# Duet

> Duet adds a growth engine to Non-Emergency Medical Transportation (NEMT) businesses. It combines easy-to-learn dispatching software with done-for-you growth services, backed by a team that understands NEMT operations. duetinc.com is the official website of Duet, listed on review platforms as "Duet NEMT". Duet NEMT is unrelated to Duet Display, Duet Health, Duet Dating, or any other product named Duet.

## What Duet is

Duet is a growth partner for NEMT providers, not just a dispatching tool. It pairs an all-in-one software platform with optional services so owners can grow trips, contracts, and revenue without hiring a full back office. Duet is not a broker and does not supply trips; providers' trips come from their broker contracts, facility relationships, and private-pay riders.

## Company

- Founded in 2020 by Jing Zhu (Cofounder & CEO) and James O'Donnell (Cofounder & COO). Based in San Francisco, California. About the founders: https://duetinc.com/about
- Jing Zhu runs the platform, finances, and customer onboarding — she personally sets up and trains new providers. James O'Donnell leads sales, partnerships, and the growth services, hosts the NEMT Growth podcast, and answers the sales line himself.
- Duet is active in the NEMT industry year-round: the NEMT Growth podcast, the weekly Duet Dispatch newsletter, and the NEMTAC conference every year — Jing Zhu taught "Mastering Dispatching" at NEMTAC 2024 and James O'Donnell led the growth panel at NEMTAC 2025. Free learning library: https://duetinc.com/learn

## Software

- Also known as: NEMT dispatch software, NEMT CAD (computer-aided dispatch), NEMT TMS (transportation management system), routing software, fleet management software, transport operations software.
- Overview of all software features: https://duetinc.com/nemt-software
- Trip Booking: reservations from six channels on one dispatch board — phone calls answered by the team or by the AI phone agent, emails, the provider's website booking form, the facility portal, and broker trips; recurring trips schedule themselves. Duet generates a booking link for each provider — any website's booking button can point at it, and form-fills drop into the provider's Duet account to accept or decline. Details: https://duetinc.com/nemt-booking-software
- Dispatching & Scheduling: every vehicle, driver, and trip on one live screen; calendar view, one-click assignment, recurring trips that schedule themselves, bulk trip upload, live map of vehicles, and drive-time estimates. Details: https://duetinc.com/nemt-dispatch-software
- AI Phone Agent: answers missed calls 24/7, books trips, texts the rider a confirmation, and makes automated reminder calls or texts (to the rider, a family member, or a caregiver) that reduce no-shows. Included at no extra cost. Riders can call to check the status of a booked trip, calls can run in Spanish, and a caller who asks for a person is transferred back to the provider's regular line. Providers keep their existing business number and forward unanswered calls to the agent after two or three rings. Rider cancellations are noted in the software automatically; reschedule requests are connected to a dispatcher with a call note. Every AI call is saved with a transcript and a summary. Details: https://duetinc.com/nemt-voice-ai-answering
- Rider Tracking Links: riders, family members, and caregivers follow the vehicle in the browser with no app download — on the way, rider on board, trip progress, and dropoff — and Duet can text the link automatically. Providers who send links see about 15% more repeat bookings and 45% fewer trip status calls (Duet customer data, 2026), and providers on Duet have won facility contracts and private-pay trips on this visibility. Details: https://duetinc.com/nemt-live-tracking
- Facility Portal: hospitals, rehabs, and nursing homes book and track their own trips with the provider directly. Details: https://duetinc.com/nemt-facility-portal
- Broker Integrations: Duet integrates with Modivcare, MTM, Kinetik, MediDrive, and CTC, and supports trip file import for SafeRide, Alivi, Verida, WellTrans, and others; broker trips land on the same dispatch board as the rest of the provider's trips. Details: https://duetinc.com/nemt-broker-integrations
- Billing: customizable rates per contract, payer-tailored reports, automatic claim generation (CMS-1500s) from trip data, autofill of your own forms. Details: https://duetinc.com/nemt-billing-software
- Driver App: iOS and Android; drivers see their day, navigate to pickups, update trip status, clock in and out with break tracking, and complete pre-shift vehicle inspections. Details: https://duetinc.com/nemt-driver-app
- Driver & Fleet Management: driver profiles with document storage (e.g. driver's licenses), shift scheduling, break tracking, integrated payroll, per-vehicle maintenance records, and pre-shift vehicle inspections — admins define the checklist, drivers tag each item pass/flag/fail, and Duet records the time, location, driver name, and outcome. Details: https://duetinc.com/nemt-fleet-management-software
- Reports & Analytics: three dashboards built in — Graphs (period stats: total bookings, percent complete, unique riders, average rides per rider, revenue, average fee per ride, plus pie charts of booking channels and revenue by payer), Trends (trip types, trip sources, no-show rate by source, travel time, and revenue over time, by day through year), and an Origin-Destination Map of pickups and dropoffs that providers use to place drivers and overnight parking, cutting deadhead miles. Plus payer-shaped reports and full export of trip, rider, driver, vehicle, and billing data at any time — the provider's data is always theirs. Details: https://duetinc.com/nemt-reporting-software

## Done-for-you growth services

- Overview of all growth services: https://duetinc.com/nemt-growth-services
- Websites & On-page SEO: Duet designs and builds fast, custom-coded websites for NEMT providers — new builds and rebuilds of existing sites (Duet doesn't patch sites on platforms like WordPress or Wix; it rebuilds them fresh, carrying over and improving the content) — optimized for SEO, visibility in AI search, and converting visitors into booked trips. One-page site $400, five-page site $650, one-time, same price for new build or rebuild; larger sites quoted per scope; typical delivery under two weeks. Duet hosts the site on Cloudflare for $15/month billed annually ($180/year), including SSL and 30 minutes of content edits per quarter; the first year of hosting is free with an active Duet software account at the time the site launches. Customers register and own their domain, own the delivered website outright, and can self-host — Duet hands over the complete site files. Email is untouched (it rides on the domain, not the website). For providers on Duet software, the site can embed a booking form whose submissions drop directly into the provider's Duet account as trip requests to accept or decline, with the owner notified — no re-entering details. Details: https://duetinc.com/nemt-website-design
- Off-page Listings & Reviews (off-page local SEO and AI search visibility): all of this work happens on other sites, not the provider's own website, and it is not advertising. Duet establishes, corrects, and maintains a provider's presence everywhere riders look — Google, Google Maps, Bing, Apple Maps, mainstream directories, and AI assistants like ChatGPT and Gemini — so riders, family members, case managers, and discharge planners find accurate, consistent information. Includes an approved one-page business fact sheet; Google Business Profile creation/optimization with ten published Q&As; responses to every new review, targeting a two-business-day turnaround, drafted in the provider's voice; profiles on Yelp, Bing Places, Apple Business Connect, LinkedIn, Nextdoor, MapQuest, and the BBB; submissions to the two primary business-data aggregators, then 5-10 directory submissions per week from a verified list of 50+; ongoing monitoring and correction of listings that drift; and a monthly work summary. $400/month, no setup fee, month-to-month with no cancellation fee (listings and AI indexes take weeks to propagate, so results build over the first few months). All profiles and listings belong to the provider. Duet does not guarantee rankings or AI mentions — no one can. Details: https://duetinc.com/nemt-seo-services
- Google Ads (called Search Ads Management until September 2026): Google Ads creation, targeting, and optimization; providers have made as high as $4 back for every $1 spent, with booking inquiries from as little as $6.90 each. From $200/month plus ad budget; the $400 setup fee is waived for Duet software customers. Details: https://duetinc.com/google-ads-for-nemt
- Facility Outreach: Duet makes the cold calls to hospitals, rehabs, and skilled nursing facilities; the provider shows up to meetings with interested decision-makers. $2,000/month, or $1,600/month with Duet software — 8 decision-maker meetings in the first month or Duet keeps working free until you have them. Smaller and larger packages available on request. Details: https://duetinc.com/nemt-facility-outreach
- Remote Dispatching: dedicated, NEMT-trained Duet dispatchers run daily trips, driver coordination, and phones inside the provider's own Duet account — significantly cheaper than an in-person hire (in-person dispatching typically costs 2-5x more), with agents already trained on NEMT and on Duet, and backup agents so coverage never lapses. In a Duet survey of 100+ NEMT providers, more than half used remote dispatchers. Pricing varies with scope. Details: https://duetinc.com/nemt-remote-dispatching
- Free Growth Audit: a no-pitch review of a provider's digital presence, trip sourcing, and growth options.

