roughly $120K to $200K before adjustments for assets, debt, growth, and local market quality.

How much does it cost to start a Non-Emergency Medical Transport (NEMT)?

Startup costs range from $30K to $120K depending on location, equipment, and scale.

Route

Non-Emergency Medical Transport (NEMT)

Q: What are the profit margins for a Non-Emergency Medical Transport (NEMT)?

The average profit margin for a Non-Emergency Medical Transport (NEMT) is around 20%. Driver wages and fuel are 60–70% of revenue. Other costs: vehicle insurance (high for medical transport), maintenance, dispatch software, and state licensing fees.

55 million Americans need rides to dialysis, chemo, and doctor's appointments — and Medicaid pays

Bottom line

Worth studying, but do not buy without strong local proof.

Non-emergency medical transportation (NEMT) companies provide scheduled rides to medical appointments for elderly, disabled, and Medicaid-eligible patients. The federal government mandates Medicaid covers transportation to medical care — meaning the state pays per trip, creating a reliable government-backed revenue stream. A 5-vehicle operation can generate $500K–$800K annually. The aging U.S. population (10,000 Boomers turning 65 every day) is a permanent demand tailwind.

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Acquisition score

Strong

Avg Revenue

$400K

Profit Margin

20%

Acquisition Multiple

1.5x - 2.5x

Startup Cost

$30K - $120K

How It Works

NEMT companies contract with state Medicaid brokers (or directly with Medicaid) to provide rides. Drivers transport patients to dialysis centers, cancer treatments, and specialist appointments. Revenue is $30–$56 per vehicle per day on the low end, scaling to $2,500–$4,700/month per vehicle. Adding vehicles is the primary growth lever.

Revenue Range

Low End

$150K

Typical

$400K

High End

$800K

BizBite underwriting snapshot

Pass for now

Non-Emergency Medical Transport (NEMT) has enough high-level data for a first look, but BizBite has not assigned a category-specific operating model yet. Treat the score as preliminary.

Avoid / 100

Data confidence

medium

52/100

Financing fit

medium

Category-level fit before lender-specific diligence.

Confidence cap

Weak source data caps the final score.

Why it may work

+SBA dataset shows 9 recent comparable loans

Be careful

!Source link status has not been verified yet
!No last-checked date yet
!No category operating model yet
!No category model yet

Real Acquisitions in This Category

SBA 7(a) change-of-ownership loans · NAICS 485991 · Special Needs Transportation

Deals tracked

9 in last 24 mo

Median loan

$719K

$459K–$1.0M p25/p75

Implied deal size

$846K

median · ~85% LTV

Charge-off rate

—

not enough resolved loans

Deal Size Distribution

<$150K

$150K–500K

$500K–1M

$1M–2M

>$2M

Deal Flow Over Time

12-month momentum

-20.0%

deal volume vs prior 12 mo

Median loan Δ

-12.9%

4 recent · 5 prior

Financing Profile

Median rate

10.25%

11% fixed · last 24 mo

Median term

120 mo

standard 10-yr

Collateralized

of loans secured

Median jobs

supported per deal

Top lenders in this space

The Huntington National Bank2

First Pryority Bank1

The Peshtigo National Bank1

Merchants Bank of Indiana1

Truliant FCU1

Where deals happen

FL4

IL3

CA3

SC2

OK1

WI1

MA1

MO1

OH1

KS1

Recent Comparable Deals

Closed	State	Loan	Implied deal	Jobs	Franchise
Sep 2025	SC	$1.3M	$1.5M	21	—
Sep 2025	SC	$100K	$118K	21	—
Sep 2025	MO	$510K	$600K	11	—
Jul 2025	MA	$1.1M	$1.3M	2	—
Mar 2025	KS	$918K	$1.1M	—	—
Mar 2025	OH	$458K	$539K	13	—
Feb 2025	IL	$1.9M	$2.2M	16	—
Dec 2024	IL	$459K	$540K	12	—
Jun 2024	IL	$2.9M	$3.4M	54	—
Apr 2024	FL	$1.2M	$1.4M	11	—

Volume rank #237/544Deal-size rank #258/544Momentum rank #235p90 loan: $1.3MData as of Mar 2026

Source: SBA 7(a) FOIA dataset, filtered to acquisitions (loans where business age is "Change of Ownership"). Implied deal size assumes an 85% loan-to-purchase ratio, a common SBA change-of-ownership structure. Charge-off rate shown only when 10+ loans have resolved (paid in full or charged off). Interest rates reflect last 24 months only. Actual deal values vary with equity injections, seller financing, and working capital terms.

Pros

+Government (Medicaid) is the primary payer — low collection risk
+Aging population creates permanent, growing demand
+Low startup cost — used wheelchair vans start at $15K–$40K
+Essential service with minimal competition in underserved areas

Cons

-Medicaid reimbursement rates are low and vary by state
-Driver turnover is high — difficult to retain reliable staff
-Significant compliance and state licensing requirements

Best For

Community-oriented operators with patience for government contracting and compliance

Operating Costs

Driver wages and fuel are 60–70% of revenue. Other costs: vehicle insurance (high for medical transport), maintenance, dispatch software, and state licensing fees.

SBA Financing Estimator

Adjust the deal — see if it cash flows after debt service

$-2982/mo

after debt service

Deal price — $850K

Range: $400K (1.5×) to $1.4M (2.5×+)

Down payment — 15% ($128K)

SBA minimum equity injection is 10% for change-of-ownership

Interest rate — 10.25%

SBA median for this category: 10.3%

Loan term — 10 years (120 mo)

SBA median for this category: 120 months

Down payment

$128K

15% equity injection

Loan amount

$723K

85% SBA-financed

Monthly payment

$10K/mo

$435K total interest

Monthly profit

$7K/mo

at 20% margin

Monthly cash flow after debt service

$-2982/mo

Margin does not cover debt service at these terms. Lower the deal price, increase the down payment, or extend the loan term.

Estimates only. Excludes owner compensation, capex, working capital draws, and taxes. Margin assumes average occupancy and volume. Actual SBA terms vary by lender and borrower profile.