Overview | FTA Programs Eligible for NEMT | FTA Technical Assistance Centers | Resources

Overview

Non-emergency medical transportation (NEMT) consists of providing transportation to individuals for the purposes of receiving medical and health care. Millions of Americans, particularly those requiring regular access to medical services, such as older adults or people with disabilities, rely on NEMT. A lack of access to NEMT can result in delayed care and poorer health outcomes. This webpage serves to consolidate information about using Federal Transit Administration (FTA) funding for NEMT.

FTA is one of several Federal agencies with programs that may fund NEMT. FTA leads the Coordinating Council on Access and Mobility (CCAM), a federal interagency council that works to coordinate funding and provide expertise on human services transportation. The CCAM focuses on federal programs that are able to provide funding for human services transportation for one or more of the CCAM’s three targeted populations: people with disabilities, older adults, and individuals of low income.

Two CCAM members who fund NEMT include the U.S. Department of Veterans Affairs (VA) and the U.S. Department of Health and Human Services (HHS). The VA provides NEMT services to certain veterans. HHS, via the Centers for Medicare and Medicaid Services (CMS), oversees the Medicaid Program, which provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements. The program is funded jointly by states and the federal government. Medicaid NEMT is a critical service that assists Medicaid beneficiaries with accessing covered Medicaid services and has a direct impact on health outcomes.

FTA Programs That May Fund NEMT

As of April 2025, NEMT activities are eligible to be funded from the following seven FTA programs.

*Per FTA’s 5010.1F Circular, capital projects may include purchasing or leasing equipment, such as a bus or other vehicle, and leasing a public transportation facility—view more activities in 49 U.S.C. 5302(4). Operating expenses include costs needed to operate, maintain, and manage a public transportation system, such as driver salaries and fuel.

**Per 49 U.S.C. § 5302(4)(I), eligible capital projects include the provision of nonfixed route paratransit transportation services in accordance with the ADA (42 U.S.C. § 12143) for amounts not to exceed 10 to 20 percent of the recipient’s annual formula apportionment under Urbanized Area Formula Grants (Section 5307) and Formula Grants for Rural Areas (Section 5311).

***Per FTA’s 9070.1H Circular, the Federal share is 85 percent for the acquisition of vehicles that comply with the CAA or are accessible to people with disabilities. The Federal share is 90 percent for vehicle-related equipment or facilities that comply with the CAA or are accessible to people with disabilities.

Here are examples of FTA recipients that have elected to use FTA funding under multiple programs to assist their communities with NEMT-related activities:

• In Flint, Michigan, Mass Transportation Authority (MTA) has used FTA funds from multiple programs, including Section 5307, 5310, and 5339, to support the MTA Rides to Wellness program. This comprehensive NEMT service offers mobility management, door-to-door service, and same-day transportation for medical, health, grocery, and wellness appointments, as well as expanded services for veterans. The service is available to residents of MTA’s service area, regardless of their specific needs.
• In the Arrowhead region of northern Minnesota, the Bois Forte Band of Chippewa received FTA funds from multiple programs, including FTA Sections 5310, 5311, and 5311(c)(2), to purchase vehicles and provide dial-a-ride service, including NEMT.

FTA Technical Assistance (TA) Centers

In 2025, FTA launched the new Coordinating Council on Access and Mobility Technical Assistance Center (CCAM-TAC). The CCAM-TAC’s mission is to promote and facilitate human services transportation, public transit, and NEMT coordination that advances people’s access to everyday destinations. The CCAM-TAC NEMT webpage includes NEMT State-by-State profiles and case studies. The Centers for Medicare and Medicaid Services (CMS) is one of the Center’s seven federal CCAM-TAC agency partner advisors and will provide expertise to help the CCAM-TAC disseminate information on NEMT, to include examples of coordination between state Medicaid agencies, state Departments of Transportation, transit associations, and public transit agencies, and address related TA inquiries.

FTA also funds the following three TA centers that have awarded community grants used for NEMT. View this FTA webpage to learn more about FTA-supported TA center community grants.

• National Aging and Disability Transportation Center (NADTC) (awards community grants annually)
  • An example of NADTC’s community grants is the 2020 Innovations in Accessible Mobility Grants. These grants awarded $284,898 in competitive grants to communities in 10 states—Alabama, California, Idaho, Kansas, Minnesota, New Mexico, New Hampshire, South Carolina, Virginia, and Washington state—to implement innovative projects that will remove barriers to transportation and expand mobility options for older adults and people with disabilities. The 10 grantees each received grants of up to $30,000 to fully launch transportation programs that address the needs of older adults and people with disabilities living in their communities.
    • Grantee Highlight: In Ketchum, ID, Mountain Rides Transportation Authority, one Innovations in Accessible Mobility 2020 grantee, established a new fixed-route NEMT bus service that connected the rural communities in south-central Idaho to essential services in Twin Falls.
       
• National Center for Mobility Management (NCMM) (awards community grants annually)—please note, NCMM’s cooperative agreement with FTA is ending in 2025 and the new CCAM National TA Center will replace this center.
  • An example of NCMM’s community grants is the 2019 Healthcare Access Ready-to-Launch Grants. These grants, of up to $75,000, supported pilot projects to improve residents’ access to healthcare services through expanded transportation options. Each community created a detailed “operations manual” for the implementation of these pilots and continued to test the financial feasibility, operational viability, and customer desirability of the solutions through proof-of-concept launches.
    • Grantee Highlight: In Colorado Springs, CO, one Healthcare Access Ready-to-Launch Grantee, Envida, implemented a limited launch of a demand-responsive transportation solution that reduced barriers to care and rider anxiety, identified affordable and effective transportation options, and lowered healthcare costs. Envida’s solution reduced barriers to schedule and travel to appointments and reduced lost opportunity costs for providers due to no shows and cancellations.
       