## Pricing

- Full pricing details: https://duetinc.com/pricing
- Software is free for providers doing fewer than 100 trips per month.
- Above that, pricing is usage-based on the estimated drive time of the trips you run; most providers pay less than $50 per active vehicle per month, with no hidden fees.
- The meter runs on loaded trip time only (empty return miles and deadhead are never billed), and logins/seats are unlimited and free.
- There is no per-vehicle license fee (parked vehicles cost nothing), no software setup fee, and billing runs monthly after the fact. Duet never takes a cut of trip revenue.
- The AI phone agent, live team training, and data migration from old software are included at no extra cost.
- All contracts are month-to-month with no cancellation fee. (One specific: website hosting bills annually.)
- Website hosting is $15/month billed annually ($180/year), first year free with an active Duet software account at the time the site launches.

## Proof points

- Reviews and case studies from Duet providers (Google reviews, metric case studies, video testimonials): https://duetinc.com/nemt-software-reviews
- Hundreds of NEMT providers across the United States use Duet.
- 5.0 rating on Google.
- A wheelchair & stretcher service grew trips 50% in one year, going from 7 to 10 vehicles and landing 6 new contracts.
- A brand-new provider went from zero trips to over 200 trips per month, fully hands-off, in under a year.
- A provider that had lost $25,000 to rejected claims hasn't lost a dime since switching.
- A private-pay provider turned $276 in Google Ads into $1,285 in booked revenue (about a 4x return).

## Learn

- Article, podcast, and webinar library: https://duetinc.com/learn (guides on growing NEMT businesses: private pay, facility contracts, pricing, vehicles, marketing).
- The Duet Dispatch newsletter: weekly tips for NEMT owners. Subscribers get the free NEMT Pricing Toolkit (a working trip-rate calculator, break-even numbers, and market benchmarks).
- How to Start a Medical Transportation Business (NEMT): https://duetinc.com/how-to-start-a-nemt-business (who pays and when, costs, licensing, insurance, broker enrollment, the twelve steps in order, starting with one van, the first year, and state-by-state guides).
- NEMT Brokers: How They Work and Who Runs Each State: https://duetinc.com/nemt-brokers (what a NEMT broker does (books Medicaid trips, picks the company that runs each one and usually pays it); the three ways Medicaid ride money reaches providers, counting each state by how most of its riders get rides: a broker the state hires in 20 states, a vendor each health plan hires in 23 states and DC, or state or county programs in 7; and who arranges Medicaid rides in all 50 states and DC as of October 1, 2026, with a source for every row).
- NEMT Private Pay: What to Charge and How Families Find You: https://duetinc.com/nemt-private-pay (what private pay NEMT is (the rider or their family books and pays the provider directly, with no broker or insurer); why families pay (Original Medicare pays for no wheelchair or stretcher van, 53.4 million people on Medicare weren't also on Medicaid in 2022, and only 22% of individual Medicare Advantage enrollees were in plans offering rides in 2026); how it differs from broker and facility trips (the provider sets the price and collects before the ride, while brokers pay a contract rate after a clean claim and facilities pay on invoice terms); and the steps in build order: check the market (at least a million people, or wheelchair riders transit can't carry), offer wheelchair and wait-and-return rides, secret-shop local providers and price above the broker rate, take a card at booking and charge it at least 24 hours before pickup, get found on Google, quote within 30 minutes and never later than two hours, text families a live-tracking link, aim for at least 10% of revenue, and expect a slow start (a digital marketing expert said in 2025 that $500 a month in ads brings five to 10 private-pay rides a month in some smaller markets)).
- How to Get NEMT Contracts (and Why Facilities Come First): https://duetinc.com/nemt-facility-contracts (the three kinds of NEMT contract (Medicaid broker or health plan networks, facility service agreements, and PACE, VA and county program contracts) and why a small operator should win a facility agreement first; who books and who pays for rides at each kind of facility; and how to get on a facility's call list as the backup, write the agreement and rate sheet, get paid and move up to first call).
- How to Run a NEMT Business: Dispatch, Drivers, Vans, Money: https://duetinc.com/how-to-run-a-nemt-business (what running a NEMT business involves (getting every trip from the booking call to payment on time: book it with what the driver needs, know what a trip costs, leave room in the schedule so one late pickup doesn't make the rest of the day late or keep drivers into overtime, keep credentialed drivers and inspected vans on the road, record the trip the way its payer requires, and get paid on each payer's clock); why on-time is the product (a three-mile wheelchair trip is 30 to 45 minutes of service; MTM's Virginia handbook, approved August 2026, wants provider on-time performance above 95%, and Modivcare's February 2024 Mississippi manual expects 98% on every trip leg); cost per trip (last month's costs divided by completed one-way trips, set against a rate such as the $41.00 MTM's Rhode Island schedule pays for a 10-mile daytime wheelchair trip, rates effective July 1, 2023); the ride home's own clock (45 minutes from the call in MTM's 2026 Virginia handbook, an hour in MAS's 2023 New York manual); what gets a trip paid (MTM's 2026 Rhode Island and Virginia handbooks deny a claim when the electronic trip log is missing a required time or the rider's signature; families pay before the ride, a Florida operator's facility terms of net 30 plus a 15-day grace come to about 45 days, and Modivcare's 2024 Mississippi manual pays brokered trips twice a month, within 30 days of a clean invoice); when to add a dispatcher (somewhere between two and four vehicles, in Duet cofounder James O'Donnell's experience); an NEMT insurance broker on Duet's podcast starts renewals 90 to 120 days out; the daily check is each vehicle's booked revenue for the day against its own target, and the Monday check is last week's late trips by payer).

