From the equipment costsand employee salaries to flaws in how EMS services are reimbursed, there are many factors that contribute to our high ambulance costs.
As we’ve covered before, emergency medical services (EMS) often cost more than you think. Ambulance bills can exceed $1,000 and occasionally even reach $2,000. We spoke with Scott Moore, the human resources and operational consultantat the American Ambulance Association to try to get to the bottom of why ambulances are so expensive.
Equipment and Workers Cost Money
When you receive a bill for an ambulance ride, rarely do you think about all the costs that go into the vehicle before you ever dial 9-1-1.
“People just don’t consider the costs that go into purchasing an ambulance,” says Moore. “For instance, my town just purchased a new ambulance. It was $225,000 for that vehicle. You can get ambulances cheaper than that but the average box-style ambulance costs between $125,000 to $150,000.”
It’s not just the vehicles either. Moore goes on to explain the loads of equipment and medication that need to be accounted for. Not only are these things already expensive, but they’re actually getting more costly.
Stretchers, which were only $2,500 in the 1990s, can now cost as much as $40,000. Cardiac monitors also cost around $40,000. A LUCAS compression machine, which applies better compression than any human could possibly do, has a price tag of around $15,000. Then there are the copious amount of smaller costs, like $300 for a set of EpiPens, that add up; that includes the hundreds of medications that need to be continually restocked, gas costs, and vehicle maintenance.
“Look, we can’t just say, ‘this patient needs epinephrine, lets run out and get some.’ We always need to be ready so those costs are there,” says Moore.
Aside from the equipment needs, there’s also staffing costs. According to Moore, when you need at least two field providers per ambulance working at any given time (covering all 24 hours of the day and all seven days of the week), the costs can be staggering. Including the insurance benefits provided to field workers, the average costs spent on EMS workers increase by 10 percent annually.
Medicare and Medicaid Underpay for Services
Actually getting paid for the services EMS provides is a sensitive issue, especially when it comes to reimbursements from government programs like Medicare and Medicaid.
“Reimbursements are the biggest issue facing EMS today,” Moore says. “If you look back at [Government Accountability Office] reports then you will see that they have been reimbursing at less than what it costs.”
Moore is right. A 2012 report from the Government Accountability Office (GAO) shows that average Medicare reimbursements rates for EMS are -1 percent. In other words, Medicare is paying slightly less for ambulance rides than the rides actually cost.
Medicaid pays even less, with rates as much as 40 percent lower than what Medicare pays.
As costs of EMS services continue to rise, Medicare and Medicaid rates have stagnated or even decreased.
“Reimbursement rates from Medicare and Medicaid have stayed the same or gone down every year for the past 20 years. It sounds crazy to me. It’s as if the government came in and said ‘you did some work for the federal government; we are going to pay you a little bit less than it costs to actually do the work, but that’s the way it works if you want to play in the game.’”
Insurance Companies Follow Suit
When the government underpays EMS providers, it has ripple effects – and it’s contributed greatly to why ambulances are so expensive. Insurance companies see those low reimbursement rates and cry foul when they are required to pay more.
Moore encountered this himself when he negotiated a contract with the largest insurance provider in his state.
“I tried to work with Blue Cross Blue Shield and when I was negotiating they said ‘that’s what Medicare pays. Why are you charging us more? You’re gouging us.’ And I said ‘Medicare is paying us less than it costs, you need to pay us more than that. We are entitled to cover costs.”
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It is important to note that EMS industry leaders are not solely motivated by profit margins. They are just looking to cover costs. Most ambulance workers join the field for far nobler reasons than for the money they will earn, which isn’t much. Moore actually took a pay cut when he left his job at a local grocery store to start working in EMS.
If insurance companies start paying more for EMS services, he believes they will see innumerable long-term savings.
Let’s say you need a cath lab and you decide not to take an ambulance because it’s too costly. You’ll get to the emergency room and be forced to wait for hours, all the while your heart fails. That wait time can require you to pay for costly maintenance heart medicine for the rest of your life.
“If you go through EMS, you get that cath lab right away. You’re getting treated faster and may never have the need for rehab, bypass surgery, or maintenance drugs. This is saving money – and people – down the line.”
Flaws in the Payment Model
It’s not just the amount that EMS services are paid that’s a problem. There are flaws in the entire payment model for EMS, says Moore.
