Operators ask this question because it decides two things at once: whether a federal agency can audit you, and whether your auto policy needs to be filed, endorsed, and sized to a federal minimum that is higher than what most Medicaid brokers ask for. Here is the test, the numbers, and what it means for your insurance.
You need a USDOT number only when a vehicle meets a size-or-seating threshold and the trip is interstate commerce. FMCSA's own registration page lists the vehicle triggers: a gross vehicle weight rating or gross combination weight rating of 10,001 pounds or more; designed or used to transport more than 8 passengers (including the driver) for compensation; or designed or used to transport more than 15 passengers (including the driver) without compensation.
Then the trip has to be interstate: between a state and a place outside that state, between two places in a state through another state, or as part of a movement that originates or terminates outside the state.
For NEMT, that last clause matters. A Medicaid member who is driven from a rural clinic to the state line and handed to another carrier is still one interstate movement. Trips that begin or end in another state (a dialysis center across the river, a VA hospital in the neighboring state) put that vehicle in interstate commerce even if it spends 95 percent of its week in-state.
A minivan, a side-entry wheelchair conversion, and most mid-size transit vans seat fewer than 9 people including the driver. On seating alone, they do not trigger federal registration.
Weight is the trap. Some full-size vans and nearly every cutaway bus carry a GVWR at or above 10,001 pounds. The number is on the door-jamb certification label, not in the sales brochure. If any vehicle in the fleet is at or above 10,001 pounds and you run an interstate trip in it, that vehicle pulls the company into FMCSA registration.
This is where NEMT operators get surprised. Broker credentialing (Modivcare, MTM, Verida and the rest) commonly asks for $1,000,000 combined single limit on auto liability. The federal minimum for a for-hire passenger carrier in interstate commerce is higher.
Under 49 CFR 387.33, the schedule of limits for for-hire motor carriers of passengers in interstate or foreign commerce is:
| Seating capacity (including driver) | Minimum public liability |
|---|---|
| 15 passengers or fewer | $1,500,000 |
| 16 passengers or more | $5,000,000 |
FMCSA's insurance filing chart shows the same figures and names the forms: a BMC-91 or BMC-91X filed by your insurer (or a BMC-82 surety bond), plus the MCS-90 endorsement attached to the policy. FMCSA will not grant operating authority until the filing is on file, and the filing has to stay current or the agency starts revocation proceedings.
A policy written at $1,000,000 cannot be filed to satisfy a $1,500,000 requirement. If you are an interstate for-hire passenger carrier, the auto policy has to be written at $1.5M from the start, and the carrier has to be one that will make the federal filing. Not every program that writes NEMT will.
Section 387.33(b) has a provision for vehicles used under an agreement with a government body funded by a 49 U.S.C. 5307, 5310 or 5311 grant, covering a transit service area in more than one state, including transportation for elderly individuals and individuals with disabilities. For those operations the minimum is the highest level required by any of the states in which the vehicle operates, and the provider must register as a for-hire passenger carrier and certify the limits. If you hold a 5310 subcontract that crosses a state line, read your agreement and check with the state transit agency.
FMCSA publishes the list of states that require a USDOT number for intrastate commercial vehicle registrants. As of the page's September 2025 update it includes California, Texas, Florida, New York, Georgia, Ohio, Pennsylvania, North Carolina, Arizona, Colorado, Michigan, Minnesota and roughly two dozen others. A state USDOT requirement does not by itself impose the federal $1.5M filing; it is a registration and safety-tracking tool. What it does mean is that your state can inspect your driver files, vehicle maintenance records and proof of insurance, and that underwriters will see your USDOT number and pull your safety data.
Your state Medicaid agency or broker contract may also set its own auto liability floor. The federal rule is the floor only when the federal rule applies.
If you are intrastate only, under 9 seats, under 10,001 pounds: no federal filing. Your auto limit is set by your broker contracts and state rules, commonly $1,000,000 CSL. Build the program around those, as described in our broker requirements guide.
If any vehicle is at or above 10,001 pounds or seats 9 or more, and you run any interstate trip: you need a USDOT number, operating authority, a $1,500,000 (or $5,000,000) filed policy with an MCS-90, and a carrier willing to e-file the BMC-91X. Tell your broker before you quote, because it changes which markets can write you.
If you are adding a cutaway bus or a route across a state line: that single change can move you from the first category to the second. Treat it like a new-business event and run it through the vehicle and driver change checklist before the vehicle goes into service.
Two more notes. The MCS-90 is a public-liability endorsement; it does not add passenger-specific coverages like abuse and molestation, which brokers still require separately. And whether or not you are federal, keep the door-jamb label photo for every vehicle in the file, because the GVWR question comes up at every audit and every renewal.
Not on seating alone, because most wheelchair vans carry fewer than 9 people including the driver. It needs one if its GVWR is 10,001 pounds or more and it runs in interstate commerce, or if your state requires a USDOT number for intrastate commercial vehicles.
For a for-hire passenger carrier in interstate commerce, 49 CFR 387.33 sets $1,500,000 for vehicles seating 15 or fewer (including the driver) and $5,000,000 for 16 or more. The policy must be filed with FMCSA on a BMC-91 or BMC-91X and carry the MCS-90 endorsement.
It satisfies the broker, and it is enough if you are not subject to federal registration. If you are an interstate for-hire passenger carrier, the federal minimum of $1,500,000 overrides the lower contract figure.
Yes. FMCSA defines interstate commerce by the nature of the movement, not the percentage of your trips. A trip that starts or ends in another state, or passes through one, is interstate.
FMCSA lists roughly three dozen, including California, Texas, Florida, New York, Georgia, Ohio and Pennsylvania. Check the current list on FMCSA's registration page, then confirm the registration steps with your state agency.
No. The MCS-90 is a public-liability endorsement for bodily injury, property damage and environmental restoration. Abuse and molestation is a separate coverage that brokers require on its own.
NEMT Insurance Pros places SAM coverage at broker-required limits, on forms we read line by line, alongside your commercial auto, general liability, and workers' comp.
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This article is general information, not legal or insurance advice. Coverage terms, exclusions, and limits vary by policy form and carrier; review your specific policy. NEMT Insurance Pros is the national non-emergency medical transportation insurance practice of Thrive Risk Management.