Georgia Medicaid NEMT (2026): Broker, Booking, and Appeals

A Medicaid card by itself is not always enough to get a person to a doctor's appointment. Georgia Medicaid NEMT, the state's non-emergency medical transportation benefit, exists to close that gap. For an 82-year-old widow in Albany who no longer drives, a dialysis patient in Macon who needs to reach the Davita center three times a week, or a parent in Valdosta whose child has a specialty appointment at a children's hospital in Atlanta, the transportation problem can be as serious as the underlying health problem.

Federal Medicaid law solves that problem with a benefit called Non-Emergency Medical Transportation (NEMT). Under 42 CFR 431.53, every state Medicaid plan must ensure necessary transportation for beneficiaries to and from providers, and 42 CFR 440.170(a) defines that transportation as a covered service. The Consolidated Appropriations Act, 2021 wrote the requirement directly into statute (42 U.S.C. 1396a(a)(4)), so NEMT is now a mandatory Medicaid benefit codified in the Social Security Act, not only in regulation.1

Georgia administers NEMT through a statewide broker. Effective April 1, 2026, Verida (formerly Southeastrans) is the statewide Medicaid Transportation Broker for all five Georgia NEMT regions: North, Atlanta, Central, East, and Southwest. Verida arranges NEMT in every region under contract with the Department of Community Health.2 This guide explains how the broker model works, how to book a ride, who is eligible, what modes of transportation are available, what to do when something goes wrong, and how NEMT interacts with Georgia Families managed care, the HCBS waivers, the PACE program, and Medicare.

The federal NEMT mandate

Under 42 CFR 431.53, a state Medicaid plan must specify that the Medicaid agency will ensure necessary transportation for beneficiaries to and from providers, and describe the methods it will use to meet that requirement. 42 CFR 440.170(a) defines "transportation" as a covered service: expenses for transportation and related travel determined necessary by the agency to secure medical examinations and treatment for a beneficiary.1 The brokerage provision of the same regulation, 42 CFR 440.170(a)(4), describes the population a broker serves as members who need access to medical care and have no other means of transportation.4

For decades, NEMT existed in a peculiar regulatory space. It was sometimes treated as a covered service (eligible for federal financial participation as a medical service), sometimes treated as an administrative cost. The Consolidated Appropriations Act, 2021 (Public Law 116-260, Division CC, Section 209) resolved that ambiguity by amending Section 1902(a)(4) of the Social Security Act (42 U.S.C. 1396a(a)(4)) to require that the single state Medicaid agency ensure necessary transportation to and from providers. NEMT's mandatory status is now codified in the Act itself, not only in regulation.1

States may deliver NEMT through broker arrangements, ride-share platforms, public transit passes, mileage reimbursement, and managed care, but they may not eliminate it. Federal law sets the rules for the broker path: Section 1902(a)(70) of the Social Security Act (42 U.S.C. 1396a(a)(70)) and 42 CFR 440.170(a)(4) let a state establish a NEMT brokerage program under a competitively procured contract, selecting brokers through a competitive bidding process, in order to furnish rides more cost-effectively.4 Federal rules also let states either include NEMT in managed care capitation or run it through a separate broker. Georgia took the broker path.

How the Georgia broker model works

Georgia is divided into five NEMT regions, and as of April 1, 2026, all five are served by one statewide broker: Verida. DCH contracts the brokers and pays a broker a monthly capitated rate based on the number of eligible Medicaid members residing in its contracted region, so the broker's payment does not rise or fall with the number of rides an individual member takes.2 The broker subcontracts with local transportation providers who operate the vehicles and employ the drivers, and handles reservations, dispatch, mode determination, quality assurance, complaints, and reporting to the Department of Community Health (DCH).

