How to Start a Non-Emergency Medical Transportation Business in Florida

If you want to start a non-emergency medical transportation (NEMT) business in Florida, the first thing to know is that the state does not issue a standalone NEMT license. Most people searching for an NEMT license in Florida are really asking two other questions: what do I need to operate legally, and what do Medicaid transportation brokers require before they will send me trips? This guide covers the steps in the order most new operators handle them, with the state fees you need to budget for and the points you need to confirm with the right agency.

This is informational content, not legal or tax advice. Talk to a Florida business attorney and a CPA before you form an entity, sign a broker contract, or decide how to handle taxes, especially if you plan to bill Medicaid trips.

What Florida requires and what it does not

Florida has no state general business license. It also has no standalone NEMT license that every transport operator must hold. Your requirements come from several layers instead:

• Business formation with the Florida Department of State, Division of Corporations (Sunbiz), if you form an LLC or corporation.
• A local business tax receipt under Chapter 205 of the Florida Statutes, where your city or county levies one. This receipt is a tax, not a test of your ability to transport patients. Not every county or city levies it, so check the jurisdiction where you will operate.
• Tax registrations with the Florida Department of Revenue, if your business sells taxable goods or services.
• Medicaid requirements that flow through the Agency for Health Care Administration (AHCA), the Statewide Medicaid Managed Care (SMMC) plans, and the transportation brokers that contract with them.
• County vehicle-for-hire ordinances, which may apply to wheelchair and stretcher vans.

Medicaid NEMT is a covered service of SMMC managed care plans. Trips are coordinated and authorized through transportation brokers that contract with the plans and AHCA. That structure means your largest source of Medicaid trips will likely come through a broker, not directly from the state.

Materials and information to gather first

• A proposed business name that meets Sunbiz naming rules
• A Florida street address for your registered agent (a P.O. Box will not work)
• A federal Employer Identification Number (EIN) from the IRS
• A list of vehicle types you plan to run: sedan, ambulatory van, wheelchair van, and stretcher van
• Titles, registrations, and inspection records for each vehicle
• Insurance quotes, plus the written minimum coverage each broker you target requires
• Driver application forms and a plan for Level 1 background screening under s. 435.03 or an equivalent screening
• A startup budget that covers state fees, the annual report, insurance, vehicles, and payroll
• The name and phone number of the business tax office in your city and county

Step 1: Decide which NEMT market you will serve

Your first decision controls almost everything after it. Medicaid trips and private-pay trips have different paperwork, different payment timelines, and different gatekeepers.

For Medicaid work, you will need to get onto broker networks. Brokers typically require proof of licensure, insurance, vehicle inspections, and driver screening, and they may ask for more than the baseline. For private-pay work, such as hospital discharges, senior living transfers, or dialysis runs paid by the patient or a facility, you set your own rules but still need the same vehicles and drivers to meet state and local requirements.

Pick one vehicle type and one service area to start. A wheelchair van serving one county is easier to launch and staff than a fleet of mixed vehicles across several counties, because each county may apply its own ordinance.

Step 2: Choose your legal entity and name

Most small operators form a Florida limited liability company (LLC). The filing fee for Articles of Organization is $125. The name must end with "Limited Liability Company," "LLC," or "L.L.C." It must also be distinguishable on Department of State records. You can search existing names at the Sunbiz corporation search.

If you need time to secure a name, you can file a name reservation for $25, which holds the name for 120 days. Do not treat a name as approved until you receive a filing acknowledgment. You can file online through Sunbiz eFile.

A corporation requires Articles of Incorporation for a Florida Profit Corporation, with a $70 filing fee. Corporations face a 5.5% Florida corporate income tax on net income, and their annual report fee is higher (see Step 3). Most owner-operators choose the LLC because it is simpler to maintain, but the choice depends on how you plan to take profits and bring in partners, so ask your CPA.

The Division of Corporations does not offer expedited filing service. You can walk in to 2415 N. Monroe Street, Suite 810, Tallahassee, Monday to Friday, 8am to 5pm, where most requests are completed while you wait. There is no guaranteed turnaround for mailed or online filings, so do not schedule your first trip or your insurance binder around a filing date you have not received.