For example, ambulance services are only reimbursed for the actual rides (or transports) to the emergency room (ER). However, ambulance personnel are paid an hourly rate that is independent of the number of rides they provide. This means that if there’s a day where no transports are made, EMS won’t get reimbursed to pay the ambulance personnel.
“If you don’t do transports you don’t get paid. But we don’t just call people in whenever there’s a call. We have to have people sitting there because there is an expectation that an ambulance will be by your side within a few minutes.”
Then there’s the fact that all charges are bundled together. So, if an ambulance takes someone who is under cardiac arrest to the hospital, there is no separate charge for the stretcher, for the compressor or for the cardiac monitor.
“Nobody line-item charges anyone for an ambulance. You’ll see a rate and mileage charge. That’s it.”
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Response Time Requirements Are Restraining
Many state and local government regulations set unrealistic response time requirements for EMS services to meet. Nationally, those requirements average at 8 minutes and 59 seconds. Although it seems like a good idea in theory, the requirements can have negative consequences, argues Moore.
“The truth is, 80 percent of calls are really not time-sensitive.”
For example, let’s say you have stomach pains for two days. While it’s likely that you can put up with another couple hours, you decide to call 9-1-1 instead of finding an alternative way to the hospital. According to Moore, under current contractual obligations to state and local governments, EMS must be at your door within 10 minutes. Moore considers this a huge issue that needs to change.
“We need to evolve the way we develop our response time requirements so we start saying ‘we will have someone to you shortly but they’re not going to be there within 8 minutes and 59 seconds. Based on the nature of what you told me, it sounds like it’s not acute.’”
Public Expectations Need to Change
Even if changes to protocols do occur, public expectations will continue to expect that a 9-1-1 call is followed by an ambulance at your door within minutes. Moore believes we need to better educate the public on why ambulances are so expensive in order to alter those expectations.
“The public’s expectation is that there will be someone at your door in less than 5 minutes and that is not the way it should be in many instances.”
The portrayal of emergency services in the media and on television reinforces this expectation even further, he says.
“We watch TV – where they get there and the patient survives. But most cardiac arrests do not survive; It’s just not the way it works.”
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Minimize Your Costs: Inform Yourself
While Mr. Moore and the American Ambulance Association continues to advocate for changes in legislation to help reform the EMS system in the United States and to lower the price of ambulance rides, there are things you can do as a consumer.
For one, you may be able to avoid to taking an ambulance to the ER in non-emergencies by usinga taxi or ridesharing service to go to an urgent care center that, depending on the situation, may be able to provide you with the care you need.
However, it is always best to err on the side of caution. If you are unsure of the nature of the emergency, your safest bet is to dial 911 and hop in an ambulance.
“I’ve found that people who should’ve called 911, didn’t until it was too late. People who shouldn’t have called, call too often…The real message should be to get the right response, right care, at the right time, in the right place, in the most cost effective manner.”
You should also look into what your insurance policy covers for ambulance rides and which companies they contract with.
“People know what their co-pay is for their yearly physical but no one expects to call an ambulance so one knows what their policy is,” Moore says.
There are clear advantages to staying informed on these issues. For instance, if you’re at the hospital and need to be sent to a rehab center via an ambulance, it behooves you to know which ambulance company your insurance contracts with. This way, you can request that the hospital call the right ambulance company and save yourself the headache of covering your bill out-of-pocket.
According to Moore, our best hope for EMS is continued education.
“EMS is critically important. I’ve been on calls where had we not been there, the person would not be walking the planet. But there are a lot of dynamics that the public doesn’t realize and needs to learn more about.”
FAQs
How expensive is an ambulance ride in us? ›
Without insurance, the average cost of an ambulance ride is around $1200. However, factors like ground mileage and severity of services affect the final prices of ambulance services.
What is the most expensive ambulance? ›There are a total of only seven Lykan HyperSport units in the world and cost at about 26 crores for one. The car is capable of accelerating from a standstill to a 100 kilometres per hour in just 2.8 seconds and has a claimed top speed of 400 kilometres per hour.
How much is an ambulance ride in Texas? ›...