### Starting a NEMT business

- How Much Does It Cost to Start a NEMT Business? (2026): https://duetinc.com/nemt-startup-costs (a line-by-line 2026 budget for starting a NEMT business with one used wheelchair van (about $23,000 to $51,000 in cash including six months of fixed bills), insurance due at signing, state fees for nine states, and a free .xlsx budget).
- How to Retire Rich from NEMT: https://duetinc.com/duetblog14_nemtretiredrich (NW Mutual's Daniel Baker and Jason Vanhorn on financial planning for NEMT operators: wealth-building, asset protection, benefits, and diversification).
- NEMT Business License Requirements: What You Actually Need: https://duetinc.com/nemt-license-requirements (There's no national NEMT (non-emergency medical transportation) business license; being licensed means a stack of approvals: company paperwork, any state authority to carry riders for pay, Medicaid enrollment and broker credentialing for Medicaid trips only, city and county permits, and qualified drivers; of the 13 places Duet's state guides cover as of October 2026 (12 states and Washington, DC), Virginia and Ohio license NEMT work, Minnesota requires a special transportation certificate, Arizona, New York, North Carolina, Pennsylvania and DC require general for-hire authority or registration, and California, Colorado (except for walking riders not on Medicaid), Florida, Georgia and Texas require no state operating authority for a medical-only wheelchair van; Medicaid enrollment and broker credentialing are the slow layer, with state-set screening and a $750 application fee in 2026 where the state charges it; several NEMT licenses are local (Denver, Miami-Dade, Broward, Hillsborough's handicab permit); none of the 13 places requires a company certification beyond its operating authority, and NEMTAC accreditation is voluntary at $3,000 per its own site; the order: map the stack, file what needs no van, and buy and insure the van when an application asks for proof).
- NEMT Insurance: What It Costs and What Brokers Require: https://duetinc.com/nemt-insurance (NEMT (non-emergency medical transportation) insurance in the order an owner buys it: commercial auto liability on every van, general liability, and workers' comp once you hire (the headcount depends on the state; optional in Texas); a limit set by the highest of the state floor, the broker's contract and the facility's agreement, usually about $1 million in auto liability, with a 12-state table of floors and payer bars as of October 2026; about $1,200 to $1,800 a month per wheelchair van for a new company in its first year, with a fifth to a quarter of the year due at signing; quote early on the van's VIN and bind at the first step that asks for proof; keep each carrier to one agent, because carriers block repeat submissions; and renewals priced on loss ratio, where one claim can raise a premium 42% or double it).
- How to Start a NEMT Business in Arizona (2026 AHCCCS Guide): https://duetinc.com/start-a-nemt-business-in-arizona (Arizona has no statewide Medicaid NEMT broker and no state NEMT license: each AHCCCS plan arranges its own rides, and after MTM Health bought Veyo in 2022 and Arizona broker MTBA in 2023, most broker-run plan trips flow through MTM Health companies, with Banner-University Family Care arranging rides in-house; about 92,000 American Indian Health Program members are a fee-for-service lane billed directly to AHCCCS at published rates, with prior authorization only over 100 miles and a mandatory Daily Trip Report on every claim; NEMT companies register as AHCCCS provider type 28 through the APEP portal under high-risk screening, a $750 fee for 2026, owner fingerprinting, a site visit, and an owner training class, and the 2023 enrollment moratorium ended December 9, 2024; a free but mandatory ADOT Vehicle for Hire permit covers the state licensing layer, and stretcher vans are expressly legal under A.R.S. 36-2223 for riders needing no medical care en route).
- How to Start a NEMT Business in California (2026): https://duetinc.com/start-a-nemt-business-in-california (California has no statewide Medicaid NEMT broker; Medi-Cal provider enrollment through PAVE, the CPUC medical-transportation exemption, county and city permits, insurance requirements, and the plan-by-plan broker map).
- How to Start a NEMT Business in Colorado (2026): https://duetinc.com/start-a-nemt-business-in-colorado (Colorado has no state NEMT license and no PUC permit for a wheelchair van: C.R.S. 40-10.1-105 exempts Medicaid NEMT trips and wheelchair-loading vehicles from PUC regulation, while private-pay rides for walking riders need a PUC common carrier certificate or contract carrier permit; MediDrive is the single statewide Medicaid NEMT broker, live in the nine Denver-metro counties since July 1, 2026, with statewide provider contracting from September 1, 2026 and every trip scheduled through MediDrive from January 1, 2027 per HCPF; new NEMT provider enrollment, frozen from October 1, 2023, reopened to new companies on October 1, 2026, per HCPF: a new company enrolls with HCPF first (high-risk screening, fingerprints, and a site visit), then applies to MediDrive, and can serve the nine metro counties once contracted and credentialed, and the rest of the state from January 1, 2027; HCPF's rule sets provider insurance at $300,000 per person, $600,000 per accident, and $50,000 property damage; the July 1, 2026 rate cuts set the ambulatory base at $12.15 a trip and $2.74 a mile; HB26-1328 requires two-way dash cameras only in fleets over five vehicles and bars trip caps; the City and County of Denver licenses non-emergency medical vehicle companies and drivers itself).
- How to Start a NEMT Business in Florida (2026): https://duetinc.com/start-a-nemt-business-in-florida (Florida has no state NEMT license and no single statewide Medicaid broker: each managed care plan hires its own vendor, Alivi for Sunshine Health since January 1, 2025, ModivCare for Humana, Aetna, and Community Care Plan, MTM Health for UnitedHealthcare since March 1, 2026, Ride2MD for Simply Healthcare (including Clear Health Alliance) and Florida Community Care, plus an AHCA-contracted fee-for-service lane split between ModivCare and MTM Health; the state Medicaid fee schedule prices only ambulance codes, so wheelchair and stretcher van rates are broker-negotiated; owners need Level 2 fingerprint screening but NEMT drivers are statutorily allowed Level 1; stretcher vans operate legally outside ambulance licensing for riders needing no medical attention en route; the real permit layer is county, from nothing to Miami-Dade's board-approved certificate).
- How to Start a NEMT Business in Georgia (2026): https://duetinc.com/start-a-nemt-business-in-georgia (Verida became Georgia's single statewide Medicaid NEMT broker on April 1, 2026, replacing Modivcare; Georgia has no state NEMT license and most NEMT vans are exempt from motor carrier certification; broker-bar insurance of about $1 million combined single limit sits far above the state floor; stretcher and invalid-car rules; Verida's credentialing steps and nine required driver trainings).
