Non-Emergency Medical Transport (NEMT)
55 million Americans need rides to dialysis, chemo, and doctor's appointments — and Medicaid pays
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.
Avg Revenue
$400K
Profit Margin
20%
Acquisition Multiple
1.5x - 2.5x
Startup Cost
$30K - $120K
Difficulty
3/5
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
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
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Quick Facts
- Category
- route
- Difficulty
- 3/5
- Acquisition Price
- $600K - $1.0M
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Non-Emergency Medical Transport (NEMT)
$400K/yr • 20% margins • 1.5x–2.5x multiple
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