To complete a NYS Medicaid transportation provider application, you enroll through the state’s eMedNY system: secure a Letter of Support from Medical Answering Services (MAS), assemble the required forms and category-specific vehicle documents, pay the $750 application fee, and mail the package with original signatures. Review commonly takes 90 days or more, and a single missing item sends the entire packet back.
What to Line Up Before You Apply
Your business needs to exist on paper first. That means a valid registration with the New York Department of State as a corporation, LLC, or partnership. If you haven’t filed your Certificate of Incorporation or Articles of Organization yet, the Medicaid application won’t move forward.
You also need a National Provider Identifier, the 10-digit number issued through the federal National Plan and Provider Enumeration System. Every healthcare provider that bills Medicaid or Medicare has one, and CMS issues them for free.1Centers for Medicare & Medicaid Services. How to Apply The NPI appears on nearly every form in the package, so apply for it early.
The step that surprises most first-time applicants is the Letter of Support from MAS. MAS is the private company the Department of Health contracts with to schedule trips, run call centers, and manage the transportation provider network.2New York State Department of Health. Medicaid Transportation – Program Overview Since April 2024, any new application submitted without a MAS support letter is rejected and returned outright.3eMedNY. Provider Enrollment and Maintenance – Transportation Reach out to MAS through its “Become a Provider” page or at tprelations@medanswering.com before you build the rest of your packet.
Pick Your Transportation Category
New York Medicaid recognizes several distinct service categories, and your application must match the one you’ll operate under. Each carries its own licensing, registration, and inspection requirements. Applying as a livery when your vehicles are licensed as ambulettes creates delays that can add months to the process.
The categories in the Medicaid Transportation Policy Manual are:4eMedNY. New York State Medicaid Transportation Provider Policy Manual
- Ambulette (Category 0602): a special-purpose vehicle with wheelchair-carrying capacity, stretcher-carrying capacity, or the ability to transport disabled individuals, subject to NYS Department of Transportation licensure and inspection under 17 NYCRR §720.3(A).
- Taxicab (Category 0603): a motor vehicle other than a bus used to transport passengers for compensation under a license or permit from a local authority, defined in Vehicle and Traffic Law §148-a.
- Livery (Category 0605): a motor vehicle other than a taxicab or bus used to transport passengers for compensation, defined in Vehicle and Traffic Law §121-e.
- Transportation Network Company (Category 0609): an entity licensed under Vehicle and Traffic Law Article 44-B that connects passengers to drivers through a digital network.
- Ambulance (Category 0601): a vehicle designed and equipped to provide emergency medical services during transit, certified or registered by the Department of Health under Public Health Law §3001.
eMedNY publishes an “Additional Requirements for Transportation Enrollment” chart listing exactly which documents each category has to submit.3eMedNY. Provider Enrollment and Maintenance – Transportation
The Enrollment Package
The core of the application is the BUSINESS Enrollment Form (eMedNY-436701), which collects your legal business name, federal tax identification number, NPI, and service category. Alongside it, you submit the Transportation Information Request (form eMedNY-424601), which gathers fleet and operational details.5eMedNY. Transportation Information Request Form
The full package also includes:3eMedNY. Provider Enrollment and Maintenance – Transportation
- Electronic Funds Transfer Authorization (form 701101) for direct deposit of reimbursements. Attach a voided check from the deposit account, or for savings accounts, an original notarized bank letter on letterhead with the routing number, account number, and account owner information.6eMedNY. Electronic Funds Transfer Authorization Form
- ETIN Certification Statement (form 490602 for new enrollments), which links your billing systems to eMedNY’s electronic claims processing. Without an active ETIN, you cannot submit claims or receive electronic remittances.7eMedNY. ETIN Information
- The IRS assignment letter showing your FEIN and legal name. A W-9 is not accepted as a substitute.
- Copies of certificates, registrations, permits, and licenses appropriate to your category.
- The Letter of Support from MAS.
- A signed Attestation for Non-Medical Transportation Providers, available on the eMedNY enrollment page.
- Prior Conduct Questionnaire (form 431001), required if you answer “yes” to any conduct-related questions on the enrollment application, or if the Department finds an exclusion during review.
Ownership Disclosure
Every provider files a Disclosure of Ownership and Control Interest Statement identifying anyone who holds a 5% or greater direct or indirect ownership stake, along with officers, directors, and partners.8New York Codes, Rules and Regulations. 18 NYCRR 504.1 – Policy and Scope The disclosure collects Social Security numbers and home addresses so the Department can run background checks and verify no listed person has been excluded from federal healthcare programs.
