Non-Emergency Medical Transport (NEMT)
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.
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.
BizBite verdict
Watch / verify
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.
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
SBA 7(a) data
Real acquisitions in this category
Change-of-ownership loans · NAICS 485991 · Special Needs Transportation
Deal size distribution
Deal flow over time
Financing profile
Recent comparable deals
| Closed | State | Loan | Implied deal |
|---|---|---|---|
| Sep 2025 | SC | $1.3M | $1.5M |
| Sep 2025 | SC | $100K | $118K |
| Sep 2025 | MO | $510K | $600K |
| Jul 2025 | MA | $1.1M | $1.3M |
| Mar 2025 | KS | $918K | $1.1M |
| Mar 2025 | OH | $458K | $539K |
| Feb 2025 | IL | $1.9M | $2.2M |
| Dec 2024 | IL | $459K | $540K |
| Jun 2024 | IL | $2.9M | $3.4M |
| Apr 2024 | FL | $1.2M | $1.4M |
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.
Deal Calculator
Priced off $80K SDE — can this deal service its own debt?
SDE = revenue × margin estimate for this niche; it includes owner compensation, so budget your salary out of cash flow. Excludes working-capital injection, capex reserves, and taxes. Actual SBA terms vary by lender and borrower.
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.
Where to Buy
Find NEMT and medical transport businesses for sale
Browse transportation business acquisition opportunities
Buyer's Toolkit
Essential tools to get started
Some links may be affiliate links. We only recommend tools we'd use ourselves.
Ready to Buy? Start Here →
Largest business-for-sale marketplace in the US
SBA loans and business acquisition financing — get funded fast
ROBS financing — use retirement funds to buy a business tax-free
Bookkeeping for small business owners — hands-off financials
Some links may be affiliate links. We only recommend tools we'd use ourselves.
Get the full breakdown in your inbox
Weekly boring business breakdowns
One boring business. Real numbers. Every week. Free.