Previously, the regions were split across more than one broker; before April 2026, Modivcare served the Central, Southwest, and East regions while Verida served North and Atlanta. As of April 1, 2026, Verida covers all five regions statewide. To confirm current reservation and contact information, contact DCH NEMT customer service or check the Georgia DCH NEMT webpage. Georgia's five regions cover:

• North: North and Northwest Georgia
• Atlanta: Metro Atlanta
• Central: Central Georgia
• East: Northeast Georgia and the East Central/Coast corridor
• Southwest: Southwest Georgia

If you are enrolled in a Georgia Families CMO

Georgia Families is Georgia's Medicaid managed care program, and it currently has three Care Management Organizations (CMOs): Amerigroup Community Care, CareSource, and Peach State Health Plan. WellCare is no longer a separate Georgia Families Medicaid CMO; a 2024 reprocurement that would have changed the slate remains in a bid-protest phase with no announced go-live date, and the current three-CMO contracts have been extended through June 30, 2027.3

Being in a CMO does not put you outside the NEMT broker system. DCH defines NEMT as transportation for any eligible Medicaid member with no other means of transportation available, to any Medicaid-reimbursable service, and Verida provides it in all five regions.2 So the practical rule for a CMO member is: start with the statewide broker, and have your Georgia Medicaid ID rather than your CMO ID card in front of you when you call, because the broker works from Medicaid enrollment.

DCH's public NEMT pages describe the benefit as broker-arranged and do not describe transportation as part of what a CMO is paid to cover, but they are also silent on whether an individual plan offers any transportation help of its own. If your plan advertises a transportation benefit, ask the plan directly what it covers on top of NEMT rather than instead of it.

For more on the CMO structure and what IS in Georgia Families capitation, see the Georgia managed care plans guide.

Three situations work differently:

• PACE participants: PACE provides its own transportation through PACE vans. PACE does not use the NEMT broker for PACE-coordinated trips.
• HCBS waiver members (EDWP, served through the CCSP or SOURCE model, and ICWP): medical transportation continues through the NEMT broker. Some non-medical transportation (e.g., to an adult day center) may be provided as a waiver service.5
• Medicare-only: under Original Medicare, Part B covers ambulance transportation, and only when traveling in any other vehicle could endanger your health, and only to the nearest appropriate medical facility. Some Medicare Advantage plans offer transportation as a supplemental benefit, and CMS's special supplemental benefits describe a transportation category for non-medical needs, such as grocery shopping or banking, for chronically ill enrollees. Dual-eligibles can use Georgia Medicaid NEMT for Medicaid-covered services.6

Who is eligible for Georgia Medicaid NEMT

Any active Georgia Medicaid member is eligible for NEMT if all four of the following are met. DCH defines the benefit for an eligible Medicaid member with no other means of transportation available, traveling to a Medicaid-reimbursable service.2

1. Currently enrolled in Georgia Medicaid (any pathway: ABD, LTC, MAGI children and parents, pregnant women, Pathways to Coverage, Family Medicaid, MSP-Plus dual)
2. The trip is to or from a Medicaid-covered service
3. The member has no other reasonable means of transportation (no working vehicle, no available driver, no accessible public transit)
4. The trip is booked with appropriate advance notice (3 business days for non-urgent; urgent same-day where medically necessary)

The "no other means of transportation available" test is applied by the broker at the time you book, not decided in advance by a published checklist. Explain your actual situation on the call (no working vehicle, no available driver that day, no accessible transit route) and let the broker make the determination rather than assuming you will be turned down.

What kinds of trips are covered

NEMT covers trips to and from any service the member can receive under Georgia Medicaid. Federal regulation defines covered transportation as travel necessary to secure medical examinations and treatment for a beneficiary,1 and DCH's own definition reaches any Medicaid-reimbursable service.2 The list of covered destinations is extensive:

• Primary care physician visits
• Specialty care (cardiology, neurology, oncology, endocrinology, orthopedics, urology, gastroenterology, pulmonology, psychiatry, and others)
• Behavioral health (outpatient mental health, substance use disorder treatment, methadone clinic visits)
• Dental (limited for adults, full for pediatric under Early and Periodic Screening, Diagnostic, and Treatment (EPSDT))
• Vision (limited for adults, full for pediatric)
• Hearing
• Pharmacy pickup, when medically necessary
• Outpatient surgery and procedures
• Physical, occupational, and speech therapy
• Dialysis (typically three times weekly with a standing order)
• Chemotherapy and radiation oncology
• Wound care
• Hospital outpatient departments
• Federally Qualified Health Centers and Rural Health Clinics
• Durable medical equipment pickup
• Court-ordered evaluations if Medicaid-covered
• HCBS waiver service appointments when covered by the broker rather than the waiver
• Adult day health (for members where the broker is the assigned transportation provider)

NEMT does NOT cover:

• Trips to non-Medicaid providers
• Trips for non-medical purposes (grocery shopping, banking, social visits, court appearances except court-ordered medical evaluations)
• Trips outside Georgia in most cases (exceptions for out-of-state specialty care pre-authorized by Medicaid)
• Trips for members not currently active on Medicaid (eligibility lapses cancel NEMT until reinstated)

Modes of transportation

Brokers assign the least expensive mode that meets the member's medical need. The mode hierarchy is:

Public transit pass. In areas with public transit (Atlanta MARTA, Augusta, Macon, Savannah), the broker may provide a one-day or one-month bus pass instead of a vehicle. This applies to members who can navigate public transit safely with their medical condition.

Mileage reimbursement. A family member or friend drives the member in a private vehicle. The driver submits mileage logs and visit verification (signed by the provider's front desk). Reimbursement is per mile at the broker's current contract rate; ask the broker for the current rate and the form before the trip, since it is set by contract and not published as a fixed statewide figure here.

Ambulatory ride (sedan). Standard sedan with a driver. The member walks to the vehicle with minimal assistance, sits in a seat, and walks from the vehicle to the appointment. Suitable for members without mobility devices.

Wheelchair-accessible van. Van with a wheelchair lift or ramp. The member remains in their wheelchair during transport. The driver is trained to secure the wheelchair.

Stretcher van. For members who cannot sit up and must be transported supine but do not require emergency ambulance services. Includes a stretcher and an attendant.

Non-emergency ambulance. For medically necessary supine transport with monitoring needs beyond what a stretcher van can provide. Less common than the other modes.

The mode is set at booking based on the medical certification submitted by the member's provider. If a member's condition changes (newly using a wheelchair, no longer able to walk), the member should notify the broker so the mode is updated.

The 3-business-day rule

For non-urgent trips, members must call the broker at least 3 business days before the appointment. Eligible members arrange covered rides through the statewide broker, Verida, which the Department of Community Health contracts to administer the benefit.2 The broker uses that lead time to:

• Verify the member's active Medicaid eligibility
• Verify the destination is a Medicaid-covered service
• Assign a transportation provider
• Schedule the pickup time
• Send confirmation to the member

Count the days the way DCH counts them. Per DCH's NEMT FAQ, the three-workday advance-scheduling window includes the day you call but not the day of the appointment. A call placed Monday therefore satisfies the window for a Thursday appointment.

Trips booked with less notice may be denied as "late requests" unless the request qualifies as urgent care. Do not treat an urgent trip as a favor the broker may or may not grant: DCH's NEMT contract defines urgent care and sets a response standard for it, so if your situation is genuinely urgent, say the word "urgent" on the call and ask the broker to apply the urgent-care standard. Confirm the current definition and response time on DCH's NEMT FAQ or with DCH NEMT customer service.

Standing orders relax the advance-notice rule for repeat trips. A dialysis patient who attends three times a week sets up a standing order with the broker at the start of treatment, and the rides are dispatched on the same schedule each week. The member does not call before each trip. If the schedule changes (vacation, missed week), the member notifies the broker to pause the standing order.

Urgent same-day trips run outside the advance-notice window. Examples: hospital discharge, urgent care follow-up, life-sustaining medication pickup. DCH's NEMT FAQ notes that the broker call center runs around the clock for hospital discharges and for "Where's My Ride" calls, so a Friday-evening discharge is not a dead end.