Sec. 5-02. - Emergency service generally.
| Service | Fee |
|---|---|
| Basic Life Support (BLS) | $750 |
| Advanced Life Support (ALS) 1 | $850 |
| Advanced Life Support (ALS) 2 | $950 |
The last increase was in 2021. Back then, the price for an ambulance ride ticked up 16% from $775 to $900. The fire department's ambulance service — which costs roughly $600 million per year — handles about 70% of the city's hospital transports.
Is calling an ambulance free in USA? ›It depends on the ambulance company. Some may not charge you unless they provide transportation. Others may charge for being called to the scene, even if you aren't taken to the hospital.
Does insurance cover ambulance in us? ›Ambulances are covered when medically necessary
In general, insurance will cover the cost of an ambulance when it is determined to be medically necessary. In those cases, insurance companies will consider the cost of an ambulance ride in the same manner as they would any other medical expense after a car accident.
The cost can be nothing out-of-pocket in cities where services are covered by taxes, but usually ranges from less than $400 to $1,200 or more plus mileage.
How much is an ambulance ride in China? ›A trip in an official ambulance costs about 500 yuan (HK$630) in Hangzhou, but the patient was charged 1,600 yuan by the fake emergency vehicle's operator, the report said.
What is the fastest ambulance? ›seconds and reach a top speed of 400kph, powered by its twin-turbocharged 780-horsepower Porsche engine. The world's fastest ambulance has set a Guinness world record. Owned by Dubai Ambulance Corporation, the Lykan HyperSport is manufactured in the UAE by W Motors and was unveiled at Expo 2020 Dubai in January.
Is it better to call an ambulance or drive to the hospital? ›All of this can happen while you are being taken to the hospital, which is why an ambulance is a better option than having someone drive you to hospital. Don't be surprised if the paramedic team drives past your nearest hospital and takes you to another.
How much do ambulance drivers make in Texas? ›
| Percentile | Salary | Location |
|---|---|---|
| 25th Percentile Ambulance Driver Salary | $31,913 | TX |
| 50th Percentile Ambulance Driver Salary | $33,202 | TX |
| 75th Percentile Ambulance Driver Salary | $36,598 | TX |
| 90th Percentile Ambulance Driver Salary | $39,691 | TX |
Is ambulance free in Singapore? If you are facing an emergency, the SCDF emergency ambulance that conveys you to a hospital will be free. However, for non-emergency cases, SCDF charges $274. For non-emergency ambulances in Singapore, you can call 1777.
How much do ambulance drivers make in New York? ›How much does an Ambulance Driver make in New York, NY? The average Ambulance Driver salary in New York, NY is $39,821 as of February 27, 2023, but the range typically falls between $38,274 and $43,895.
Does NY Medicaid cover ambulance? ›Trips are arranged at the most medically appropriate, cost-effect level of service. These include public transit, taxi/livery, ambulette, ambulance (ALS/BLS), and personal vehicle mileage reimbursement.
Do you have to pull over for an ambulance in New York? ›Drivers MUST use due care when approaching an emergency vehicle or hazard vehicle including police vehicles, fire trucks, ambulances, construction and maintenance vehicles and tow trucks. The Move Over Law applies to both sides of the roadway, not just the shoulder on the right.
Is it illegal to not call an ambulance for someone? ›Whilst there is no law that forces anyone to treat a casualty this does not mean that one can simply leave a casualty who you know is in danger. To do so may make you liable through your omission to act.
Can you refuse an ambulance in America? ›Yes, an adult can refuse an ambulance. The patient has to consent to treatment. Consent is either implied, as in the patient is unconscious, or it is expressed, as in “I have chest pain….”
Why is American healthcare so expensive? ›The United States healthcare system is complex and most costs are market driven. High, unregulated prescription drug costs and healthcare providers' salaries rank higher than in other western nations, and hospital care accounts for 31% of the nation's healthcare costs.
Does Florida Blue cover ambulance? ›Ambulance Ground ambulance services must be Medically Network Non-Network 100% of Allowed Amt 100% of Covered Charge 100% of Allowed Amt after CYD 100% of Covered Charge after CYD Necessary to transport a patient: (1) from a Hospital unable to provide care to the nearest Hospital that can provide the Medically ...
How much does an ambulance ride cost in Minnesota? ›By contrast, patients in California, Massachusetts and Minnesota can expect to pay over $1,000 out of pocket for an ambulance ride, after whatever costs their insurance provider covers. In California, the median bill for an ambulance ride is about $1,200, while in Massachusetts it's $1,024 and $1,133 in Minnesota.