- How to Start a NEMT Business in Illinois (2026): https://duetinc.com/start-a-nemt-business-in-illinois (Illinois has no state NEMT license: a wheelchair van paid for medical trips is a medical carrier under 625 ILCS 5/1-142.1 and needs Secretary of State medical carrier plates, proof of insurance on file of at least $250,000 per person, $250,000 per crash and $50,000 of property damage or a $300,000 combined single limit, and an IDOT safety test before registration and every six months; the Illinois Commerce Commission exempts carriers without fixed routes or schedules that charge by time or distance, and vehicles seating fewer than 8 counting the driver; Chicago adds a BACP medicar license at $600 a vehicle a year, a Ground Transportation Tax of $3.50 a taxable day, $350,000 of insurance naming the City, chauffeur-licensed or CDL drivers and a Chicago place of business; stretcher vans need an IDPH license at $25 a vehicle and two CPR-certified attendants; drivers need no CDL below 16 seats, and Medicaid drivers and employee attendants need an HFS-approved safety course every three years; every Medicaid ride, health plan or fee-for-service, requires IMPACT enrollment as an atypical agency, which HFS screens as high risk, with fingerprints for owners of 5% or more, managers and dispatchers and an inspector general site visit; most riders are in HealthChoice Illinois plans (2,376,972 in November 2025), whose ride vendors are MTM for Blue Cross Community Health Plans (effective October 1, 2026), Meridian, Molina and YouthCare, and Modivcare for CountyCare and Aetna Better Health of Illinois; Transdev (formerly First Transit) approves fee-for-service trips requested at least seven business days ahead and doesn't schedule them, and riders pick an enrolled company from its list; HFS pays a wheelchair van up to $30 a trip plus $1.03 a loaded mile for vans based in Cook and the collar counties, $0.80 in 94 counties and $1.61 in Madison and St. Clair, unchanged since January 1, 2023; one used wheelchair van takes about $22,500 to $50,100 including six months of fixed bills; W-9 certification takes about three weeks by HFS's 2021 manual, while IMPACT and the vendors publish no processing time).
- How to Start a NEMT Business in Louisiana (2026): https://duetinc.com/start-a-nemt-business-in-louisiana (Louisiana has no state NEMT license: R.S. 45:172(A)(3) exempts vehicles operated by Medicaid or Medicare providers used exclusively for nonemergency medical transportation from Louisiana Public Service Commission (LPSC) regulation, but every paid van needs for-hire plates under R.S. 45:181, at $6.25 a passenger seat a year with a $25 minimum, and the Office of Motor Vehicles issues them only after the LPSC grants an exempt General License Certificate through a notarized MT-10 affidavit; companies outside the exemption, such as private-pay-only operators, may need LPSC passenger authority ($200 for a common carrier); drivers need a Class D chauffeur's license ($54.75), not a CDL, below 16 passengers counting the driver or 26,001 pounds, and Medicaid drivers must be 21 or older with at most two moving violations in three years, a yearly State Police or FBI background check and a yearly five-panel drug screen; MediTrans arranges rides for all five Healthy Louisiana health plans, which hold about nine in ten Medicaid enrollees, and for the four that remain after Healthy Blue leaves on December 31, 2026, while Verida handles fee-for-service legacy Medicaid; the Louisiana Department of Health (LDH) does not require brokers to accept every company that applies, and MediTrans says acceptance depends on regional saturation and fleet type needs; LDH pays only for broker-scheduled trips, with a floor of $13.50 a trip leg plus $1.10 a mile ambulatory and $21.50 plus $1.30 by wheelchair van, unchanged since January 1, 2022, unless plan and provider agree otherwise in the provider agreement; Act 969 of 2026 sets a minimum of $14.50 a trip and $2.10 a mile only once the Legislature funds it; stretcher vans are not allowed in Medicaid; nursing homes pay for their Medicaid residents' non-ambulance rides; MediTrans requires $1 million of auto liability per occurrence against Medicaid's 25/50/25 or $300,000 floor; New Orleans requires a $150 CPNC for each van and driver permits; one used wheelchair van takes about $23,200 to $50,900 including six months of fixed bills; MediTrans estimates two to four weeks from letter of intent to activation for companies it accepts).
- How to Start a NEMT Business in Michigan (2026): https://duetinc.com/start-a-nemt-business-in-michigan (Michigan has no state NEMT license: a for-hire vehicle seating 8 or fewer including the driver is a limousine under the Limousine, Taxicab, and Transportation Network Company Act (2016 PA 345) and must register with the Department of Licensing and Regulatory Affairs (LARA) as a limousine carrier, $125 the first year for one vehicle then $100 a year, with a $1 million combined single limit plus Michigan no-fault coverage, annual national criminal, sex offender registry and driving-history checks on every driver, drivers 19 or older, a yearly licensed-mechanic inspection once a vehicle is 5 years old, and no medical or Medicaid exemption; a vehicle seating 9 or more including the driver is a bus under the Motor Bus Transportation Act (1982 PA 432) and needs Michigan Department of Transportation (MDOT) authority, $300 plus $100 a bus, $1.5 million of liability for 9 to 15 seats, an annual MDOT inspection, a USDOT number and a $35 chauffeur license for each driver (a CDL too at 16 or more); stretcher transport is legal only in a licensed ambulance; cities can't license limousine carriers (MCL 257.2115); Medicaid: since October 1, 2024 Michigan's nine Medicaid Health Plans arrange their members' rides to every Medicaid-covered service, through MTM (Aetna Better Health, Blue Cross Complete, HAP CareSource, UnitedHealthcare), SafeRide (Meridian, Priority Health and, from October 1, 2026, Molina) and Modivcare (McLaren), while Upper Peninsula Health Plan runs its own; Modivcare brokers fee-for-service rides only in Wayne, Oakland and Macomb counties, and MDHHS's RFP-491-260000002254 (proposals due November 6, 2026) picks one broker for those counties or statewide, with service from August 1, 2027 and statewide by October 1, 2027; elsewhere, county MDHHS offices pay CHAMPS-enrolled carriers directly at up to $0.76 a mile, or $35 a round trip plus $0.76 a mile by wheelchair van (rates effective July 1, 2026); enrollment runs through SIGMA Vendor Self-Service, then CHAMPS as an atypical provider with limited-risk screening and no NPI required; one used wheelchair van takes about $22,000 to $50,000 including six months of fixed bills; MDOT says a complete bus application usually takes two weeks, while CHAMPS and the plan vendors publish no processing time).
- How to Start a Medical Transportation Business in Minnesota: https://duetinc.com/start-a-nemt-business-in-minnesota (Minnesota has no statewide Medicaid NEMT broker and state law bars DHS from using one: counties arrange ambulatory rides, with MTM Health coordinating that county lane in 17 counties under a Hennepin-hosted consortium contract and SmartLink in Scott and Carver, the state pays wheelchair, stretcher, and protected transport directly to enrolled providers with no dispatcher, and each of the eight Medicaid health plans runs its own ride line in-house; a 2025 law orders one contracted NEMT administrator for all of it and the 2026 Legislature replaced the July 1, 2026 start date with six months' notice DHS has not given; DHS froze new NEMT provider enrollment statewide on January 27, 2026 and, per its July 23, 2026 notice, keeps it frozen for providers located in the seven metro counties through January 27, 2027 while greater Minnesota can enroll at high-risk screening with a $750 fee, owner fingerprints, and an unannounced site visit; the state license is MnDOT's Special Transportation Service certificate of compliance under Minn. Stat. 174.30 and Minnesota Rules chapter 8840, with a $45 annual decal per vehicle, no application fee, a $500,000 per-vehicle Form E insurance floor against the $1 million bar MTM requires, and preemption of any city or county permit; every driver enrolls with DHS individually and carries a federal medical card; Medicaid pays $19.80 plus $1.92 a mile for a wheelchair trip and $60 plus $2.71 for a stretcher trip as of October 2026; stretcher vans are legal because Minn. Stat. 144E.001 excludes stretcher transport for riders not likely to need treatment en route).