How to book a ride step by step

The booking sequence is:

Broker contact information

As of April 1, 2026, Verida is the statewide Medicaid Transportation Broker for all five Georgia NEMT regions; before that date Modivcare served the Central, Southwest, and East regions and no longer provides Georgia Medicaid NEMT there.2 Reservation and member services numbers change periodically, so confirm the current one with DCH NEMT customer service before booking a critical trip.

When something goes wrong

Your ride is late or does not show up

Call the broker's customer service line immediately. Document the time of your call, the operator's name, and the response you received. If the no-show or excessive lateness causes you to miss your appointment, file a complaint.

Do not pay for Uber, Lyft, or a taxi unless you have prior broker authorization. NEMT generally does not reimburse for self-arranged alternative transportation.

Your ride request is denied

Common reasons for denial:

• Member is not currently active on Medicaid (check active status at gateway.ga.gov)
• Destination is not a Medicaid-covered service
• The member has another reasonable means of transportation
• Booking made with less than 3 business days notice for a non-urgent trip
• Mode requested exceeds medical necessity (e.g., ambulance requested when an ambulatory ride is medically sufficient)

If a trip is denied, request the reason in writing. If the denial is based on a determination that affects ongoing eligibility for services (rather than a one-off booking issue), the member can request a fair hearing. Georgia state agencies transmit the hearing requests of Medicaid applicants and beneficiaries to the Office of State Administrative Hearings (OSAH), which can be reached at (404) 657-2800 or toll-free at 1-877-809-0007, at 225 Peachtree Street NE, Suite 400, Atlanta, GA 30303.7 If you filed a hearing request with the agency and have heard nothing after 30 days, OSAH publishes a Medicaid-only form representatives can file directly. Confirm current filing deadlines with DCH before you rely on a date.

Driver issues

Report concerns about driver conduct, vehicle cleanliness, lateness patterns, unsafe driving, or any safety issue to the broker's complaint line and to DCH NEMT Quality Assurance. Brokers track driver complaints and remove drivers with repeated issues from the network. For unsafe driving, also call local law enforcement and report to DOT if appropriate.

Missed appointment due to broker failure

If a documented broker failure causes a missed medical appointment, file a complaint. Some healthcare providers charge missed appointment fees; in cases of broker failure, the broker may be responsible for absorbing those fees rather than the member. Document the broker failure carefully.

How NEMT plays out: three examples

The following examples are illustrative, not real people. They show how the booking, mode, and complaint mechanics described above come together in common Georgia situations.

Example #1: Mrs. Adams, dialysis 3x/week in Macon

Mrs. Adams is 71, on Medicare and Georgia Medicaid (categorical ABD), and lives in Macon. She has end-stage renal disease and attends dialysis at a Davita center 6 miles from her home Monday, Wednesday, and Friday from 8 AM to noon. She uses a wheelchair.

Macon is in the Central region, one of the regions Verida took over as the statewide broker on April 1, 2026.2 Mrs. Adams or her daughter calls the broker the week before treatment starts. The broker verifies Mrs. Adams's Medicaid status, confirms Davita is a Medicaid-enrolled provider, and sets up a standing order: pickup at home 7:15 AM, transport to Davita, return ride after treatment.

Because Mrs. Adams uses a wheelchair, the broker assigns a wheelchair-accessible van. The driver is trained to secure her chair during transport.

For 12 months the standing order runs without a call before each trip. Twice during the year the ride is badly late; the daughter calls the broker both times and files a formal complaint the second time, and the broker documents and reviews the route. When Mrs. Adams travels out of state for a week, the daughter calls to pause the standing order and again to reactivate it. She is not charged a co-payment for any of the rides.

Example #2: Mr. Lee, post-hospital cardiology in Atlanta

Mr. Lee is 68, dual-eligible (Medicare + Georgia Medicaid), and lives in 30303 (Atlanta region). He was hospitalized for a heart attack and is being discharged on Friday. The discharge planner schedules a cardiology follow-up at Grady Memorial in 5 days. Mr. Lee has no car. His daughter works full time and cannot drive him.

