Passenger transportation

Books and taxes for non-emergency medical transport companies.

Medicaid broker trips billed weeks before they pay, private-pay rides, wheelchair van upkeep, and driver training costs. Gus sorts all of it, an accountant checks every transaction, and you get one number a month.

Book a call What we handle
  • From $197 a month
  • An accountant on every transaction
  • Cancel whenever
MarchExample month
$10,400
what you made

March came in at $10,400. Modivcare paid out at a lower rate than what was billed on eleven trips, so I logged the gap as a broker adjustment, not a bookkeeping error.

  • Modivcare payoutMedicaid broker trips
  • Private-pay rider, HensleyPrivate-pay trips
  • Wheelchair lift repairVan maintenance
  • Speedway fleet fuel cardFuel
  • NEMT driver payrollDriver wages
Money in$47,300
Money out$36,900
Set aside for taxes$2,500
An example month. Yours will have your numbers.

Why your books are different

An NEMT company's books go wrong in the same few places.

A generalist sees deposits and fuel bills. Your business runs on Medicaid brokers who pay weeks late and sometimes less than billed, wheelchair lifts that need constant upkeep, and drivers who need training records on file. When the books do not know that, the return misses what it should catch.

  1. 1

    Broker payments get counted before they actually land

    A trip billed to Modivcare or MTM in one week often does not get paid until weeks later, and sometimes at a lower rate than what was billed. Counting the invoice as cash the day the trip runs makes the bank balance and the books disagree.

    What we doTracks what has been billed to each broker against what has actually been paid, so you can see what is still owed and what came in short.
  2. 2

    A lift repair and a lift replacement look the same on the statement

    A wheelchair lift repair costs a few hundred dollars and a full lift replacement can run several thousand, but both can land in the same maintenance line, hiding which vans are becoming money pits.

    What we doKeeps repairs and equipment replacement in separate lines, so you can see when a van is costing more to maintain than it is worth.
  3. 3

    Driver training and certification costs get lost in general expenses

    Wheelchair securement training, defensive driving courses, and background checks are recurring costs specific to this work, and buried in general supplies they disappear from the picture of what it actually costs to staff a van.

    What we doKeeps driver training and certification costs in their own line so you can see what it costs to keep a driver road-ready.
  4. 4

    Private-pay and broker trips blur into one income line

    A ride paid directly by a family member and a ride billed through a Medicaid broker can land in the bank on the same day and look identical, making it hard to tell which part of the business is actually growing.

    What we doKeeps private-pay trips and each broker's trips in their own categories, so you can see where the business is actually earning.
  5. 5

    A new wheelchair van gets filed with routine repairs

    A wheelchair-accessible van with a ramp or lift costs far more than a standard van, and filed alongside oil changes and tires, the purchase muddies the month and the return misses a depreciation deduction it should get.

    What we doLogs vehicle purchases as equipment the month they show up and flags them for the accountant's call on how they get written off.

Your categories

The categories Gus keeps for an NEMT company.

Set up once for how you get paid and what you spend. You never pick a category. He does, and an accountant checks it.

Money in

  • Medicaid broker tripsTrips billed through Modivcare, MTM, or LogistiCare, tracked by what was billed versus what was paid.
  • Private-pay tripsRides paid directly by riders or family members.
  • Facility contractsStanding arrangements with clinics, dialysis centers, or care facilities.
  • Insurance reimbursementsTrips billed to private insurance rather than Medicaid.

Money out

  • Driver wagesPayroll for drivers, kept apart from any subcontracted driver pay.
  • Van maintenanceWheelchair lift, ramp, and securement equipment repairs.
  • FuelFuel for a fleet that runs frequent short trips.
  • Van loans and leasesMonthly payments on wheelchair-accessible vans.
  • Commercial fleet insuranceCoverage required to transport passengers with mobility needs.
  • Driver training and certificationWheelchair securement training, defensive driving, and recurring certifications.
  • Background checksRequired screening for drivers transporting medical riders.
  • Dispatch softwareScheduling tools used to route and confirm trips.

What we watch for you

  • Broker payment gap

    What was billed versus what was paid, so a slow broker does not get mistaken for a slow month.

  • Cost per trip

    What fuel, upkeep, and driver time cost against what each broker or rider actually paid.

  • Fleet upkeep per van

    Repair costs by vehicle, so a van eating the budget gets noticed before it fails on a run.

  • The set-aside

    What you will owe, tracked as broker payments land, so April is no surprise.

Ask Gus

Things NEMT owners ask Gus.

Text him like you would text anybody. He answers in plain English, and when a question is above his pay grade, an accountant looks and gets back to you.

Modivcare paid us less than we billed on a batch of trips. Is that a bookkeeping mistake?

No, that is a broker adjustment. I track what was billed against what actually paid out, so you can see the gap instead of wondering where the money went.

We just replaced a wheelchair lift for $4,200. Does that come off differently than a regular repair?

Usually, yes. I logged it as equipment, not maintenance, and flagged it so the accountant decides how it gets written off.

