How to Start a NEMT Business in California

Thinking about starting an LLC in California? We’ve got all the details you need.

Begin by selecting a unique business name, appointing a registered agent, and filing your Articles of Organization with the California State Corporation Commission, which includes a $100 processing fee.

You can do this independently, consult with a business attorney for specialized legal guidance, or join the other 75% of our readers and hire a specialized California LLC formation service (recommended).

Zenbusiness (Starting at $0 Plus State Fees)

Northwest ($39 + State Fees)

What Is a NEMT Business?

NEMT Businesses, also known as non-emergency transportation businesses, are there to help people who don’t have emergencies get to their appointments. These can be medical appointments that help people visit their doctor for a checkup or appointments that take elderly people to events or meeting groups. Ultimately, the idea came about to help people who have trouble getting to their doctor’s appointments in a more affordable way than an ambulance. That said, they can also be used for other types of transportation, but this is rare.

Is Non-Emergency Medical Transportation a Good Business?

Yes, a non-emergency medical transportation business is a good business. The industry is projected to grow in the future, and there is already a lot of demand for this type of service. In fact, some sources suggest that the industry may grow by $15 billion from 2023 to 2031. This is enough growth for you to invest in the industry confidently.

The only drawback to a NEMT business is the cost of getting started. You have to obtain a non-emergency medical transportation license, which will cost money in each county, hire staff, and purchase vehicles. However, if you can afford the upfront costs, the venture will be well worth it.

How Much Does it Cost to Start a Non-Medical Transportation Business in California?

The cost of a NEMT business in California depends on several factors. First and foremost, it can depend on your location because you’ll need local licenses. For example, the cost of a business license in San Francisco differs from that of a business license in San Diego. That said, you can expect to pay around $12,000 to $30,000 when you first start. This will cover the licenses, non-emergency transportation licenses, and a vehicle.

However, if you plan on expanding or starting a larger company, you’ll need to invest in more staff and vehicles. A good dispatcher can cost more than $50,000 per year, and competitive drivers will also want more than $50,000 per year in California. This doesn’t factor in new and expensive vehicles, which can cost upwards of $100,000.

For these reasons, the cost fluctuates based on your needs, vision, and how you plan on approaching the business.

How to Start a NEMT Business in California in 6 Easy Steps

Starting a NEMT business in California isn’t challenging once you know the steps. Learn more about each step to start a NEMT business in California below. These steps are similar for any business you want to start in California.

Step 1: Come Up with a Business Plan

If you want to start a NEMT business in California, you need a plan. Without a plan, you won’t be able to get approval for licenses, purchase vehicles, or even spend your money properly. Ultimately, a plan is important because it lays out a step-by-step process for how your business will get started and generate money.

To create a business plan for a NEMT business, you should include the following information:

• An Executive Summary: an overview of your business, what your goals are, and the services you provide.
• Market Analysis: Include information about the market for NEMT work in California and how you plan to tap into it.
• Services: Include what you plan on offering people and who you plan on helping with your NEMT business.
• Pricing: Plan out how much it will cost to run the business and how much you need to charge clients.
• Marketing: Cover how you will market your NEMT business to people who need it.
• Sales: Outline your plan for building relationships and closing deals with clients.
• Type of Business: Cover the legal structure of your business; is it an LLC, partnership, or sole proprietorship?
• Financial Plan: Include how much you’re planning to make in the first year, the amount of debt you’ll have, and growth projections

For a NEMT business, you might also want to cover the licenses you need, the cost of vehicles, and other information you have about the business.

Step 2: Choose a Registered Agent in California

If you’ve decided to establish your business as an LLC or corporation in California, your next important task is to select a registered agent. This is a required step when you’re preparing your Articles of Organization, the document necessary to officially register your LLC or corporation with the California Secretary of State.

So, what does a registered agent do? A registered agent is a person or business entity designated to receive important documents on behalf of your business, such as tax forms, legal notices, lawsuits, and official government communications. Essentially, the registered agent serves as the main point of contact between your business and the state.

Who is eligible to be a registered agent? The registered agent must be either a resident of California or a corporation authorized to do business in the state, such as a registered agent service. If you want to act as your own registered agent, you must designate an individual within your company, as California law prohibits business entities from serving as their own registered agents.

For more information on the requirements for registered agents in California, refer to the California Corporations Code.

Don’t forget that to run a business, you need to: register a business entity (LLC is the most suitable option, more details here), obtain an EIN (you can apply online here), open a business bank account (more details here), understand accounting and taxes (more details here), and register a domain and create a website (this is optional, you can do it here).

Alternatively, you can delegate all of this to a registered agent starting from $0 + State Fees and get everything done in 1 day. This can save you time and ensure everything is done correctly, leaving you to focus on growing your business.

Apply Online

Step 3: NEMT Requirements and Permits

Next, it’s important to focus on any requirements or permits you might need for a NEMT business. This is a specific type of business, so you’ll need a unique business license as well. Learn more about the requirements and permits you need for a NEMT business below.