What is Medicare Part B? ›
Part B (Medical Insurance): Helps cover: Services from doctors and other health care providers. Outpatient care. Home health care. Durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment)
How much is an ambulance in Canada? ›$250 if a patient is not transported, or. $385 if a patient is transported.
How much does an ambulance cost in Los Angeles? ›The rate for a private ambulance response for a call with basic equipment and personnel is now $1,305, and a response to a call requiring a paramedic ambulance is $1,852.
How much does an ambulance weigh? ›Weight Guides
Type I ambulance – 10,001 to 14,000 pounds. Type I AD (additional duty) ambulance – 14,001 pounds or more. Type II ambulance – 9,201 to 10,000 pounds.
It is important to note that using an ambulance in Japan is free of charge, even for international visitors. Therefore should you require emergency medical assistance or should someone call an ambulance on your behalf, don't hesitate to use it. You won't be charged.
Does China have Emts? ›Currently the Chinese EMS system is divided into three parts: prehospital emergency services, emergency departments, and intensive care units. Prehospital emergency services include ambulance services and prehospital care funded primarily by provincial and city bureaus of public health.
Is ambulance free in China? ›Under the new pricing standard, patients can be charged up to 50 yuan ($7.70) for being transported by ambulance for up to 3 kilometers, and 7 yuan for every kilometer after that. If an ambulance is called but not required, 50 yuan must be paid.
How many ambulances died in 911? ›Ultimately, 8 EMS providers and 343 firefighters died that day and countless more have succumbed to 9/11-related illnesses from their time working at Ground Zero.
Can ambulances go past the speed limit? ›What is the speed limit for an ambulance? An ambulance has to obey the same traffic laws (including speed limits) as other vehicles unless it is an emergency situation. In an emergency an ambulance gets dispensation from obeying certain traffic laws including the speed limit.
Is Japan ambulance free? ›In Japan, transportation of patients by ambulance is free, but fees are charged for the costs of care.
Does an ambulance get you seen quicker? ›
Calling an ambulance does NOT get you seen faster in the emergency room. You will be triaged like other patients and seen in the order the emergency room can assist you based off the needs of other patients. FOR TRUE MEDICAL EMERGENCIES, please call 9-1-1.
What do you say to get seen faster in an emergency room? ›As your friend did, you can always try to drop a big name, like say you're friends with the president of the hospital. In general, if they think you're a VIP (even if you're not), you'll definitely get seen more quickly. ...
Should you call an uber instead of an ambulance? ›Similarly, Uber commented, “Uber is not a substitute for law enforcement of medical professionals. In the event of any medical emergency, we always encourage people to call 911.” In certain circumstances, the professionals I interviewed agreed: It's perfectly reasonable to call a ride instead of dialing 911.
Can paramedics make six figures? ›Yes, paramedics make good money.
Paramedics working in Hawaii or Washington, for example, average around $56,000 a year, while those working in West Virginia, Alabama, and Kentucky average around $30,000 a year. Top ten highest-paying states for paramedics in 2021: Hawaii average paramedic salary: $56,610 a year.
How Much Does a Paramedic Make? Paramedics made a median salary of $46,770 in 2021. The best-paid 25% made $58,810 that year, while the lowest-paid 25% made $37,120.
Are paramedics highly paid? ›The average salary for Paramedic is £36,305 per year in the London. The average additional cash compensation for a Paramedic in the London is £5,441, with a range from £1,449 - £20,436. Salaries estimates are based on 106 salaries submitted anonymously to Glassdoor by Paramedic employees in the London.
Is calling 995 free? ›When Should You Call an Emergency Ambulance Service? 995 is a free ambulance service? Yes, the service is free only if it is a true emergency.
What happens when you call 995? ›The public will be asked to provide pertinent information on the patient's condition when they call 995 for EMS assistance. The cooperation of the caller in providing such information during an emergency is critical for the EMS response to achieve its desired efficacy.
How much is an ambulance ride in Houston Texas? ›Houston City Council approved a $13.00-per-mile fee for ambulance service on top of the base charges already in place. It's the city's attempt to soften the financial blow it takes from people who can't afford to pay for the service.
Who is the highest paid EMT? ›- Emergency medical dispatcher.
- Emergency room technician.
- Crime scene technician.
- Health information technician.