Mr. Lee calls the statewide broker on the day of discharge. With 5 days notice (3 business days), the request is within the standard window. He provides his Medicaid ID, his apartment address, Grady Memorial cardiology clinic's address, the appointment date and time, and confirms he is ambulatory.

The broker books an ambulatory sedan. Pickup window is 12:30 to 1:30 PM for a 2 PM appointment. The driver arrives at 12:50 PM. Mr. Lee walks to the car. The driver takes him to Grady, waits for the appointment to end (within reasonable time limits), and drives him home.

Mr. Lee is not charged a co-payment for the ride. He is enrolled in CareSource, one of Georgia Families' three current CMOs,3 and he booked through the statewide broker rather than through his plan's member services line, giving the broker his Georgia Medicaid ID.

Example #3: Mrs. Diaz, no-show troubleshooting in Albany

Mrs. Diaz lives in Albany (Southwest region) and books a ride to a 10 AM behavioral health appointment, with a 9 AM to 9:30 AM pickup window. At 9:15 AM no ride has come, so she calls the broker's "Where's My Ride" line; the operator says the driver is roughly 30 minutes out. The ride arrives at 9:45 and she reaches the appointment at 10:10.

The next day she files a complaint with the trip confirmation number, the scheduled window, and the actual pickup time. That documentation is the whole point: broker quality assurance runs on accumulated, dated complaints, and DCH monitors broker performance through required reporting and on-site review.

NEMT for HCBS waiver members

Georgia operates the Elderly and Disabled Waiver Program (EDWP) and the Independent Care Waiver Program (ICWP) as Section 1915(c) Home and Community-Based Services (HCBS) waivers for older adults and adults with physical disabilities. The Community Care Services Program (CCSP) and Service Options Using Resources in a Community Environment (SOURCE) are the two service-delivery models found within EDWP, not separate waivers.5 Members of these waivers continue to use the NEMT broker for Medicaid-covered medical appointments. The waiver itself may provide non-medical transportation as a service (e.g., to an adult day center, to socialization activities, to senior centers) through the waiver care coordinator's network.

For Medicaid-covered medical trips, the booking flow is identical to non-waiver members: call the statewide broker, provide the member's Georgia Medicaid ID, schedule the trip. The waiver care coordinator does not arrange medical trips through the broker; the member or family books directly.

For non-medical waiver trips, the care coordinator arranges through the waiver-funded transportation provider.

NEMT and PACE

PACE participants do not use the NEMT broker for any trips. PACE provides its own transportation through PACE vans. The PACE organization is at full financial risk and integrates transportation into its capitated payment. PACE vans pick up participants for day center attendance, transport them to PACE-network medical appointments, and return them home.

If a PACE participant has a medical need outside the PACE network, the interdisciplinary team (IDT) has to authorize the service and arrange the transportation with it. Do not assume an unauthorized outside trip will be paid for by either PACE or the NEMT broker; go through the IDT first, and if the team declines, ask for the decision in writing so you can appeal it.

For more on PACE, see the Georgia PACE program guide.

NEMT for dual-eligibles

Dual-eligibles (Medicare + Georgia Medicaid) can use NEMT for trips to Medicaid-covered services. Medicaid is the secondary payer for most medical services, but transportation is paid through the NEMT benefit directly to the broker.

Under Original Medicare, Part B covers ambulance transportation, and only in defined circumstances: when traveling in any other vehicle could endanger your health, and only to the nearest appropriate medical facility. Members with Original Medicare and no Medicaid should not count on a routine ride benefit.6

Some Medicare Advantage plans offer supplemental transportation as an extra benefit. CMS describes the Special Supplemental Benefits for the Chronically Ill category as transportation for non-medical needs, such as grocery shopping or banking, for chronically ill enrollees. These benefits are plan-specific and not guaranteed.6 So a dual-eligible may have both Georgia Medicaid NEMT and a plan transportation benefit, or only the former. Check your plan's Evidence of Coverage for what it actually includes and how many trips, rather than assuming one benefit is the default.

