Most NEMT owners track two numbers: how many trips they ran and whether the bank account went up. That works until a broker sends a performance letter, and then you find out they have been tracking eleven numbers you were not.
This is the list that actually matters, split into the ones your broker is scoring you on right now and the ones that decide whether the business makes money.
The metrics your broker is already scoring
These are contractual. Miss them and you lose trip volume before anyone calls you.
1. On-time performance
What it is: the share of trips where you arrive inside the contractual pickup window.
The window is not what you think. Modivcare's Kansas provider manual defines on time as the scheduled pickup time up to fifteen minutes after. Arriving early is fine. Arriving sixteen minutes late is a miss. New York's MAS network manual uses plus or minus fifteen minutes. So on-time performance is a one-sided distribution, and tracking average minutes late will hide your failures — a run of early arrivals cancels out nothing.
Benchmark: Health Management Associates' 2025 multi-state survey found state and broker stakeholders consider 95 to 99 percent reasonable and attainable. Arizona uses a flat 95 percent timeliness standard. Your own contract governs.
2. Late and missed trip rate
The sharpest number in the industry: Modivcare's Kansas manual caps late-or-missed at 2 percent of assigned trips, and states that providers exceeding 1 percent missed pickups risk having trips reduced. That 1 percent is the line where a broker starts moving volume to someone else.
For scale, Mississippi holds its statewide broker to the same 2 percent daily ceiling. In July 2024 actual performance was 5 percent late plus 1 percent missed — 6 percent, triple the limit, across more than 52,000 scheduled trips.
3. Complaint rate
Complaints per 100 trips. Real-world tolerances are tiny: Mississippi's current broker contract caps complaints, excluding rider no-shows, at 0.17 percent of monthly trips. Rhode Island runs under 0.20 percent. Indiana's March 2025 statewide report shows 18 complaints against 29,497 fulfilled trips, about 0.06 percent.
Virginia's legislative audit found 78 percent of complaints were late trips and 14 percent were no-shows. Complaint rate is mostly a lagging echo of on-time performance — fix the schedule and the complaints follow.
4. Will-call and hospital discharge response time
Measured and penalized separately from ordinary lateness. The published standards are consistent across brokers: will-call returns within 1 hour of ready notification, hospital discharge within 3 hours (Modivcare Kansas, MAS New York, Nevada). Maine requires same-day and urgent pickups within 1 hour urban, 2 hours rural.
Mississippi's contract attaches up to $5,000 per instance per day for will-call and discharge failures. These trips are unschedulable by definition, which is exactly why they wreck route density and why brokers watch them.
5. Provider no-show rate
Trips you failed to cover at all — distinct from lateness, penalized separately. Indiana's March 2025 statewide figure was 0.5 percent. Mississippi attaches $1 to $5,000 per unfulfilled trip.
The metrics that decide whether you make money
6. Timely filing compliance
The most avoidable revenue loss in NEMT, and entirely inside your control. Modivcare's Kansas terms: invoices and trip logs within 90 days of service; submissions after 90 days take a 10 percent reduction; claims past 180 days are disallowed entirely.
That is a hard cliff, not a sliding scale. Track average days from date of service to submission, and treat anything past 60 as an escalation.
7. Claim denial rate
Indiana's broker reported a 4.75 percent denial rate against 22,634 clean claims — low single digits, well below hospital norms. That is because the NEMT failure mode is documentation, not clinical coding: missing trip logs, signatures, GPS records.
8. Cost per trip
Be careful with published figures. Almost everything you will find is a reimbursement rate or state program cost, not what it costs an operator to run a trip. Mississippi's 2024 contract pays $37.55 per one-way ambulatory trip and $74.29 per advanced trip. That roughly 2-to-1 spread is the clearest public evidence that mode mix drives margin more than volume does.
Calculate your own: total operating cost divided by completed one-way trips, monthly, with fuel, insurance, maintenance, wages and software all in.
9. Days sales outstanding
Owner-operators finance payroll and fuel out of the float, so this is the number that determines whether growth is survivable. There is no published NEMT benchmark. What is documented: Indiana's broker reported an average claim lag of 15 days from service to receipt and average adjudication of 18 days — roughly a month from service to cash when everything works.
Split the metric in two. Filing lag is yours. Adjudication time is not. Only one of them is worth a meeting.
Three metrics everyone quotes and nobody can source
We went looking for defensible benchmarks on these and could not find any. Every figure traces back to software marketing with no underlying data — including, to be fair, our competitors'.
- Trips per vehicle per day. No sourced benchmark exists. The nearest hard number is the Federal Transit Administration's 1.6 passenger trips per vehicle revenue hour for demand-response service in FY2021, and that is publicly operated paratransit with a completely different cost structure.
- Deadhead percentage. No government, academic or trade-association source publishes one for NEMT.
- Driver turnover. No NEMT-specific figure. The closest proxy is APTA's transit workforce research, which found attrition concentrated early: 16 percent leave during training, 20 percent during probation, 23 percent within two years. That is public transit, not NEMT — but the shape of it is useful. Your retention problem is onboarding, not year five.
Track all three anyway. Baseline your own number, watch the trend, and ignore anyone quoting you an industry average for them.
Where to start
If you are tracking nothing today, start with two: on-time performance measured against your broker's actual window, and days from service to claim submission. The first protects your trip volume. The second protects your cash. Everything else can wait a quarter.
Bambi tracks these automatically as trips run, so the numbers come off the board rather than out of a spreadsheet someone rebuilds every Monday. See how Fleet HQ and Get Paid work, or read the complete guide to starting a NEMT business.
Sources
- Modivcare Kansas NEMT Provider Manual, May 2022
- MAS Transportation Provider Network Manual, New York, October 2023
- Health Management Associates, NEMT multi-state review, April 2025
- Indiana FSSA NEMT Report, March 2025
- Mississippi PEER Committee Report #705, October 2024
- Virginia JLARC Report 477, December 2015
- Federal Transit Administration, National Transit Summaries and Trends, FY2021
- APTA Transit Workforce Shortage Report, 2022
