The Centers for Medicare & Medicaid Services (CMS) has not published a newer nationwide state-by-state comparison of Medicaid non-emergency medical transportation (NEMT) utilization since releasing its Report to Congress analyzing 2018 through 2020 data. As a result, the report remains the most comprehensive federal source for comparing how frequently Medicaid beneficiaries use NEMT across the United States.

Rather than counting every individual trip, CMS measures annual ride days per 10,000 Medicaid beneficiaries. A ride day represents a day on which a beneficiary used NEMT services and provides a standardized way to compare utilization between states. While the data is not intended to represent real-time 2026 activity, it remains the latest nationwide benchmark available for understanding how Medicaid transportation programs differ across the country.

The Latest Nationwide CMS Comparison

According to CMS, these states recorded the highest annual Medicaid NEMT utilization based on ride days per 10,000 Medicaid beneficiaries.

For comparison, the national average was 10,441 ride days per 10,000 Medicaid beneficiaries, illustrating how significantly utilization can vary from one state to another.

Why Do Some States Record Higher NEMT Utilization?

A higher utilization rate does not necessarily mean a state has more NEMT providers or drivers. Instead, it reflects how often Medicaid beneficiaries rely on transportation to reach covered healthcare services.

Several factors can influence utilization, including the size of a state’s Medicaid population, the percentage of beneficiaries who require transportation assistance, rural versus urban geography, access to healthcare providers, managed care arrangements, and the way each Medicaid program administers transportation benefits.

CMS also notes that some differences are related to reporting methods. Certain states claim transportation costs as administrative expenses instead of medical services, meaning portions of their NEMT activity may not appear in the national utilization data.

Wisconsin’s Numbers Stand Apart

Wisconsin recorded the highest utilization in the CMS report with more than 50,000 annual ride days per 10,000 Medicaid beneficiaries, nearly five times the national average.

The report does not attribute that result to a single factor. Instead, it reflects the combined effect of the state’s Medicaid transportation program, beneficiary needs, reporting methods, and healthcare access patterns.

For transportation providers, the data demonstrates that NEMT demand can vary dramatically between states even when overall population size differs.

What This Means for NEMT Providers

State utilization data helps illustrate where Medicaid transportation has historically played a larger role in connecting beneficiaries with healthcare.

For NEMT companies and drivers, higher utilization often reflects consistent demand for transportation related to recurring medical appointments such as dialysis, behavioral health services, rehabilitation, specialist visits, primary care, and other Medicaid-covered healthcare.

At the same time, utilization data should not be viewed as a ranking of today’s business opportunities. Local provider networks, broker contracts, reimbursement structures, managed care participation, and regional healthcare needs all influence the amount of work available in a particular market.

Understanding the Data

One of the most important points in the CMS report is that these figures represent the latest nationwide federal comparison currently available, not a live ranking of NEMT activity in 2026.

Although CMS continues to publish Medicaid transportation guidance and research, it has not released a newer state-by-state utilization comparison since this Report to Congress. Until updated nationwide data becomes available, these figures remain the primary federal benchmark for comparing Medicaid NEMT utilization across states.

Frequently Asked Questions

What state had the highest Medicaid NEMT utilization?

According to the latest nationwide CMS comparison, Wisconsin recorded the highest Medicaid NEMT utilization with 50,405 annual ride days per 10,000 Medicaid beneficiaries.

What is a ride day?

CMS defines a ride day as a day when a Medicaid beneficiary used non-emergency medical transportation. A single ride day may include more than one individual trip.

Does higher utilization mean a state has more NEMT drivers?

No. Utilization measures how frequently Medicaid beneficiaries use transportation services. It does not measure the number of providers, vehicles, or drivers operating in a state.

Why do states report different utilization rates?

Differences in Medicaid program design, managed care participation, healthcare access, geography, beneficiary needs, and reporting practices all affect utilization rates.

Is this the newest nationwide CMS data?

Yes. The CMS Report to Congress remains the latest nationwide state-by-state comparison of Medicaid NEMT utilization currently available. While the report analyzes 2018 through 2020 data, CMS has not published a more recent national state utilization ranking.

The ProDriverPoint editorial team creates practical, driver focused content for rideshare, taxi, and non-emergency medical transportation professionals. Our articles cover industry news, transportation trends, regulations, business insights, and operational topics that help professional drivers stay informed and build successful careers.

Last Updated: July 14, 2026