- Firefighter.
- Physician assistant.
- Surgical technician.
- Medical technologist.
How much do ER doctors make NYC? ›
How much does a Physician - Emergency Room make in New York? The average Physician - Emergency Room salary in New York is $384,013 as of February 27, 2023, but the range typically falls between $325,128 and $431,171.
How much does a 911 operator get paid in NYC? ›Starting salary ranges from $39,329 to $45,228. Potential maximum salary of $53,251 after 3 years of service.
Do you have to pay for ambulance in NYC? ›There is a cost associated for FDNY ambulance transport based on type of services rendered.
Does Medicaid cover ER visits NYC? ›Each state has two sets of Medicaid benefits: those that are required by the federal government to be offered (mandatory) and those that the state chooses to offer on its own (optional). Emergency room care is a mandatory benefit that Medicaid covers in every state.
Who qualifies for emergency Medicaid in NY? ›To qualify, you must: Meet income requirements (have low-income). Be a NYS resident (temporary lawful residents do not have to meet the State residency requirement). All hospitals must treat you if you have a medical emergency, regardless of your ability to pay.
Is it illegal to go around an ambulance? ›Other rules about driving around emergency vehicles
Additionally, you're never allowed to pass a moving emergency vehicle while it's using its lights and siren. You may be allowed to pass one if it's parked and the emergency personnel directing traffic are waving you past the parked vehicle.
There is no regulation concerning the speed limit at which an officer can go if he or she is on call. If, however, the officer is patrolling and not responding to a call, legal speed limits and traffic rules must be obeyed.
How much is an ambulance ride in NY? ›Costs for advanced life support emergency transports, which require more highly-trained paramedics, could see similar increases. The last price increase was in 2021, when the price for an ambulance ride ticked up 16% from $775 to $900.
How much is an ambulance ride in Illinois? ›Service Fees
Mileage: $16.00 per mile. Advanced Life Support I and II: $3,717.40 plus mileage.
| Code | Description | Non-Resident Amount |
|---|---|---|
| A0426 | ALS Non-Emergency | $575 |
| A0427 | ALS Emergency | $740 |
| A0428 | BLS Non-Emergency | $415 |
| A0429 | BLS Emergency | $585 |
How much is an ambulance ride in Colorado? ›
Get flown to the hospital (air ambulance) – Average Cost $8,928. Get driven to the hospital (ground ambulance) – Average Cost $607.
How much do ambulance drivers make in Illinois? ›How much does an Ambulance Driver make in Illinois? The average Ambulance Driver salary in Illinois is $34,805 as of February 27, 2023, but the range typically falls between $33,453 and $38,366.
Do you have to pay for an ambulance? ›In a medical emergency, call 999 and ask for an ambulance. You will not have to pay to be taken to hospital in an emergency. A medical emergency is when someone is seriously ill or injured and their life is at risk. Read about when to call 999.
Are ambulance rides free in California? ›Ambulances are the safety net of the safety net; an ambulance service will never refuse to provide emergency service regardless of a patient's ability to pay.
What is the average ambulance bill in California? ›| Rank | County | Average annual expenses |
|---|---|---|
| 1 | Los Angeles | $112 million |
| 2 | Cook | $83 million |
| 3 | Harris | $57 million |
| 4 | Philadelphia | $41 million |
How much does an Ambulance Driver make in California? The average Ambulance Driver salary in California is $37,856 as of February 27, 2023, but the range typically falls between $36,385 and $41,728.
Does Medicaid cover ambulance Michigan? › Medicaid reimburses air ambulance services only when a beneficiary requires medical or surgical (not diagnostic) procedures, and their condition requires rapid transportation to a treatment facility.
Do you have to pull over for an ambulance in Michigan? ›Michigan's Emergency Vehicle Caution Law, more commonly known as the Move Over Law, requires motorists to slow down and move over for station- ary emergency vehicles with their lights activated.
How much do ambulance drivers make in Colorado? ›How much does an Ambulance Driver make in Colorado? The average Ambulance Driver salary in Colorado is $33,710 as of January 26, 2023, but the range typically falls between $32,401 and $37,159.
Does Colorado Medicaid pay for ambulance? ›Emergency ambulance service is a component of the Colorado Medicaid Medical Transportation benefit. Emergency ambulance service is available when the client's condition requires immediate medical attention.