The disclosure is not a one-time filing. Under 18 NYCRR § 504.7(e), it must stay current, with annual updates and updates whenever ownership changes. Failing to maintain it, or failing to submit one within 35 days of a Department request, terminates Medicaid participation automatically.9New York Codes, Rules and Regulations. 18 NYCRR 504.7 – Duties of the Provider
Vehicles, Drivers, and Insurance
Your application documents every vehicle in your fleet. MAS verifies each vehicle’s registration, VIN, and insurance through its system.10Medical Answering Services, LLC. MAS Transportation Provider Network Manual Proof of general liability insurance, workers’ compensation, and NYS disability insurance must be uploaded as ACORD forms.
Drivers are screened too. All undergo Medicaid exclusion checks, and their license information is enrolled in the NYS DMV’s License Event Notification Service (LENS), which flags suspensions, revocations, and other events in real time so problems don’t wait until renewal.10Medical Answering Services, LLC. MAS Transportation Provider Network Manual GPS geocodes must be correctly recorded and reported to MAS for every trip as a condition of network participation.
The $750 Application Fee
New transportation provider applications carry a $750 fee. If your organization qualifies for an exemption, submit the Application Fee Exemption form (form 520101) in place of payment.3eMedNY. Provider Enrollment and Maintenance – Transportation The fee is not refunded if the application is denied, so verify that every form is complete before you send anything.
How and Where to Mail It
The completed package has to be mailed. The state requires original signatures on all documents; photocopies, initials, and rubber stamps are not accepted.3eMedNY. Provider Enrollment and Maintenance – Transportation Every required document must be valid on the application date and stay valid through the Department’s review.
Standard mailing address: eMedNY, P.O. Box 4603, Rensselaer, NY 12144-4603.
Expedited or priority mailing address: eMedNY, ATTN: Box 4603, 327 Columbia Turnpike, Rensselaer, NY 12144.
Certified mail or a trackable service is worth the cost. If the Department finds one missing form or one blank field, the whole packet comes back, and you’ll want proof of when you originally sent it. Complete every field on every form unless the instructions say otherwise. Blanks are one of the most common reasons packets are returned.
What Happens During Review
eMedNY enrollment commonly runs 90 days or longer.11New York State Department of Health. Provider Enrollment Guidance During review, the Department of Health verifies your business data, runs background checks on owners and key personnel, and may follow up electronically with questions.12eMedNY. Introduction to Provider Enrollment – Section: Step 3
Approval comes as a written determination that includes your Medicaid provider ID (also called an MMIS number or PID) and the effective date. Denials also come in writing. One thing to keep in mind: being enrolled doesn’t mean trips start flowing. MAS assigns trips based first on the Medicaid member’s choice of provider, then the medical practitioner’s preference, and only by rotation when no preference is expressed.3eMedNY. Provider Enrollment and Maintenance – Transportation
Federal Screening and Site Visits
Alongside state review, all owners, key managers, and drivers are screened against the OIG’s List of Excluded Individuals and Entities. Employing or contracting with a listed person exposes the company to civil monetary penalties, and OIG advises that healthcare entities check the list on an ongoing basis rather than only at enrollment.13Office of Inspector General, U.S. Department of Health and Human Services. Exclusions Program
CMS assigns risk levels to different provider categories. Providers rated moderate or high risk may face a mandatory pre-enrollment site visit, where a contractor physically inspects the business location. Ambulance services and certain other provider types fall into these elevated categories. Refusing a site visit can result in denial.14Centers for Medicare & Medicaid Services. Provider Enrollment Site Visits
Staying Enrolled
Enrollment creates ongoing duties, and treating it as a one-and-done event is how providers lose their status.
Federal regulations require state Medicaid agencies to revalidate every provider at least once every five years, which means resubmitting updated documentation and going through another round of review.15eCFR. 42 CFR Part 455 Subpart E – Provider Screening and Enrollment Missing a revalidation deadline can end your participation.
Ownership disclosure has to stay current at all times, with changes reported within the Department’s timelines. Under 18 NYCRR § 504.3, enrolled providers agree to keep records for six years, accept Medicaid payment as payment in full, submit claims only for services actually delivered, and permit audits by the Department, federal HHS, and the Deputy Attorney General for Medicaid Fraud Control.16New York Codes, Rules and Regulations. 18 NYCRR 504.3 – Duties of the Provider
ETIN certification renews annually. If it lapses, you lose the ability to submit electronic claims, receive electronic remittances, and access ePACES, which effectively freezes billing until certification is restored.7eMedNY. ETIN Information The renewal is easy to miss in the middle of daily operations, and letting it slip is one of the fastest ways to open a gap in cash flow.