• Register Your Business: Register your NEMT business with California’s Secretary of State. You need to register the name, and we recommend getting any associated online property (domains).
• Insure Your Business: To avoid liability and protect your assets, you need business insurance. You’ll also need insurance for each vehicle.
• California Business License: Every city or county requires a business license to operate a NEMT business or any type of business. Fill out the business license application for the areas you plan on operating in.
• Fill out the non-emergency transportation provider application.
• Adhere to Vehicle Guidelines: There are specific laws for how a NEMT vehicle needs to operate. Learn about the regulations in your area and follow them.

An important part of owning a NEMT business is helping the elderly and disabled, so it doesn’t hurt to get your Medi-Cal certification. If you want to service people who use this insurance, you’ll need to get the certification and become a Medi-Cal provider. It’s similar to the non-emergency transportation provider application.

Step 4: Building Your Vehicle Roster

Once you have the approval and permits to begin your NEMT business, you need vehicles to transport people. All of the vehicles need to follow NEMT safety guidelines and other California requirements. Learn about what you need to build your roster below:

• Vehicles: You should get a few vehicles to start, and ensure you get a variety of vehicles. Options include wheelchair-accessible vans, stretcher vans, buses, and much more. Vehicle type will vary based on your client’s needs and we recommend niching down at first.
• Safety: California has safety standards for NEMT vehicles that include securement systems, proper safety restraints, and guidelines for the proper medical equipment. Make sure your vehicles are up to code.

Safety is very important, but you also need to maintain your vehicles. Some NEMT businesses have their own mechanics, but when you start, it’s a good idea to deal with a local mechanic for quick and affordable repairs.

Step 5: Contracting

When you start a NEMT business, you need to have the proper systems in place for contracting with insurance companies, hospitals, and much more. Who you work with depends on your clientele and preferences, but we have some tips to help you below:

• Contact doctor’s offices, hospitals, and other healthcare providers to see if patients need help making appointments.
• Reach out to insurance agencies to see if you can save money for them and their clients with your transportation.
• Get in touch with local governments to see if you can assist with non-emergency ambulance calls to free up ambulance assistance for others.
• Come up with a payment structure that’s easy to sign up for or for customers to pay .

These are only a few things you can do to get off to a good start. We recommend contacting individuals and other people you may know in the healthcare industry to see if there are more opportunities available.

Step 6: Hire Staff

A NEMT business isn’t something you can do on your own. While you could try, it wouldn’t be very effective because you’d only have yourself and one vehicle to handle all calls, transportation, and bookkeeping. Therefore, it’s important to hire the following staff:

• Drivers: You want qualified drivers with experience in the NEMT or adjacent industries. This is because they need first aid and CPR certifications to drive for a NEMT business.
• Dispatchers: You’ll want someone to handle incoming calls, schedule transportation, and speak with the drivers.
• Bookkeepers: Every business should have someone looking over the financial side to avoid tax problems and poor money management

When hiring your staff, it’s important to train them as well. Many drivers and dispatchers for a NEMT business will already have experience, but you need to make sure they fit into your business and operate the way you need them to.

Tips for Starting a NEMT Business in California

NEMT businesses aren’t hard to start, but if you want to be successful, you must be good at what you do. To help you excel, we have some tips to help you start a NEMT business in California.

Marketing Tips

The most important part of creating a business is marketing. Helping people will generate revenue, but you have to reach an audience. Learn about some of our marketing tips for starting a NEMT business below:

• Register a domain that matches your company name and create a website. We also recommend purchasing all similar domains or domains that include variations of your name to avoid problems.
• Advertise online with Google ads or use an SEO company or consultant to appear in search results for your area.
• Visit places where people who need your services will be and post about what you offer in local newspapers.
• Use social media to your advantage.
• Build relationships with people in your area.

We also recommend doing a lot of research before starting your NEMT business to avoid any problems.

Quality and Improvement Tips

Once your NEMT business is off the ground, that doesn’t mean you can sit back and relax. Now, it’s time to take things to the next level. Follow the tips below to improve your NEMT business.

• Evaluate the performance of your staff, promote from within, and expand your vehicle and staff roster
• Continue to train your staff to ensure that they’re following the most accurate information and best practices
• Remain compliant with state and local regulations
• Hire compassionate people who can be passionate about people who have mental or physical disabilities

NEMT businesses can be a lot of work, but if you follow the tips we covered, you shouldn’t have any issues with growth.

Understand NEMT Vehicle Requirements

The last tip that we have for you is to understand every single NEMT vehicle requirement. This will protect your business and ensure that you remain compliant. The NEMT vehicle requirements you need to know are:

• Each vehicle needs a vehicle identification number
• Have the vehicle’s make, model, and year
• License plate number
• Copies of insurance and registration
• Compliance with the Americans with Disabilities Act (ADA)
• Emergency medical equipment
• Proper restraints
• One extra wheelchair
• Compliance with California Occupational Safety and Health Administration standards
• Securement systems for wheelchairs

Make sure you maintain these requirements and have your vehicles inspected to prevent problems.

Start a NEMT Business in California Today!

NEMT Businesses are a great way to help the community and turn a profit at the same time. While the cost to start a NEMT business can vary depending on how many vehicles you need and the number of cities you plan on entering, there is plenty of opportunity in California, and you can make a lot of money as you expand. Always remember to remain compliant with Medi-Cal regulations, California state laws, and the Americans with Disabilities Act (ADA) for the best outcomes.