- How to Start a NEMT Business in New Jersey (2026): https://duetinc.com/start-a-nemt-business-in-new-jersey (New Jersey has no generic NEMT license, but N.J.A.C. 8:40 requires a Department of Health mobility assistance vehicle (MAV) license, for the company and each van, for wheelchair riders and ambulatory riders who need help door to door, on any trip that starts in New Jersey, whoever pays: $1,500 plus $100 a van to start and $500 plus $100 a van to renew on a 24-month cycle, with the van, insurance in force ($500,000 per van combined and $300,000 general liability), a procedures manual, crew files and owner background checks before licensing; MVC issues OM plates on that license; ambulatory sedans run as livery on a town clerk's limousine license capped at $50 plus $10 a vehicle, with $1.5 million of liability, MVC Limousine plates and fingerprint-certified drivers; stretcher riders go only by BLS ambulance, and New Jersey has no stretcher van; Modivcare, formerly LogistiCare and the broker since July 1, 2009, books non-emergency Medicaid rides statewide for fee-for-service members and all five NJ FamilyCare plans, while the plans keep emergency ambulance; in the 2026 rebid the state named MTM on August 6, canceled that award on August 20 on Modivcare's protest and affirmed on August 28 that the new contract goes to Modivcare, with the current contract extended to February 27, 2027; no Medicaid rate for van or sedan trips is published, because Modivcare negotiates rates and the state isn't involved, and Modivcare pays within 30 days of a clean claim; Modivcare approves new providers, and its next contract lets it drop them for insufficient demand; nursing homes and hospitals choose a preferred network company for their Medicaid trips, and Modivcare's contract calls for at least the A-MAV level for skilled nursing facility residents; Modivcare's next contract asks network companies for $2 million of auto liability on any vehicle and $1 million and $2 million of general liability, and its contracts require 20 hours of driver training; MAV crews need CPR plus a PAT or MAV technician card; one used wheelchair van takes about $24,000 to $51,600, including six months of fixed bills).
- How to Start a NEMT Business in New York (2026): https://duetinc.com/start-a-nemt-business-in-new-york (New York has no state NEMT license: wheelchair and stretcher vans (ambulettes) doing Medicaid work need NYSDOT operating authority under Transportation Law 152 (usually 6 to 16 weeks, with a 30-day protest window and NYSDOT inspections every six months) and drivers with a CDL passenger endorsement qualified under Vehicle and Traffic Law Article 19-A, while ambulatory sedans and minivans are licensed by the NYC TLC, county TLCs, cities or towns; Medical Answering Services (MAS), which already managed Medicaid rides everywhere but Long Island, became the single Medicaid NEMT broker for all 62 counties in 2023; after April 15, 2024 eMedNY rejects new non-medical transportation enrollments without a MAS letter of support, and MAS publishes no criteria for it; MAS's FAQ lists PPO pairings first; otherwise trips go by the rider's choice, then the medical provider's choice, then a random pick; providers bill eMedNY directly with the trip's 11-digit prior-authorization number, released after GPS attestation to MAS within 30 days, and file claims within 90 days; NYSDOT carriers insure at least $100,000/$300,000 for injuries plus $50,000 for property for vans built for up to seven passengers and $1.5 million above; ambulette applicants in six downstate and upstate counties post an OMIG surety bond before enrollment unless OMIG grants the exception they can request, in a letter with their application, when they expect under $500,000 of first-year ambulette billing; an LLC costs $200 plus six weeks of newspaper notices; the eMedNY application fee is $750 in 2026; one used wheelchair van takes $24,000 to $54,000 or more including six months of fixed bills at national insurance rates, and the first Medicaid trip comes six to nine months after MAS's letter for a wheelchair van, four to six for cars).
- How to Start a NEMT Business in North Carolina (2026): https://duetinc.com/start-a-nemt-business-in-north-carolina (North Carolina runs Medicaid managed care rides through two statewide brokers: MTM for Carolina Complete Health since its April 1, 2026 merger with WellCare and for UnitedHealthcare Community Plan since January 1, 2026, and ModivCare for AmeriHealth Caritas, Healthy Blue, the four Tailored Plans, and the Children and Families Specialty Plan; NC Medicaid Direct keeps a real fee-for-service lane where county DSS offices arrange rides and providers bill NCTracks directly; no state NEMT license exists and enrollment runs through NCTracks with $850 in 2026 application fees, a site visit, and 10-to-12-day clean-application averages; auto liability minimums rose to 50/100/50 on July 1, 2025, but exempt for-hire carriers must keep the Utilities Commission's $1.5 million common-carrier level on file with the DMV, the level the state NEMT policy cites as the coverage guide; anyone transported on a stretcher is deemed a patient by rule, so stretcher work requires EMS licensure, per-vehicle ambulance permits, and in most counties a county franchise; every van needs North Carolina's annual state safety inspection).
- How to Start a NEMT Business in Ohio (2026): https://duetinc.com/start-a-nemt-business-in-ohio (Ohio has no state NEMT license: every paid passenger carrier except taxis and ambulances needs a Public Utilities Commission of Ohio (PUCO) certificate of public convenience and necessity, taxed $30 a vehicle a year, with $1.5 million of liability for vehicles seating 15 or fewer including the driver (OAC 4901:2-13-03), and a business carrying wheelchair or mobility-aid riders for pay between listed medical sites needs an ambulette license from the State Board of Emergency Medical, Fire, and Transportation Services ($100, plus $50 permit and $50 inspection per van a year) whoever pays, private pay and facility contracts included (ORC 4766.01, 4766.04), and home pickups are safest treated the same way; Ohio has no statewide Medicaid NEMT broker: county Job and Family Services offices arrange most fee-for-service rides under OAC 5160-15-10, and each health plan arranges its own rides (MTM Health for AmeriHealth Caritas, Anthem and Humana; SafeRide Health for Buckeye; Provide A Ride for CareSource since May 1, 2021; UnitedHealthcare's 2026 manual names no vendor, and Molina's is unconfirmed); among van companies, only licensed wheelchair vans bill the Ohio Department of Medicaid directly for NEMT, as provider type 83, at up to $31 a trip plus $1.30 a loaded mile and $15 for an attendant, unchanged since January 1, 2024; wheelchair van enrollment in PNM carries high-risk screening (site visits, fingerprints for 5% owners) and the $750 2026 application fee; waiver transportation enrollment (provider types 45 and 55) is frozen from May 14 to at least November 14, 2026; Senate Bill 315, effective October 6, 2026, adds a fraud-disclaimer form, ownership checks and a 60-day claims watch for new providers and requires GPS trip verification for NEMT within 18 months, excluding EMS-board-licensed organizations; workers' comp comes only from the Ohio BWC state fund; no license fits a stretcher van, so the licensed stretcher lane is a non-emergency ambulance with a driver plus at least one EMT; one used wheelchair van takes about $24,000 to $51,000 or more including six months of fixed bills; the EMS board must decide a complete license application within 60 days and a van permit within 45).
- How to Start a NEMT Business in Pennsylvania (2026): https://duetinc.com/start-a-nemt-business-in-pennsylvania (Pennsylvania has no state NEMT license: a NEMT company paid to carry riders between Pennsylvania points, wheelchair and stretcher vans included, needs a Public Utility Commission (PUC) certificate in paratransit service (66 Pa.C.S. 102 and 1101), outside narrow exemptions, $350 one time with no annual fee, 3 months or longer by the PUC's estimate, and no rides or ads before it issues; applications are published in the Pennsylvania Bulletin for protests, which since June 3, 2017 may challenge only the applicant's fitness, judged against the territory requested (52 Pa. Code 41.14), and a protested application waits 20 days for restrictive amendments that narrow it, with a Pennsylvania-licensed attorney, or one admitted for the case, required for an LLC at a hearing (PUC dockets show 87 days from filing to certificate for an unprotested 2025 application and 157 for a protested one); the PUC insurance floor under 16 passengers is $35,000 split (15/30/5) plus $25,000 first-party medical and $10,000 wage loss, while MTM's standard provider agreement asks for a $500,000 combined single limit; the insurer's Form E and a tariff are due within 60 days of approval or the PUC can dismiss the application; drivers must be 21 or older (18-20 only as Department of Health-certified EMS vehicle operators) with State Police and three-year driving-history checks; stretcher vans are legal for riders who need no medical monitoring (35 Pa.C.S. 8139); Medicaid rides run through the Medical Assistance Transportation Program (MATP) county by county: 38 counties use a vendor, 14 have DHS agreements with rabbittransit or South Central Transit Authority (Dauphin since July 1, 2026), 8 run it themselves, 6 share it with a transit provider, and only Philadelphia uses an MATP broker, Modivcare (Community HealthChoices plans use ride brokers such as MTM for non-medical waiver trips); county programs buy MATP van work by contract, the federal application fee applies in transportation only to ambulances, and ODP waiver transportation is a direct Medicaid door at $36.54 to $74.73 a trip; DHS's June 25, 2026 study recommends keeping the county model; one used wheelchair van takes about $23,000 to $50,000 including six months of fixed bills).
