The medical transport industry includes services associated with ground, air, specialty care, and non-emergent transports. There are a few significant players in the market and more than 5,000 ambulance service providers in the United States. Larger companies have advantages of scale in contract negotiations, service capabilities, technology, and geographic coverage. In comparison, smaller companies can compete effectively in specific locales. Each market participants is faced with a highly regulated environment that requires legal contracts when working with hospitals and a keen understanding of coding guidelines.