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

Last reviewed: 2026-09-10

TennCare delegates the administration of Non-Emergency Medical Transportation (NEMT) and waiver-funded transportation services to two primary transportation brokers, Verida and Tennessee Carriers, alongside three Managed Care Organizations (MCOs). Providers seeking to offer waiver-specific transportation under the CHOICES, ECF CHOICES, or Katie Beckett programs must also complete the Department of Disability and Aging (DDA) credentialing process before MCO contracting.

Approval requires securing a network contract with at least one of these brokers or MCOs, as TennCare does not enroll independent NEMT providers directly for fee-for-service billing. A provider cannot operate or bill for these services in Tennessee without first passing broker vehicle inspections and proving network need in their target counties.

1. Service Definition and Scope

In Tennessee, Non-Emergency Medical Transportation (NEMT) covers shared, non-emergency rides for TennCare members to and from covered medical services. For members enrolled in Home and Community-Based Services (HCBS) waivers, transportation also includes non-medical community integration rides.

Trips must be scheduled at least two business days in advance through the member's assigned health plan broker. The service accommodates various mobility needs through different vehicle classifications.

2. Regulatory and Oversight Agencies

The Division of TennCare oversees the Medicaid program, setting the overarching rules for NEMT and managing the contracts with the MCOs. The Department of Disability and Aging (DDA) is responsible for credentialing providers who deliver services under the HCBS waivers.

Day-to-day compliance, dispatch, and vehicle inspections are managed by the contracted NEMT brokers and the MCOs.

3. Gatekeeping Prerequisites: Who Can Even Apply

Tennessee does not allow open enrollment for NEMT providers to bill Medicaid directly. An applicant is structurally blocked from operating unless a designated broker or MCO has an active need for transportation capacity in specific counties.

For waiver-specific transportation, providers must pass DDA credentialing before an MCO will offer a contract.

4. Licensure and Certification Requirements

The Tennessee Department of Health does not issue a specific facility or agency license for NEMT providers. Operating authority is instead granted through DDA credentialing and broker certification.

Providers must ensure their vehicles and drivers meet state commercial driving regulations and local business tax requirements.

5. Medicaid Provider Enrollment

Even though billing is routed through brokers and MCOs, transportation providers must register with TennCare to receive a Medicaid Provider ID.

This process is completed online and requires standard federal tax and disclosure documentation.

6. Staffing, Training and Background Checks

Drivers must meet strict background and training standards enforced by DDA and the transportation brokers.

Training covers safety, emergency response, and population-specific needs, with documentation maintained in driver files.

7. Documentation, Policies and Records

DDA and the brokers require specific policy manuals to be submitted during the credentialing phase.

Once operational, providers must maintain rigorous trip and vehicle records for audit purposes.

8. Billing, Rates and Claims

Billing is not submitted to TennCare directly; claims are processed through Verida, Tennessee Carriers, or the respective MCOs.

Rates are either negotiated with the brokers for standard NEMT or set by DDA fee schedules for waiver services.

9. Approval Sequence and Timeline

The approval process is sequential: business setup, DDA credentialing (if applicable), TennCare registration, and finally broker contracting.

The entire process can take 4 to 8 months, heavily dependent on broker network status and inspection scheduling.

10. Common Denials and Survey Findings

Applications are frequently rejected at the broker level due to closed networks in specific counties.

Post-approval audits focus heavily on driver qualifications and the accuracy of trip documentation.

11. Key Contacts and Resources

These official portals and agency pages are essential for submitting applications, registering for Medicaid, and contacting brokers.

Providers should monitor these sites for updates to fee schedules and credentialing requirements.

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