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EMS vs. NEMT Services - What is the Difference

There are two types of medical transportation services based on patient needs and requirements – Emergency Medical Services (EMS) and Non-Emergency Medical Transportation (NEMT).  

As the name suggests, EMS responds to healthcare emergencies. Conversely, people use NEMT for getting to non-emergency appointments—like regular health check-ups, doctor’s appointments, etc.—when their health prevents them from traveling by standard means.   

What is EMS? 

Emergency medical services (EMS) provide quick and efficient patient care during emergencies and are a vital component of the healthcare ecosystem. They most often use ambulances and trained personnel such as paramedics or Emergency Medical Technicians (EMTs) to offer immediate treatment and transport to the hospital.   

 As first responders, EMS delivers urgent medical care to patients on the scene. If necessary, they will transport the patient to a hospital’s emergency department. However, a significant portion of EMS calls do not result in a patient being taken to hospital. 

EMS acts as an essential link between the community and the healthcare system, providing quick and efficient access to medical care in times of need. 

What is NEMT? 

Non-Emergency Medical Transportation (NEMT) refers to the transportation of individuals who require medical assistance but do not have an immediate or urgent medical need.   

Individuals using NEMT may include people with disabilities, the elderly, or those without access to reliable transportation. Specialized transportation companies typically provide NEMT services using vehicles like vans or buses, usually equipped to transport individuals with mobility issues. 

NEMT aims to provide safe and reliable transportation for people who need medical care but cannot access it independently. It helps individuals access necessary medical appointments and treatments and improves their overall health and well-being.    

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The Difference 

EMS and NEMT render medical assistance and transportation; however, they differ on various grounds. They have distinct goals, operational processes, transportation costs, and governing regulations.   


EMS responds to emergencies, such as accidents, heart attacks, and other life-threatening conditions. So EMS providers are equipped with advanced medical equipment and training to provide life-saving interventions. Their goal is to transport patients to the nearest hospital as soon as possible.   

NEMT serves individuals who require medical services but are not in imminent danger. Specialized transportation providers use vans equipped to handle their passengers’ mobility or medical needs. The main objective of NEMT is to ensure safe and dependable transportation for people who need medical care. 

Market Size 

The EMS and NEMT market size will grow in the coming years. This growth trend is due to an aging population, an increasing incidence of chronic diseases, and a growing demand for emergency and non-emergency medical transportation services.   

In the US, the EMS market is worth $13.4 billion. It will reach $20.9 billion by 2027, growing at a CAGR of 5.3%. This growth is because of factors such as an aging population, increased road accidents, and a rise in emergency cases.   

The NEMT market is worth $5.5 billion, with a forecast of reaching $9.5 billion by 2028. The increasing demand for transportation services for the elderly and disabled will drive this growth in the coming years. 

Transportation Cost  

EMS transportation costs vary depending on the required care level, and the distance traveled. Generally, insurance covers EMS costs, but out-of-pocket costs may apply to patients without or with high deductibles.    

NEMT transportation cost also varies depending on the level of care and the distance. Medicaid or other government programs often cover this cost for eligible individuals. In some cases, private pay options are also available. 

How It Works 

EMS is activated in response to emergency calls for assistance. For example, when a person calls 911, a trained dispatcher will assess the situation and allocate the appropriate level of care — usually an ambulance and a squad of first responders.    

EMTs and paramedics are the frontline care providers in the EMS ecosystem. EMTs have the basic skills to provide life support, while paramedics have advanced training in administering medication or advanced airway management.   

NEMT transportation providers are usually contracted by government programs such as Medicaid or private organizations to provide services to eligible beneficiaries through intermediaries called brokers. Brokers or care managers send requests to NEMT fleet operators to book rides. Fleet operators transport the patients and then bill the broker directly.  

NEMT providers typically transport patients in vehicles designed for non-emergency medical transportation, such as vans equipped with wheelchair lifts and stretchers. Drivers trained in first aid operate the vehicle and assist patients with getting in and out. 

License and Certification 

To work as an EMT  or a paramedic in EMS, a person must have a valid EMT or paramedic certification from the National Registry of Emergency Medical Technicians (NREMT) or from the state in which they work. They must complete an accredited training program and pass an exam to obtain the certification.  

To work as a driver or attendant on a NEMT vehicle, a person must have a valid driver’s license, a clean driving record, and first aid and CPR certification. Some states also require NEMT drivers to have a commercial driver’s license (CDL) or to have completed a state-approved training program. Additionally, states may need NEMT companies to be licensed and vehicles to be inspected and certified.    


EMS and NEMT are both regulated businesses. State legislation for EMS and NEMT varies widely from state to state, but they have some similarities. 


  • The state typically oversees the certification and training of EMTs and paramedics. 
  • State-specific legislation also sets standards for the equipment and vehicles used in the EMS system. 
  • State regulations set protocols for emergency response and patient care. 


  • States set and enforce minimum standards for the vehicles used in NEMT transportation, including equipment and accessibility requirements. 
  • Also, the state administration issues standards for driver training and certification. 
  • States also regulate NEMT providers and conduct inspections. 
  • States have specific policies that set reimbursement rates for NEMT services, with Medicaid being the primary payer of NEMT services. 


In a nutshell, EMS and NEMT are both essential parts of the medical care industry.   

An emergency call for assistance activates EMS. Trained EMTs and paramedics with advanced training typically administer life support and critical frontline care. NEMT, on the other hand, is a service that provides transportation for individuals who require medical care for scheduled appointments.     

Their cost varies depending on the level of care needed, and the distance traveled. Insurance, Medicaid, and other government programs for eligible individuals often cover both. Out-of-pocket costs, however, may apply sometimes.   

The state regulates these services and segments these services regionally to ensure efficient use of resources, rapid response times, coverage for a specific population or area, and compliance.