If you have read our provincial guides you already know the headline: Canada has no Medicaid and no transportation broker, so there is no single counterparty handing out trip volume.
What Canada has instead is institutional buying. Health authorities, hospitals and their shared-service organizations move enormous numbers of patients between facilities and to appointments, and they buy that service through procurement. The skill that gets you paid in Canada is bidding, not credentialing. Here is the map.
Quebec: the most active market in the country
Quebec health institutions posted 83 distinct patient-transport procurement records on SEAO between January 2025 and June 2026. Nothing else in Canada comes close to that cadence.
- Named incumbents include Dessercom, Med-Express and VPS Service de Santé.
- Award sizes are meaningful. CISSS des Laurentides awarded $949,830 for adapted medical transport, and CIUSSS Centre-Sud awarded $1,664,361 for taxi dispatch.
- Larger files require an AMP authorization to contract, an integrity clearance from the Autorité des marchés publics. This is the closest thing to a formal vendor gate in Canada, and it takes time. Start it before you need it.
One caution. Transdev's Voyago Santé won CISSS contracts in 2022 and ceased Quebec operations in June 2026. A national operator exiting a province four years after winning public work is a signal about margins. Bid carefully.
British Columbia: non-exclusive contracts and qualified lists
- PHSA contract 10894, Patient Transfer Services, runs February 2024 to January 2032 with options, and is non-exclusive. Non-exclusive is the important word: the contract does not close the market.
- Island Health BC2024-1638 was a request for supplier qualifications that created a qualified call-out list rather than a single award.
- Health Connections already funds contracted providers. Island Health distributes funding to eight of them, and Northern Health retains a bus contractor.
- Watch BC Bid and the individual health authority portals.
BC is the province where the institutional structure most clearly adds vendors rather than consolidating to one, which makes it a reasonable place to start if you are building bid capability.
Saskatchewan: a province-wide qualified vendor list
Saskatchewan ran RFP700021326, establishing a province-wide qualified vendor list for non-medical transportation across standardized service types. A qualified vendor list is the most accessible instrument in Canadian procurement, because getting on it is a qualification exercise rather than a competitive win.
Separately, the Northern Medical Transportation Program assigns carriers a four-digit payee code for invoicing, which is a direct, ongoing payment relationship rather than a contract you have to re-win.
Correcting a widely circulated figure: you will see $0.82 per kilometre plus $22 per hour of wait time quoted as the Saskatchewan medical taxi rate. That traces to a 2008 news release. Do not budget against it. Ask the programme for the current schedule.
Manitoba: contracts that include residences
Shared Health solicitation 30335 covers 60 months of non-emergency patient transportation, and notably includes transfers between facilities and residences, not only facility to facility. Residence trips are recurring and schedulable, which is exactly the work you want.
Manitoba also issues Employment and Income Assistance standing orders in writing directly to wheelchair transport firms. That is a lower-ceremony channel that starts producing revenue faster than a formal bid.
Alberta: large volume, high clinical bar
Alberta Health Services contracts roughly 125,000 inter-facility transports a year, historically to Associated Ambulance and Guardian Ambulance, transitioning to ALTA Paramedic Health as of May 15, 2026.
The volume is the largest single block in Canada. The catch is that Alberta classifies this work as Class 4 ambulance and requires a Primary Care Paramedic on stretcher crews, so the contracts favour operators who can field clinical staff. For most new entrants, subcontracting to an existing AHS contractor is a more realistic entry than bidding directly.
Ontario: no provincial programme, so buy-side is fragmented
Ontario has no provincial transport programme and no vendor of record. Buying happens at hospital group purchasing organizations, and the real ones are:
- Mohawk Medbuy Corporation, serving Brantford, Burlington, Chatham, Kingston, London, Oakville, Thunder Bay and Toronto.
- Plexxus, serving Toronto-area hospitals.
- Champlain Health Supply Services, a not-for-profit created in 2009 serving Champlain-region hospitals.
- Healthcare Materials Management Services, the London Health Sciences Centre and St. Joseph's joint venture, affiliated with Mohawk Medbuy since 2018.
A correction, because it circulates: "MPSC" is not a real Ontario group purchasing organization. If a guide names it, that guide is wrong.
What about the federal government?
We ran a search of the complete CanadaBuys dataset and found no current federal tender for non-emergency patient transportation. Federal money for this work flows through NIHB and through the VAC, RCMP and CAF programmes administered by Medavie, both of which we cover separately. Do not spend time watching federal tender feeds for this.
Long-term care: a channel, not a payer
This distinction costs operators money, so it is worth stating plainly. Ontario long-term care homes may charge residents extra for optional services including transportation, but the regulations impose no obligation on a licensee to arrange or fund transport to appointments, and the Retirement Homes Act does not mention transport at all.
So a long-term care home is a customer or a referral source, never a guaranteed payer. Get commercial terms in writing, and be clear about who is invoiced when a resident travels.
How to build bid capability
Practical sequence for an operator with no procurement experience. Register on the portals before you need them: SEAO in Quebec, BC Bid, SaskTenders, MERX and the individual health authority sites. Target qualified vendor lists and call-out lists first, because qualification is a lower bar than competition. Get your insurance certificates, driver credentialing records and vehicle inspection documentation into a state where you can produce them in a day, because bid deadlines are short and evidence requirements are specific.
And start the slow credentials early. Quebec's AMP authorization in particular is a months-long process that will disqualify you from the largest files if you begin it after the tender drops.
Get started with Bambi
Our aiNEMT software handles scheduling, dispatching, care coordination and real-time tracking. In a market with no broker feeding you trips, the admin all lands on you, which is exactly where software earns its keep. Get in touch for a demo.
