Nebraska - Adult Health Transportation — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

The Nebraska Department of Health and Human Services (DHHS) Division of Medicaid and Long-Term Care enrolls Non-Emergency Medical Transportation (NEMT) providers under three distinct specialties—Individual (96), Commercial (95), and PSC Exempt (94)—to serve fee-for-service beneficiaries and participants in the Aged and Disabled (AD) Waiver.

Commercial NEMT agencies must secure passenger carrier certification from the Nebraska Public Service Commission (PSC) before Maximus will process their Medicaid enrollment application. Once enrolled through the Nebraska Medicaid Provider Screening and Enrollment portal, providers must contract with Heritage Health managed care organizations or the state's designated transportation broker to receive trip assignments and reimbursement.

1. Service Definition and Scope

In Nebraska, Non-Emergency Medical Transportation (NEMT) provides appropriate medical transportation to Medicaid-eligible clients traveling to covered appointments and waiver services.

The service is delivered through a mix of fee-for-service arrangements coordinated by state transportation workers and managed care networks overseen by Heritage Health plans.

• Service Name: Non-Emergency Medical Transportation (NEMT) or Non-Emergency Transportation (NET).
• Covered Expenses: Transportation, and medically necessary escort services (including meals and lodging if applicable per 42 CFR 440.170).
• Provider Specialties: Individual NET (96), Commercial NET (95), and PSC Exempt (94).
• Waiver Inclusion: Utilized by participants in the Aged and Disabled (AD) Waiver and Traumatic Brain Injury (TBI) Waiver.

2. Regulatory and Oversight Agencies

The Nebraska DHHS Division of Medicaid and Long-Term Care sets the overarching policy and fee schedules for the NEMT program.

The Nebraska Public Service Commission (PSC) regulates commercial passenger carriers, while Maximus operates the state's Medicaid enrollment portal.

• Medicaid Authority: Nebraska DHHS Division of Medicaid and Long-Term Care (https://dhhs.ne.gov/Pages/Medicaid-and-Long-Term-Care.aspx).
• Carrier Regulation: Nebraska Public Service Commission (https://psc.nebraska.gov/transportation/passenger-carriers).
• Enrollment Vendor: Maximus Nebraska Medicaid Provider Screening and Enrollment (https://www.nebraskamedicaidproviderenrollment.com/).
• Managed Care Program: Heritage Health (https://www.nebraskaheritagehealth.com/).

3. Gatekeeping Prerequisites: Who Can Even Apply

Nebraska imposes strict structural prerequisites based on the provider's operational model before Medicaid enrollment can begin.

Commercial entities must hold active state transportation authority, and individual providers are restricted in how they can structure their tax identity.

• Commercial Prerequisite: Active Public Service Commission (PSC) passenger carrier certification is required prior to Medicaid enrollment for Specialty 95.
• Exempt Prerequisite: A formal PSC Exempt Letter is required for Specialty 94 and must be uploaded during initial data entry in the Maximus portal.
• Individual Restriction: Specialty 96 providers must enroll using a Social Security Number; Employer Identification Numbers (EINs) are strictly prohibited.
• MCO Contracting: Providers must be fully enrolled via Maximus before they can be credentialed and reimbursed by Heritage Health MCOs.

4. Licensure and Certification Requirements

Nebraska DHHS does not issue a distinct "NEMT license." Instead, commercial providers must obtain Common Carrier Certification from the PSC.

This certification ensures compliance with state vehicle safety standards, insurance minimums, and operational regulations.

• Authority Type: Public Service Commission (PSC) Common Carrier Certification.
• Vehicle Standards: Must comply with Nebraska Department of Roads and PSC safety regulations.
• Safety Restraints: Mandatory compliance with Neb. Rev. Stat. §60-6,267 and 60-6,268 for car seats and booster seats.
• Smoking Ban: Smoking is strictly prohibited in vehicles when transporting Medicaid clients.

5. Medicaid Provider Enrollment

All NEMT providers must apply through the Maximus-operated Nebraska Medicaid Provider Screening and Enrollment portal.