If you plan to operate under a name other than your legal entity name, you will also need a fictitious name registration. It costs $50 to register and $50 to renew. The registration is valid for five years and is filed with the state, not the county. You must also advertise the name at least once in a newspaper in the county of your principal place of business, though no proof of advertisement is filed. Details are at the Florida fictitious name registration page.

Step 3: Appoint a registered agent and calendar your annual report

Every Florida LLC and corporation must designate a registered agent with a physical Florida street address. The agent must sign to accept the appointment. An entity cannot serve as its own registered agent, but an owner or officer who is an individual can. The designation carries a required fee of $25 for an LLC and $35 for a corporation, already included in the $125 and $70 formation totals, and changing the agent later costs the same amount.

Commercial registered agent services charge an annual fee on top of the state designation fee. Compare what they include, such as mail scanning and address privacy, before you pay. Be honest with yourself about whether you will reliably receive legal mail at a home address during business hours.

The annual report is due each year between January 1 and May 1. For an LLC, the fee is $138.75. A $400 late fee applies to reports received after May 1, bringing the total to $538.75. If the report is not filed by the third Friday in September, the LLC faces administrative dissolution. Put the January 1 opening and May 1 deadline on your calendar the day you form the company.

Step 4: Register for taxes

Get your federal EIN from the IRS before you open a bank account or hire a driver. Then confirm how your entity is classified for federal tax purposes, because that determines which Florida returns you file.

Florida has no personal income tax. An LLC classified as a partnership or disregarded entity generally does not file a Florida corporate income tax return. A Florida Partnership Information Return is required if one or more owners is a corporation, and that corporate owner must file its own Florida return. An LLC classified as a corporation for federal tax purposes pays the 5.5% Florida corporate income tax.

Sales tax is a separate question. The state rate is 6%, and businesses selling taxable goods or services must register as a sales and use tax dealer before beginning business. Whether your NEMT fares are taxable is a question you must confirm with the Florida Department of Revenue, because the answer depends on the service and how it is billed. Do not assume your trips are exempt or taxable without that confirmation. You can start the registration at the Department of Revenue registration page.

Step 5: Confirm your local business tax receipt

Florida issues no general statewide business license, but many cities and counties require a local business tax receipt for the address where you operate. Under Chapter 205, this receipt is a tax on doing business locally. It does not certify that your drivers or vehicles are qualified, so do not treat it as your NEMT license.

Call the tax collector or business tax office in each county and city where you will dispatch or pick up patients. Ask whether the receipt applies to your business type and whether an office or garage address in that jurisdiction triggers it. If your dispatch office is in one county and your vans sleep in another, ask both.

Step 6: Meet the vehicle and county requirements

AHCA policy requires vehicles that meet all licensure and regulatory requirements. Brokers may impose stricter standards. Before you buy or lease a van, get the written requirements from the brokers you plan to join, including inspection frequency, required equipment, and maximum vehicle age, if they set one.

Wheelchair vans and stretcher vans are where county rules most often surprise new operators. A county vehicle-for-hire ordinance may apply to these vehicles, and that can mean a permit, a vehicle inspection, a driver card, or a separate application. Confirm with each county's licensing or transportation office before you put a wheelchair van on the road. Do not assume that a state filing or a broker approval covers local vehicle-for-hire rules.

Step 7: Buy the insurance brokers will accept

Insurance is where Medicaid broker contracts are won or lost. Brokers may require coverage beyond what the state sets as a baseline, and the minimums can differ from one broker to the next. Ask each broker for its written insurance requirements, then have your insurance agent quote to the highest standard you plan to meet. Confirm the certificate of insurance format and the additional-insured wording each broker expects before you submit an application.

Do not rely on a general commercial policy to cover passenger transport if your agent has not written it for that use. Ask specifically whether the policy covers wheelchair lifts, stretchers, and passengers who need assistance boarding.

Step 8: Screen every driver before the first trip

AHCA policy requires drivers to pass at least a Level 1 background screening under s. 435.03 or an equivalent screening. Brokers may require more, such as additional checks or stricter disqualification criteria. Confirm the screening process, the cost, and the disqualifying offenses with AHCA or the screening provider your brokers accept before you extend an offer to a driver.

