NAICS 485991 Quarterly Industry Report
Special Needs Transportation
Comprehensive industry research for valuation professionals, business owners, buyers, and lenders
NAICS Code: 485991Sector: 48Updated: Q1 2026
About This Report
This industry report for NAICS 485991 draws on accessible transportation data from the U.S. Census Bureau[5], employment statistics from the Bureau of Labor Statistics[6], and small business lending data from the Small Business Administration[7]. Fair Market Value compiles this NAICS 485991 profile to support valuation professionals assessing non-emergency medical transport companies, paratransit operators, and accessible vehicle fleet businesses. Our research team updates this content quarterly to reflect Medicaid NEMT contract developments and regulatory changes.
Industry Snapshot
Key metrics for the special needs transportation industry.
Industry Definition & Overview
Special Needs Transportation (NAICS 485991) encompasses establishments providing non-emergency ground transportation for individuals who require accessible vehicles, mobility assistance, or medical monitoring during transit. The U.S. Census Bureau[5] classifies these operations separately from standard taxi, transit, and school bus services because the passengers served have physical, cognitive, or medical conditions requiring specialized vehicles and trained attendants.
This sector primarily serves elderly individuals, people with disabilities, and patients needing transportation to medical appointments, dialysis treatments, physical therapy sessions, and other healthcare visits. Revenue comes from Medicaid non-emergency medical transportation contracts administered by state agencies or managed care organizations, private pay arrangements, Veterans Affairs healthcare transportation, and municipal paratransit contracts that supplement ADA-mandated fixed-route transit service. Medicaid NEMT represents the largest single funding source, covering millions of trips annually for beneficiaries who lack other means of reaching medical providers.
Fleet composition includes wheelchair-accessible vans, stretcher vehicles for non-ambulatory patients, sedans for ambulatory but mobility-limited riders, and minibuses for group medical facility trips. Drivers must complete specialized training covering passenger assistance techniques, wheelchair securement procedures, and basic medical awareness. Insurance costs run substantially higher than standard transportation operations due to the vulnerable passenger population and the liability exposure associated with medical transport. Scheduling complexity is high, as trips must coordinate with appointment times, dialysis schedules, and discharge windows at healthcare facilities.
What's Included in This Industry
- Wheelchair-accessible van transportation for disabled passengers
- Non-emergency medical transportation to healthcare appointments
- Medicaid NEMT service under state agency or managed care contracts
- Dialysis patient transportation on recurring weekly schedules
- Stretcher transport for non-ambulatory patients between facilities
- Veterans Affairs medical appointment transportation
- ADA paratransit service complementing fixed-route transit
- Senior citizen transportation to nutrition sites and social services
- Group medical facility transport in accessible minibuses
- Door-through-door assisted transportation with attendant service
NAICS Classification Hierarchy
| Level | Description | Code |
|---|---|---|
| Subsector | Transit and Ground Passenger Transportation | 485 |
| Industry Group | Other Transit and Ground Passenger Transportation | 4859 |
| NAICS Industry | Other Transit and Ground Passenger Transportation | 48599 |
| National Industry | Special Needs Transportation | 485991 |
Related NAICS Codes
| Code | Description | Relationship |
|---|---|---|
| 485310 | Taxi and Ridesharing Services | Taxi and rideshare services providing general on-demand transportation, while 485991 specifically serves passengers with disabilities or medical needs requiring accessible vehicles |
| 485999 | All Other Transit and Ground Passenger Transportation | All other ground passenger transportation including airport shuttles and vanpools serving general populations rather than the medical and disability communities of 485991 |
| 485410 | School and Employee Bus Transportation | School and employee bus transportation that includes special education routes, overlapping with 485991 in serving passengers with disabilities but in a school context |
| 485113 | Bus and Other Motor Vehicle Transit Systems | Urban bus transit providing ADA-mandated paratransit as a complement to fixed routes, with some of that paratransit service contracted to 485991 operators |
| 621910 | Ambulance Services | Ambulance services providing emergency medical transportation, while 485991 covers non-emergency medical trips that do not require paramedic-level care |
| 485320 | Limousine Service | Limousine service offering premium passenger transportation focused on luxury rather than the medical accessibility and mobility assistance defining 485991 |
Geographic Concentration
Top states by share of national establishments.
| # | State | % Est. | Total Est. |
|---|---|---|---|
| 1 | California | 12.3% | 471 |
| 2 | New York | 11.5% | 440 |
| 3 | Florida | 6.1% | 234 |
| 4 | Ohio | 4.8% | 182 |
| 5 | Massachusetts | 4.3% | 166 |
| 6 | Virginia | 3.8% | 144 |
| 7 | Texas | 3.6% | 137 |
| 8 | Wisconsin | 3.5% | 132 |
| 9 | Pennsylvania | 3.3% | 127 |
| 10 | Georgia | 3.2% | 123 |
% Of Establishments
0%
12%
Source: County Business Patterns, U.S. Census Bureau[3]
SBA Lending Summary
768
Total SBA Loans
$208.9M
Total Loan Volume
$272K
Average Loan Size
9 yrs
Average Loan Term
10.05%
Average Interest Rate
9,072
Jobs Supported
Source: SBA 7(a) Program Data, U.S. Small Business Administration — FY 2025[4]
Key Insight: The Small Business Administration[7] sets the size standard for NAICS 485991 at $19 million in average annual receipts, measured over the preceding five completed fiscal years. Many special needs transportation providers are small businesses operating fleets of fewer than fifty vehicles within regional service areas. Eligible firms can access SBA 7(a) loans[8] for wheelchair-accessible vehicle purchases, lift equipment installation, and dispatch technology systems. The SBA 504 loan program[9] supports maintenance facility and office space acquisition. Federal and state contracting opportunities through Medicaid NEMT programs and VA transportation services provide steady revenue streams for qualified small operators.