Unlike most HCBS providers in Nebraska, NEMT providers are exempt from the federal NPI mandate, though they may supply one if they choose.

• Portal: Nebraska Medicaid Provider Screening and Enrollment portal (https://www.nebraskamedicaidproviderenrollment.com/).
• NPI Exemption: NEMT providers (Specialties 94, 95, 96) are allowed but not required to obtain a National Provider Identifier (NPI).
• Required Form: Nebraska Service Provider Agreement Non-Emergency Transportation Addendum (Form MC-19 Addendum).
• Revalidation: Required every 5 years under 42 CFR 455, Subpart E.

6. Staffing, Training and Background Checks

Nebraska requires comprehensive annual background screenings for all NEMT drivers and escorts.

Providers are responsible for obtaining these checks and ensuring Maximus receives the results, as inter-agency data sharing is not automatic.

• Registry Checks: Nebraska Child/Adult Abuse and Neglect Central Registry (results must be under 6 months old at submission).
• Sex Offender Check: State Patrol Sexual Offender Registry (SOR) clearance required.
• Driving Record: Driver's license must be active with fewer than 3 points.
• Data Exchange: Nebraska Data Exchange Network (NDEN) screening required annually.

7. Documentation, Policies and Records

NEMT providers must maintain precise trip logs that verify the client's presence and the route taken.

Agencies must also keep their provider agreement profiles continuously updated with Maximus to avoid claim rejections.

• Trip Routing: Must document the most direct, safe, and logical route from origination to destination.
• Client Presence: Billing records must prove the program-eligible client was physically in the vehicle during the billed time.
• Background Records: Providers must ensure Maximus has copies of self-checks, as inter-agency results are not automatically shared.
• Agreement Updates: Must maintain current name, address, taxonomy, and banking info on the provider agreement.

8. Billing, Rates and Claims

Fee-for-service claims are processed directly by the state, while managed care claims are routed through Heritage Health MCOs or their designated brokers.

Providers must ensure their billed rates do not exceed their customary charges to the general public.

• Rate Ceiling: Billed rates shall not exceed the amount charged to private payers.
• Fee Schedule: Governed by the DHHS MLTC Non-Emergency Transportation Fee Schedule.
• Retroactive Billing: Retro enrollment dates over 180 days require written justification and DHHS approval.
• MCO Alignment: Practice locations and taxonomy codes must perfectly match between Maximus and the MCO to avoid claim rejections.

9. Approval Sequence and Timeline

The approval process is strictly sequential, beginning with state transportation authority and ending with MCO contracting.

Applicants are strongly encouraged to use the online portal, as paper applications significantly delay processing times.

• Step 1: Obtain PSC Common Carrier Certification or a PSC Exempt Letter.
• Step 2: Complete background checks (Abuse Registry, SOR, DMV) ensuring results are less than 6 months old.
• Step 3: Submit the online application via the Maximus portal.
• Step 4: Contract with Heritage Health MCOs and/or transportation brokers.

10. Common Denials and Survey Findings

Enrollment delays frequently occur when providers fail to upload required prerequisite documentation or submit stale background checks.

Post-enrollment payment issues typically stem from data mismatches between the state portal and MCO credentialing files.

• Missing PSC Proof: Failure to upload the PSC Exempt Letter for Specialty 94 during data entry.
• Stale Backgrounds: Submitting Child/Adult Abuse Registry checks older than 6 months.
• Point Violations: Drivers having 3 or more points on their active driver's license.
• MCO Mismatch: Discrepancies between Maximus enrollment data and MCO credentialing files.

11. Key Contacts and Resources

Providers should direct enrollment portal questions to Maximus and transportation authority questions to the PSC.

Retroactive enrollment requests require direct coordination with the DHHS Medicaid Retro Program.

• Maximus Customer Support: 844-374-5022 or [email protected] (https://www.nebraskamedicaidproviderenrollment.com/).
• Nebraska PSC: Passenger Carrier Division (https://psc.nebraska.gov/transportation/passenger-carriers).
• DHHS Medicaid Retro Program: [email protected].
• Heritage Health: Managed Care program portal (https://www.nebraskaheritagehealth.com/).

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