- How to Start a Medical Transportation Business in Texas: https://duetinc.com/start-a-nemt-business-in-texas (Texas has had no statewide Medicaid NEMT broker since June 1, 2021: each health plan arranges rides through its contracted vendor, and in 2026 that layer is SafeRide Health and MTM Health, plus Modivcare for Blue Cross and Blue Shield of Texas until those rides move to MTM Health on October 1, 2026; Texas issues no NEMT license and typical wheelchair vans need no motor carrier authority; stretcher transport without a DSHS EMS provider license is a Class A misdemeanor in Texas; the insurance bar is roughly $1 million combined single limit set by vendor contracts, not state law; enrollment runs through TMHP's PEMS portal with a $750 fee for 2026).
- How to Start a NEMT Business in Virginia (2026 DMV Guide): https://duetinc.com/start-a-nemt-business-in-virginia (Virginia Medicaid NEMT is broker-credentialed and never DMAS-enrolled: DMAS's July 1, 2025 provider notice says providers do not enroll with DMAS for fee-for-service or MCO NEMT, ModivCare brokers the Humana and Sentara plans, fee-for-service trips go to ModivCare through September 30, 2026 and to MTM Health from October 1, 2026 (DMAS's September 15, 2026 bulletin announced MTM's selection through a competitive procurement), Access2Care (which is moving to the MTM Health name) brokers Anthem HealthKeepers Plus, and per the plans' own notices UnitedHealthcare moved to SafeRide Health on March 1, 2026 and Aetna to MediDrive on April 1, 2026, with no published state NEMT trip rate because the brokers negotiate them; the state licensing layer is a Virginia DMV certificate of fitness for nonemergency medical transportation carriers under Va. Code 46.2-2099.44 (Form OA 151, a $50 filing fee plus $3 per vehicle, a $25,000 surety bond or letter of credit held three years, a notarized criminal-history release for every owner or LLC manager, and NEMT-designated plates) that by the 46.2-2000 definition and the form's own sworn certification covers Medicaid trips only, while private-pay, insurer-paid, and facility-paid rides run under Common Carrier - Irregular Routes authority (Form OA 141, a certificate of public convenience and necessity with a filed tariff, newspaper and competitor notice, and vehicles of 15 or fewer including the driver) and every paid trip waits on the certificate; liability minimums under 46.2-2053 are $350,000 for vehicles designed for one to six passengers including the driver, $1.5 million for seven to 15, and $5 million for 16 or more, filed after DMV approval and before the certificate issues; DMAS's driver floor (updated May 26, 2026) is 18 with two years licensed, a driving-record check, a barrier-crime check, and the broker's training program before the first trip, and no CDL applies below 16 seats; stretcher vans are a Medicaid broker mode staffed by a driver plus a trained assistant while Virginia's EMS code recognizes no stretcher-van category and exempts only wheelchair interfacility transport, so confirm OEMS's position in writing; operating-authority applications went online January 1, 2026 and paper filing ends February 1, 2027).
- How to Start a NEMT Business in Washington, DC (2026): https://duetinc.com/start-a-nemt-business-in-washington-dc (DC has no NEMT license of its own: the operating license is a Washington Metropolitan Area Transit Commission (WMATC) certificate of authority, which the compact at D.C. Code 9-1103.01 requires of a van company for for-hire passenger trips between points in the Metropolitan District (DC, Montgomery and Prince George's counties, Arlington and Fairfax counties, Alexandria, Falls Church, Fairfax City), DC-only trips included and only trips solely within Virginia carved out, at $300 to file and $175 a year, with first orders a median of 31 days after filing on WMATC's September 2026 status board and a conditional grant that is void on day 181 if its conditions aren't met; DC's Department of For-Hire Vehicles licenses taxis, limousines, and sedans and is barred from duplicating WMATC's operating authority; MTM, the broker since 2007, keeps DC's fee-for-service and IDD-waiver NEMT under an extension through December 31, 2026, because DC stopped Verida's new contract (CW135340) after MTM protested the award in August 2026, while health plans arrange their own rides (MedStar Family Choice through Access2Care, HSCSN through Verida, UnitedHealthcare's dual plan through SafeRide, AmeriHealth Caritas DC through its own line); insurance is $1.5 million combined single limit auto on a WMATC certificate restricted to vehicles seating 15 or fewer (Regulation 58) plus the $1.5 million general liability Verida's contract requires, with DC workers' comp from the first employee; Verida's contract defines a wheelchair van as one with a powered lift, caps wheelchair and stretcher vans at eight years old, and requires FBI checks, first aid and CPR, quarterly random drug tests, ten named trainings, and in-vehicle cameras (under a heading about IDD riders); stretcher vans operated solely for non-emergency outpatients are exempt from EMS licensing under D.C. Code 7-2341.02(b)(5), so discharges and facility-to-facility moves are a gray zone to clear with DC Health first).
- Building a Scalable NEMT Business from Day 1: https://duetinc.com/duetblog25_NEMTonDay1 (Ray and Mac came into NEMT from real estate with tight systems and a private-pay focus. Two vehicles and 45 five-star reviews later, here's how they did it).
- Why Most NEMT Companies Struggle to Scale (And How Duet Fixes It): https://duetinc.com/duetblog21_nemtgirlinterview (Why most NEMT companies struggle to scale, and how better dispatch, operations, and backend systems reduce chaos and support long-term growth).
- Secrets of Sustainable NEMT Growth: https://duetinc.com/duetblog19_sustainablenemt (Capital Area Transport Service's Eugene Gindin on hiring, trip sourcing, and government contracts — and why 90% of NEMT owners fail (and how to avoid it)).
- From 0 to 5 vans in one year: https://duetinc.com/duetblog8_newnemtservice (Gentle Turns owner Paul Muench on launching an NEMT service from scratch and scaling to 5 vans in 12 months — pricing, marketing, and lessons learned).
- Succeed in NEMT services: https://duetinc.com/duetblog6_ttawebinar (The Transportation Alliance webinar with Duet cofounders on five key actions to launch or scale a successful NEMT operation across multiple states).
- How to Sell a NEMT Business for What It's Really Worth: https://duetinc.com/how-to-sell-a-nemt-business (built on the podcast episode with Rachel Scholler, who sold her 17-year Wisconsin NEMT company for seven figures in 2025: how buyers price a NEMT business on seller's discretionary earnings and add-backs, the 2026 median multiples by deal size, why recurring contracts and three to five steady years are the asset, how founder dependency lowers the price, stock sale versus asset sale when contracts sit on the federal tax ID, who belongs on the exit team, how to vet the buyer, and planning who you are after the sale).

