10.7.5Segment

Non-Emergency Medical Transport

Non-emergency medical transport providers serving Medicaid and private patients requiring medical transportation.

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Verticals

Overview

Non-Emergency Medical Transport (NEMT) covers the transportation of patients to and from medical appointments who do not require emergency care. It is a large, growing segment within the broader ambulance and medical-transport industry. At ~$20B (the broad ambulance/medical-transport category) it spans ambulance and medical-transport providers (Global Medical Response/AMR the largest) and NEMT brokers and operators.

Demand is driven by the aging population, Medicaid and Medicare Advantage transportation benefits (NEMT is a covered Medicaid benefit), and the shift of care across settings, making NEMT a recurring, demographically-supported service. It is a fragmented, consolidating segment and an active private-equity roll-up arena, with NEMT brokers (managing benefits), technology-enabled coordination, and Medicaid policy the key dynamics; emergency ambulance shares the same classification.

Market snapshot

Market size
~$26B
Growth
~4.2%CAGR (2017–22, nominal)
Companies
~6,482 firms
Firms by employee count

69.5% of firms have fewer than 20 employees: 4,507 micro-businesses, below most mandates.

The investable universe1,975 firms with 20+ employees
20–99
1,49075%
100–499
32817%
500+
1578%

Funded largely through Medicaid transportation benefits, which makes reimbursement policy the single biggest determinant of margin. Fragmented among small local operators, and consolidating as brokers and managed-care organizations push volume toward providers who can report compliance.

NAICS 485991, 621910. U.S. Census Bureau, 2022 Statistics of U.S. Businesses; U.S. Census Bureau, 2022 Economic Census.

Business model & economics

Revenue model

Per-trip medical-transport fees and benefit reimbursement

Key economics

Revenue per firm
$4,031,158
Revenue per employee
$108,829
Employees per firm
37.4
Recurring revenue
Moderate–High

recurring patient-transport volume

EBITDA margin
Reimbursement- and density-driven
Capex intensity
Moderate

Characteristics

  • Balanced cost base: payroll is 41% of revenue, leaving room to scale margin without cutting staff
  • Deep strategic-buyer pool: 157 firms exceed 500 employees, so a scaled asset has trade buyers
  • Transports patients to non-emergency medical care.
  • Aging population and Medicaid benefits drive demand.
  • Active PE roll-up; NEMT brokers manage benefits.

NAICS 485991, 621910. U.S. Census Bureau, 2022 Statistics of U.S. Businesses; U.S. Census Bureau, 2022 Economic Census.

Geographic concentration

AlabamaAlaskaArizonaColoradoFloridaGeorgiaIndianaKansasMaineMassachusettsMinnesotaNew JerseyNorth CarolinaOklahomaSouth DakotaTexasWyomingConnecticutMissouriIllinoisNew MexicoArkansasCaliforniaDelawareDistrict of ColumbiaHawaiiIowaKentuckyMarylandMichiganMississippiMontanaNew HampshireNew YorkOhioOregonTennesseeUtahVirginiaWashingtonWisconsinNebraskaSouth CarolinaIdahoNevadaVermontLouisianaRhode IslandNorth DakotaPennsylvaniaWest Virginia

North Dakota, West Virginia and Pennsylvania. Medical transport concentrates in rural states with aging populations and consolidated hospital networks, where patients travel furthest to reach care.

North DakotaWest VirginiaPennsylvania

U.S. Census Bureau, 2022 Statistics of U.S. Businesses (firms by state), NAICS 485991/621910. Concentration shown by location quotient.

M&A deal context

Deal activityHigh

Who’s acquiring

  • Medical-transport providers (GMR/AMR)
  • NEMT brokers & platforms
  • PE-backed roll-up sponsors

What’s driving deals

  • Roll-up of fragmented NEMT operators.
  • Aging-demographic and Medicaid demand.
  • Technology-enabled coordination.

Verticals in this segment

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