Top SBA Lenders
| # | Lender | Loans | Volume | Avg Loan |
|---|---|---|---|---|
| 1 | First National Bank of Pennsylvania | 16 | $28.3M | $1.8M |
| 2 | Port 51 Lending LLC | 16 | $18.4M | $1.2M |
| 3 | The Huntington National Bank | 136 | $17.7M | $130K |
| 4 | Byline Bank | 8 | $15.9M | $2.0M |
| 5 | Newtek Bank, National Association | 16 | $15.1M | $942K |
Frequently Asked Questions
Common questions about this industry.
What types of businesses fall under NAICS 485991?
This code covers companies providing non-emergency medical transportation, wheelchair-accessible van service, paratransit operations, and assisted transportation for elderly and disabled passengers. Typical businesses include Medicaid NEMT contractors, VA medical transport providers, private accessible vehicle fleets, and municipal paratransit operators. The U.S. Census Bureau[5] separates these from general taxi and transit services based on the specialized vehicle and passenger assistance requirements.
How is special needs transportation different from ambulance service?
Special needs transportation under 485991 covers non-emergency trips where passengers need accessible vehicles or mobility assistance but not medical intervention during transport. Ambulance services under 621910 provide emergency medical care with paramedics and advanced life support equipment. The distinction hinges on whether the trip requires medical treatment en route, not on the passenger's underlying health condition.
What is the SBA size standard for NAICS 485991?
The Small Business Administration sets the size standard at $19 million in average annual receipts over five years. Most special needs transportation companies operate well below this threshold. Details are available in the SBA size standards table[10].
What NAICS codes are closely related to special needs transportation?
Related codes include 485310 for taxi services with accessible vehicles, 485113 for urban transit with ADA paratransit, 485410 for school special education transportation, 621910 for ambulance services, and 485999 for other ground passenger transportation. The medical and disability focus separates 485991 from general passenger transport codes.
What industries are connected to special needs transport operations?
Connected industries include healthcare systems generating patient transportation demand, Medicaid managed care organizations administering NEMT benefits, vehicle modification companies installing wheelchair lifts and securement equipment, and scheduling software providers building medical transport dispatch platforms. According to the Bureau of Labor Statistics[6], the broader ground passenger sector includes substantial employment in specialized accessible transportation services.
What activities are included in NAICS 485991?
Included activities cover wheelchair van transportation, non-emergency medical trips to appointments and treatments, dialysis patient transport, stretcher vehicle service, VA medical transportation, ADA paratransit operations, senior transportation to nutrition programs, and door-through-door assisted service with trained attendants. The U.S. Census Bureau[5] classifies all non-emergency ground transportation requiring accessible vehicles or passenger assistance.
Can special needs transportation companies get SBA loans?
Operators under the $19 million revenue threshold can access SBA programs for fleet and facility investment. The 7(a) program[8] supports wheelchair-accessible vehicle purchases, lift installation, and dispatch technology. Market 504 program[9] finances maintenance garages and office facilities. These programs help small operators build the fleet capacity needed to compete for Medicaid and VA transportation contracts.
Where are special needs transportation providers concentrated?
Special needs transport operations concentrate in metropolitan areas with large elderly and disabled populations and active Medicaid NEMT programs. States with higher Medicaid enrollment including New York, California, Texas, Florida, and Pennsylvania support the most providers. Rural areas face acute transportation access challenges, creating demand for long-distance medical transport in regions where healthcare facilities are widely dispersed.
Sources & References
Government datasets and editorial sources used in this report.
- [1]U.S. Bureau of Labor Statistics, Quarterly Census of Employment and Wages bls.gov
- [2]U.S. Census Bureau, Economic Census census.gov
- [3]U.S. Census Bureau, County Business Patterns census.gov
- [4]U.S. Small Business Administration, SBA 7(a) Loan Program Data data.sba.gov
- [5]U.S. Census Bureau census.gov
- [6]Bureau of Labor Statistics bls.gov
- [7]Small Business Administration sba.gov
- [8]SBA 7(a) loans sba.gov
- [9]SBA 504 loan program sba.gov
- [10]SBA size standards table sba.gov
Disclaimer
This publication has been prepared by Fair Market Value (“Fair Market Value”) for informational purposes only. It is provided on an “as-is” and “as available” basis. Fair Market Value makes no representations or warranties, express or implied, regarding the merchantability, fitness for a particular purpose, completeness, or accuracy of the data or information contained herein. This publication is not intended to be, and should not be construed as, professional financial, legal, tax, or investment advice. Users should consult with qualified professionals before making any financial or business decisions based on the information presented.
To the extent permitted by law, Fair Market Value disclaims all liability for loss or damage, direct and indirect, suffered or incurred by any person resulting from the use of, or reliance upon, the data in this publication.
Copyright © 2026 Fair Market Value. All rights reserved. All data, information, articles, graphs, and content contained in this publication are copyrighted works and Fair Market Value hereby reserves all rights. No part of this publication may be copied, reproduced, republished, uploaded to a third party, or distributed without the prior written permission of Fair Market Value.