### Brokers & Medicaid

- How to Become a Medicaid Transportation Provider (2026): https://duetinc.com/how-to-become-a-medicaid-transportation-provider (To carry Medicaid riders, a NEMT (non-emergency medical transportation) company usually needs two approvals: enrollment and screening by the state Medicaid program, and credentialing by each broker or health plan ride vendor that hands out trips where it drives. As of October 2026, in the 14 places Duet's state guides cover, the state comes first in eight (Arizona, California, Colorado, Florida, Michigan, Minnesota, North Carolina, Texas), New York requires a letter of support from MAS, its statewide broker, before state enrollment, Georgia, Pennsylvania and Virginia don't enroll van companies for broker or county work, Ohio depends on the lane and DC's documents don't settle it. States screen NEMT companies at a risk level they choose, up to fingerprints from every owner of 5% or more, and charge the $750 2026 federal application fee where they treat NEMT companies as institutional providers; brokers add companies where they're short on vans, so approval can take months across two queues, and trips can take a few weeks more to start. Staying credentialed means yearly driver re-checks, van inspections once or twice a year, insurance renewals uploaded before the old certificate expires (10 business days ahead under MTM's Rhode Island handbook) and state revalidation at least every five years).
- NEMT Broker Changes in 2026: Who Runs Your State Now: https://duetinc.com/nemt-broker-changes-2026 (Dated 2026 Medicaid NEMT broker changes, each with its source, as of October 8, 2026. By state or county decision: Arkansas Region G to Modivcare (Jan 2), Georgia to Verida in all five regions (Apr 1), Maine's midcoast to Modivcare and Dauphin County, Pennsylvania to rabbittransit (July 1), Colorado's nine Denver-metro counties to MediDrive (July 1), Montana statewide to Modivcare (Oct 1) and Virginia fee-for-service to MTM Health (Oct 1). At the health plan level: Healthy Indiana Plan and Hoosier Healthwise members of Anthem, CareSource and MHS to WellTrans after MDwise and its broker, Modivcare, left (Jan 1); UnitedHealthcare Community Plan in Texas to SafeRide Health and in Nebraska, North Carolina and Hawaii to MTM Health (Jan 1); Nevada's rural CareSource and SilverSummit members to SafeRide (Jan 1); UnitedHealthcare in Florida to MTM and in Virginia to SafeRide (Mar 1); Aetna Better Health of Virginia to MediDrive (Apr 1); California's IEHP in-house (May 12); Blue Cross and Blue Shield of Texas and Blue Cross Community Health Plans in Illinois to MTM Health, and Molina Healthcare of Michigan to SafeRide Health (Oct 1). Pending: DC, where Verida's award is frozen by MTM's protest and MTM is extended through Dec 31, 2026; Blue Cross and Blue Shield of New Mexico to MTM Health on Nov 1, 2026; every Colorado trip through MediDrive from Jan 1, 2027; Michigan's fee-for-service broker rebid, with service from Aug 1, 2027. When a broker changes, credentialing doesn't carry over: call the incoming broker's provider relations the week it's announced, be ready for lower rates at first, and keep running for the current broker until the switch).

### Private pay

- How to succeed in private pay: an NEMT discussion: https://duetinc.com/duetblog5_privatepaywebinar (Webinar with digital marketing expert Harry Chambers on assessing the private-pay market, attracting clients, and retaining them through smart digital marketing).
- What Google Ads Cost a NEMT Company, Per Caller: https://duetinc.com/nemt-google-ads-cost (What Google Ads cost a NEMT company as of October 2026, from the campaigns Duet runs: a click usually costs $2 to $3, and about $10 to $20 of ad spend brings one interested caller (Google's Keyword Planner puts the average click higher nationally, about $4.64 for "wheelchair transportation" and $5.94 for "medical transportation"). Before spending, have a page for each service with a phone number people can tap, call tracking, someone who answers within about two minutes and a price you can defend, in a market of about a million people for steady calls. Budget for at least 30 interested callers in the first month, about $20 a day, which Google caps at $608 a month (30.4 times the daily budget); if 30% book, each new rider costs about $33 to $67 in ads. Bid on the services you run and block Medicaid, broker names, free rides, jobs and how-to-start searches ("medicaid transportation" draws about 8,100 searches a month at about $5.16 a click). Judge the cost per caller after a month, count new riders and their repeat rides at 60 to 90 days, and judge the return over a year. Facebook ads reach an audience you pick, whether or not they're looking for a ride. Give every booked rider your own number, because a Google forwarding number stops routing calls 60 days after a caller's last call).
- The 5 Must-Haves for an NEMT Website: https://duetinc.com/nemt-website-must-haves (built on the podcast episode with digital marketing expert Harry Chambers: what a private-pay family checks in the first 20 seconds, the headline formula of service plus city, a mobile-first layout, the five must-haves of stated service levels, a services page, live embedded reviews, real photos, and a short quote form, the rule for whether to post prices, the 30-minute quote-response target, and building it yourself versus hiring an agency).
- 98% of private-pay customers Google you before they call: https://duetinc.com/duetblog22_googleprivatepay (Learn how NEMT operators can grow private-pay bookings with better websites, Google visibility, reviews, and local SEO).
- How to triple private pay trips with a killer digital presence: https://duetinc.com/duetblog12_digitalmarketing (ESSIO Digital's Lana Becker on growing online NEMT bookings through web design, SEO, and Google Ads — the playbook that drove 350% revenue growth).