Cost to the member

DCH answers this one directly on its NEMT FAQ page. Asked whether a co-pay is required to ride NEMT, DCH's answer is: "There is no co-payment required." That is a Georgia program answer, not a federal guarantee. Federal law makes the transportation assurance mandatory1 but does not itself forbid nominal cost-sharing, so the no-co-payment answer rests on Georgia's own NEMT policy and is worth re-checking on that page if it has been a while. DCH pays the broker a monthly capitated rate rather than billing members per ride.2

For mileage reimbursement, the broker pays the reimbursement to the member (or to the driver if the member designates) after the trip is documented.

Common mistakes Georgia members make

A few patterns appear frequently in member calls and complaints.

Starting with the CMO instead of the broker. NEMT is arranged by the statewide broker for every region, so Amerigroup Community Care, CareSource, and Peach State Health Plan members should call the broker first.2

Booking trips to non-Medicaid providers. A specialist who does not accept Medicaid is not a covered destination. Verify the provider's Medicaid enrollment first.

Forgetting to confirm the return ride. Most rides are round-trip, but verify with the operator at booking. If the return is not in place, the appointment desk can call to schedule.

Using Uber, Lyft, or a taxi without authorization and expecting reimbursement. Self-arranged alternatives are generally not covered.

Booking during an eligibility lapse. Members whose Medicaid renewal is pending or has lapsed may have rides denied. Verify active status at gateway.ga.gov.

Not updating mode when condition changes. A member who now uses a wheelchair must request a mode update; the broker does not automatically know.

Special situations

Pediatric NEMT

Children enrolled in Georgia Medicaid (including PeachCare for Kids and Georgia Families 360°) are eligible for NEMT to all covered pediatric services, including pediatric specialty care at children's hospitals, dental visits under EPSDT, vision exams, and developmental services. A parent or guardian rides with the child.

Behavioral health NEMT

Outpatient mental health and substance use treatment appointments are covered. Methadone clinic visits, often daily for the first weeks of treatment, are covered with standing orders. Federally Qualified Behavioral Health Centers and Georgia Community Service Boards are Medicaid providers.

Pregnancy-related NEMT

Pregnant women on Medicaid are eligible for NEMT to prenatal visits, ultrasounds, and labor and delivery. Postpartum visits are also covered: Georgia extended Medicaid postpartum coverage to a full 12 months after the end of pregnancy, effective November 1, 2022, and NEMT follows that coverage, ending at the end of the month in which the 12th month falls. One carve-out matters here. A pregnant woman approved for Emergency Medical Assistance (EMA) is not automatically eligible for the 12-month extended postpartum period, so do not assume a year of NEMT on an EMA approval; she may still qualify for additional days of EMA during that period if she receives pregnancy-related emergency treatment.8

Dialysis NEMT

Dialysis is the highest-volume NEMT use case nationally. Brokers have standing-order systems specifically for dialysis. Three-times-weekly transport for years is routine for ESRD patients.

Dialysis is also the ride a storm is most likely to interrupt: when Georgia is under a disaster or public health emergency declaration, Medicaid operates under a separate set of temporary flexibilities, covered in Georgia Medicaid disaster and emergency flexibilities, and a member on a standing order whose treatment schedule shifts should call the broker rather than assume the rides will follow.

Get help with Georgia Medicaid NEMT

If you need a ride to a covered medical appointment, call the statewide broker. If you have a complaint, escalate to DCH. If a denial affects your eligibility, you have appeal rights through the Office of State Administrative Hearings. Dual-eligible members can reach GeorgiaCares, the state's State Health Insurance Assistance Program (SHIP), at 1-866-552-4464 (option 4) for free help coordinating Medicare and Medicaid transportation.9

Learn More

Find personalized help arranging Georgia Medicaid transportation at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.