• National Rural Transit Assistance Program (National RTAP) (awarded community rides grants in 2021)
  • National RTAP’s 2021 Community Rides Grant Program offered recipients and sub-recipients of FTA's Formula Grants for Rural Areas and Tribal Transit Programs the opportunity to apply for grant awards of up to $100,000 for projects that develop or strengthen transportation partnerships that improve social determinants of health in rural and tribal communities. Projects focused on increasing access to critical needs such as employment, healthcare, education, healthy food, or social services, as well as build the capacity of transit programs.
    • Grantee Highlight: In Michigan, one Community Rides grantee assisted public transportation systems to build the Rides to Wellness Program for NEMT and other services by collaborating with over 20 partners. The project added more rides for individuals in Michigan, even across county lines.

Resources

See below for relevant NEMT resources.

• Medicaid Transportation Coordination Fact Sheet
  • CMS and FTA created this Medicaid Coordination Fact Sheet to guide transportation coordination between state Medicaid agencies and state departments of transportation. In 2023, CMS issued the Medicaid Transportation Coverage Guide to serve as a comprehensive source of Medicaid transportation policy, providing a one-stop shop of guidance on federal requirements and state flexibilities. Building upon the guide, this fact sheet helps clarify and encourage partnership at the state level and includes commonly asked questions and relevant resources.
     
• CCAM Program Inventory
  • The CCAM Program Inventory identifies more than 130 federal programs that may provide funding transportation for people with disabilities, older adults, and/or individuals of low income. The CCAM Program Inventory includes detailed program information, and is used by State and local partners across the country to find information on programs that may fund human services transportation, to include the specific types of eligible transportation activities. In accordance with the 2023 – 2026 CCAM Strategic Plan, the program inventory includes information on NEMT eligibility, local match requirements, and Federal fund braiding eligibility for each respective program. Additional information on Federal fund braiding to meet local match requirements can be found in the updated CCAM Federal Fund Braiding Guide on the CCAM webpage.
     
• Transportation Technical Assistance Center Library (TACL)
  • TACL provides a sustainable methodology and platform for access and findability of coordination resources across a diverse range of transportation TA centers and FTA. TACL was launched in January 2021 and is available at no cost. The following TACL resources are related to NEMT. Visit TACL to find additional relevant resources.
    • Transportation Research Board (TRB) Transit Cooperative Research Program (TCRP) Report: Handbook for Examining the Effects of Non-Emergency Medical Transportation Brokerages on Transportation Coordination (2018)
      • This handbook provides background information and describes the different models available to states for providing NEMT for Medicaid beneficiaries. The handbook also discusses why human services transportation and public transportation providers encourage coordination of NEMT with other transportation services.
    • TRB TCRP Report: Guidebook and Research Plan to Help Communities Improve Transportation to Health Care Services (2021)
      • This guidebook details how to initiate a dialogue between transportation and health care providers as well as subsequent actions and strategies for pursuing a partnership and implementing transportation solutions appropriate for patients.
    • Health Care Providers Working to Streamline Transportation Services for Patients – NCMM Blog 
      • Healthcare providers across the U.S. have begun offering no-cost transit services to ensure that individuals are not delaying medical care because of limited transportation options. Whether it’s operating their own transportation services for patients or partnering with local public transit authorities and outside companies, these providers are working to tackle the transportation-related disparities that keep too many patients from adequately addressing their medical needs.
    • Rides to Wellness Demonstration Grants Program Evaluation
      • To help address transportation challenges to access non-emergency medical care, the FTA published a Notice of Funding Opportunity in Fiscal Year 2016 seeking proposals for its Rides to Wellness Initiative, a program that provided funding to transit agencies and other entities to help finance innovative pilot projects that would improve access to healthcare by fostering partnerships between healthcare and transportation providers. The purpose of the demonstration grants was to identify and test promising, replicable solutions that would achieve the following goals:
        • Increased access to care.
        • Improved health outcomes.
        • Reduced healthcare costs.
      • This evaluation report includes an overview of the Rides to Wellness Initiative, profiles of each demonstration project including project outcomes and lessons learned, and findings and recommendations.
    • Transportation to Support Rural Healthcare Overview - Rural Health Information Hub
      • This guide focuses on how communities can provide transportation services to support access to rural healthcare, which may also benefit healthcare providers by decreasing burden on emergency medical services, improving utilization of healthcare services, decreasing no-show rates, and increasing access to health-supporting services. 
      • The guide also highlights transportation as a community-based service that can allow the elderly and people with disabilities to live successfully in a community rather than entering a long-term care facility or needing to leave the community.

Back to top

This guidance document is not legally binding in its own right and the Federal Transit Administration will not rely upon it as a separate basis for affirmative enforcement actions or other administrative penalty. Conformity with this document (as distinct from existing statutes and regulations) is voluntary only, and nonconformity will not affect rights and obligations under existing statutes and regulations.