### Facility contracts

- NEMT Cold Calling Script for Facilities: What to Say: https://duetinc.com/duetblog18_coldcalling (a cold calling script for NEMT owners phoning nursing homes, rehabs and hospitals, built on podcast episode 14 with Christopher Buell: ask the front desk for the person who sets up transfers, ask permission before faxing or emailing information, get a name, call back two or three days later by name, ask for a short meeting, answer 'we already have someone' by asking to stay in their back pocket, and call every 'not now' again in three to six months because the person in that job may change).
- How to Get Your First Trip From a Facility Meeting: https://duetinc.com/first-nemt-trip-from-facility (what to bring, the service-agreement ask, why facilities go quiet after saying yes, who actually books rides, and how the first trip gets graded).
- How to Turn Your NEMT Drivers Into Your Sales Force: https://duetinc.com/duetblog27_driversalesforce (NEMT coach Marqus Johnson on hiring drivers for soft skills, paying commissions on the facility business they generate, and giving top drivers a region to run).

### Operations & money

- How to Reduce NEMT No-Shows (and Prove the Ones You Can't): https://duetinc.com/how-to-reduce-nemt-no-shows (how to reduce NEMT no-shows: private-pay riders confirm by paying at least 24 hours before pickup (no payment, no car; some operators also take a small nonrefundable deposit at booking), facility trips take one call to the front desk for the whole day or none, with no-show terms written into the facility's service agreement, and broker riders get a day-before confirmation on the phone they answer (call landlines, text riders who read texts, call a facility's nurse or caregiver once for all its residents); call past no-shows and unreached riders again the morning of, check the broker contract before holding back a van for a rider who never answered, and have drivers knock, wait the broker's full 10 or 15 minutes (counted from the scheduled pickup or arrival, whichever is later), call, and record the no-show before leaving; brokers almost never pay for no-shows, federal Medicaid rules bar charging riders for them, and Indiana's May 2026 state report put rider no-shows at 0.7% of scheduled rides against 7.6% cancellations).
- The Trip You Haven't Booked Yet: https://duetinc.com/duetblog24_reservation (The messiest part of NEMT dispatch deserves its own feature: how Duet's Reservations helps dispatchers handle interruptions and price shoppers).
- Do You Dispatch Or Schedule?: https://duetinc.com/duetblog2_dispatching (Real-time dispatching beats static scheduling for NEMT profitability. How dynamic optimization cuts idling, lifts vehicle utilization, and grows margins).
- Driver Management Made Easy: https://duetinc.com/duetblog1_drivermanagement (Schedule shifts, track clock-in/out by GPS, manage appointments, and automate payroll reports — how Duet makes NEMT driver management effortless).
- The EASIEST way to Cash In on Stretcher Trips: https://duetinc.com/duetblog16_brodachair (Broda's Ed Bandas on the Traversa chair — switch between wheelchair and stretcher modes to unlock dual-service trips in any state).
- How the largest EV fleet in NEMT saves money with electric vehicles: https://duetinc.com/duetblog11_evfleet (LEAP Institute's Rey Leon on running the largest electric-vehicle fleet in NEMT — operational benefits, cost savings, and what scales (and what doesn't)).
- How to pick the best NEMT vehicles: https://duetinc.com/duetblog7_nemtvehicles (Choosing and financing NEMT vehicles with industry vet Michael Shank: full-size vs minivan, new vs used, rear vs side entry, and lease/loan tradeoffs).
- How to Lower NEMT Insurance Premiums: https://duetinc.com/duetblog20_nemtinsurance (Commercial broker John Kecskes on cutting NEMT insurance costs: underwriting factors, claims management, telematics discounts, and renewal-timing strategy).
- The $20,000 NEMT Trip — How to Do Long Distance: https://duetinc.com/duetblog26_longdistancetrip (Jeanine of SailorGirl Transport on multi-day, cross-state senior moves: vehicles, crews, regulations, pricing, and referral sources for long-distance NEMT).
- High-Volume vs. High-Margin NEMT: Choosing the Right Business Model for Your own company: https://duetinc.com/duetblog23_volumevsmargin (Learn whether a high-volume or high-margin NEMT business model is right for you — and how to build your entire operation around a clearly defined strategy).
- How to PRICE NEMT trips to maximize revenue: https://duetinc.com/duetblog17_nemtpricing (Podcast from Duet: How to PRICE NEMT trips to maximize revenue).
- 30% margin and more: how to profitably grow an NEMT service: https://duetinc.com/duetblog10_highmarginnemtgrowth (Rachel Scholler on profitable NEMT growth: pricing vs volume, picking trip sources, trimming overhead, and using driver retention as a hidden margin lever).
- Fuel cards: cut NEMT expenses by 10%+: https://duetinc.com/duetblog9_fuelcards (CarIQ Pay's Khalid El-Awady on using fuel cards to cut NEMT operating costs 10%+ through discounts, spend analytics, and fraud prevention).
- Reporting And Billing Are Vital To Your Cash Flow Management: https://duetinc.com/duetblog3_cashflow (Why billing and reporting are vital to NEMT cash flow. Cover costs, balance high-margin trips, and accelerate invoice-to-payment with the right software).

### Comparisons and rankings

- 2026 NEMT dispatch software comparison, ranked and scored: https://duetinc.com/best-nemt-dispatch-software (Duet vs RouteGenie, Bambi, MediRoutes, CTS TripMaster, Simpli, RoutingBox).
- Duet vs RouteGenie head-to-head: https://duetinc.com/duet-vs-routegenie (usage pricing vs per-vehicle plus add-ons, day-one usability vs training classes, growth services vs software alone; prices dated and sourced).
- Duet vs Bambi head-to-head: https://duetinc.com/duet-vs-bambi (usage pricing vs flat $69 per active vehicle, included 24/7 AI phone agent vs dispatch-board-only AI, growth services vs dispatch software alone).
- Duet vs MediRoutes head-to-head: https://duetinc.com/duet-vs-mediroutes (no base fee and loaded-time-only metering vs base fees plus per-trip billing where no-shows bill too; modern platform vs 2008-era incumbent).
- Duet vs CTS TripMaster head-to-head: https://duetinc.com/duet-vs-cts-tripmaster (published usage pricing vs quote-based, private-operator focus vs county-transit compliance DNA).

### Other guides

- Best Patient Transport Scheduling Software (2026): https://duetinc.com/best-patient-transport-scheduling-software (Ryde Central first for hospitals, transfer centers, and nursing facilities that send ambulance, stretcher, wheelchair, and rideshare trips to a roster of vendors, with medical-necessity paperwork built in; Duet's free facility portal second for facilities whose trips are wheelchair, stretcher, and ambulatory rides with local NEMT providers; then Roundtrip, VectorCare, Ride Health, Kaizen Health, and the booking portals inside providers' dispatch software; ranked, not scored, on cost to the facility, levels of service, booking effort, visibility, provider reach, and integrations and paperwork).

## Contact

- Website: https://duetinc.com
- Book a demo: https://calendly.com/duet-nemt/meet
- Sales: +1 650 780 3465 · Support: +1 408 549 7081