Do not let a driver transport a patient until the screening clears and you have the result on file. Keep a driver file with the screening confirmation, license, training records, and any county driver card. Missing paperwork on a single trip can cost you a broker relationship.

Step 9: Get onto broker networks

Because Medicaid NEMT trips are coordinated and authorized through transportation brokers that contract with SMMC plans and AHCA, you need to be credentialed in the broker networks that serve your area. Ask AHCA which brokers operate in your region, then ask each broker which managed care plans it works with and what its provider application requires.

Expect to submit licensing documents, insurance certificates, vehicle inventories, driver rosters, and references. Read the contract for payment terms, trip documentation rules, cancellation and no-show policies, and how the broker audits your records. Compare contracts before you sign, and get a CPA or attorney to review anything with indemnity or termination clauses.

Step 10: Set up records and daily operations

Build your recordkeeping system before you run your first trip. At minimum, keep trip logs with pickup and drop-off times, passenger assistance levels, mileage, and the authorization number for every Medicaid trip. Keep vehicle maintenance logs and inspection certificates for each van. Keep driver files current. Store patient information securely and limit access to staff who need it.

Ask each broker which documents it audits and how long it expects you to retain them. The answer often determines what your software must capture. A simple spreadsheet works for one van, but most operators outgrow it quickly, so plan for dispatch and billing software before your second vehicle.

Expected results

A properly formed and credentialed NEMT business may be able to build a steady flow of trips, but results depend on your service area, vehicle mix, broker relationships, and how reliably you show up. Formation and credentialing do not guarantee a volume of trips or a particular level of revenue. Broker onboarding often takes longer than the state filing, so plan your cash reserves around the slower step, not the faster one.

You may find it useful to contact the Florida SBDC Network for advising on business planning and budgeting. The U.S. Small Business Administration also lists regional resources through its South Florida district page if your business is in that area.

Common mistakes to avoid

• Paying for a "state NEMT license." Florida does not issue a standalone NEMT license. Be skeptical of any service that sells one.
• Treating a name as approved too early. Wait for the filing acknowledgment before printing signs, vehicle decals, or contracts.
• Missing the May 1 annual report deadline. The $400 late fee is avoidable, and an LLC that fails to file by the third Friday in September faces administrative dissolution.
• Buying vans before checking county rules. Wheelchair and stretcher vans may face vehicle-for-hire requirements that change your purchase decision.
• Using a P.O. Box for the registered agent. Florida requires a physical street address.
• Skipping the local business tax receipt. Many cities and counties levy one, and the receipt is separate from your state filings.
• Assuming your fares are exempt from sales tax. Confirm the treatment with the Department of Revenue.
• Hiring drivers before screening clears. Any trip with an unscreened driver can jeopardize your broker contracts.
• Assuming one broker's requirements apply to all. Insurance, inspection, and screening standards vary, so get each broker's requirements in writing.

Tips that save time

• Create one compliance calendar with the Sunbiz annual report window, your registered agent renewal, fictitious name renewal (if applicable), tax filing dates, insurance renewals, vehicle inspections, and driver screening renewals.
• Ask brokers for a written list of their requirements and keep it in your compliance folder. Verbal assurances do not protect you during an audit.
• Start with one county and one vehicle type. Add service areas only after your first broker contract runs cleanly.
• Keep a copy of every state filing, acknowledgment, and confirmation in one place.
• Compare the cost of a commercial registered agent with the value of a home address you can trust to receive legal documents on time.

Next steps

Start with the Sunbiz name search and the Department of Revenue questions, since those answers shape your entity and tax setup. Then contact the county and city business tax offices in your service area, and ask AHCA which brokers serve your region. Confirm every figure in this guide on the agency page before you commit money, because fees, rules, and county ordinances can change.

Reminder: this article is informational and does not replace advice from a Florida business attorney or a CPA. Confirm the requirements that apply to your specific vehicles, services, and location with AHCA, the Florida Department of Revenue, and your local county or city before you operate.