One of my drivers only fills in when we are short-staffed. Does she need to be on payroll?

If she drives your van on your schedule, she usually counts as an employee even for occasional shifts. I flagged it so the accountant can walk you through it.

The tax side

The tax side of an NEMT business.

Most of what goes wrong here is timing and labels. Broker payments counted too early, a lift replacement filed like a repair, and a fill-in driver paid like a contractor.

What your return has to get right

Your accountant signs it, so it gets done right the first time.

  • Wheelchair vans and depreciationA wheelchair van bought to run Medicaid or private-pay trips can usually be depreciated, with bonus depreciation back to 100 percent for vehicles placed in service after January 19, 2025.
  • Driver classificationA driver who runs your dispatched trips on your schedule is usually an employee, not a contractor, even for occasional or fill-in shifts.
  • Contractor 1099sAny driver or transport company you call in to cover overflow trips, if not on payroll and paid $2,000 or more in 2026, gets a 1099-NEC by January 31.
  • The pass-through deductionMost owner-operators can take up to 20 percent of business profit off their taxable income, which comes out right when broker payments and expenses are tracked correctly all year.

Deductions non-emergency medical transport companies miss

Your bookkeeper knows what to look for in your statements. You never have to.

  • Wheelchair lift repairs
  • Fuel
  • Fleet insurance
  • Driver training courses
  • Background check fees
  • Dispatch software fees
  • Van detailing
  • Securement equipment
  • Vehicle inspections
  • Radios and GPS units
  • Phone for dispatch
  • Uniforms

General information about 2026 federal rules, not advice for your business. Your accountant looks at your actual numbers before anything gets filed.

All year, not just April

An NEMT year, kept every month.

Medical rides do not follow a season, but broker payments and driver certifications run on their own calendar, and your team stays on the books through all of it. Every month in between, your bookkeeper closes the books and speaks up the moment something looks off.

  1. January

    Reconcile broker payments

    Last year's return gets started, last year's broker payments get reconciled against what was billed, and a monthly set-aside gets planned for the year ahead.

  2. April

    Filed, brokers caught up

    Your return is filed and signed, with no surprise bill, because the set-aside has been running since January.

  3. July

    Broker payment tally

    A look at how broker payments are tracking against what was billed, what you will owe, and whether fleet costs are creeping up.

  4. October

    Before certifications renew

    Driver training and vehicle inspections often renew before year end. Gus looks at those costs and anything worth doing before December.

What you get

Starts at$197a month

What you pay depends on what your business needs, and it does not move after that, busy season or slow. No hourly bills, no surprise invoices, no setup fee.

Book a call
  • Monthly bookkeeping

    Every transaction sorted into categories set up for non-emergency medical transport companies. You never categorize a thing.

  • An accountant checks every transaction

    Real review, every month, before your books close. Not a spot check.

  • Your business tax return, filed

    Prepared, reviewed, and signed by that same accountant every year.

  • The monthly number

    What you made, what you spent, what to set aside for taxes.

  • Your own bookkeeper

    A real person assigned to your business, in the app whenever you need them. No hold music.

  • On your books all year

    Every month, not just in April. Your team speaks up whenever something is worth your attention.

  • Cancel any time

    No contract. No cancellation call. Your books are yours.

Straight answers

Questions NEMT owners ask first.

Can Gus track what Medicaid brokers owe us separately from what they have paid?

Yes. He tracks each broker's billed amount against what actually landed in the bank, so you can see what is outstanding and what came in short.

We bill through Modivcare and MTM both. Does that complicate things?

No. Gus keeps each broker's trips in its own category, so you can see how each one is paying out, not just a combined total.

Do I write off a wheelchair van all at once?

Often you can. Vans bought for the business can usually be depreciated, and the accountant decides how much to take now based on your whole year.

A driver only fills in occasionally. Does that keep her off payroll?

Not on its own. What matters is whether she drives your van on your schedule. Gus flags drivers who look like employees and the accountant sorts out what it means.

My books are behind by a couple of months. Is that a problem?

No. Send over the statements and whatever broker payment records you have. Gus sorts out what was billed against what was paid, and most owners know where they stand within a week.

How does Gus tell private-pay rides apart from broker trips?

He keeps them in separate categories from the start, so you always know which part of the business brought in what, instead of one blended number.

Is a real accountant checking my books?

Yes. You get your own bookkeeper, Gus does the first pass on every transaction, and an accountant checks every one before your month closes. That same accountant prepares, signs, and files your business return. Goatkeeper is not a CPA firm, and we never pretend a person looked when they did not.

What does it cost, and can I cancel?

It starts at $197 a month, depending on what your business needs. No setup fee, no hourly bills, no contract. Cancel any time from the app, and your books go with you.

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We keep books for the business next door too.

What makes a bookkeeper worth paying for Every business we keep books for

Book a call

Pick a time. That's the whole signup.

Fifteen minutes with a real person on our team. They look at where your books are, tell you straight what it takes to get caught up, and get you set up on the spot if it fits.

  • $197 a month to start
  • An accountant on every transaction
  • Cancel whenever