Menu

Ambulance Fee Structure

Montgomery County Hospital District EMS Ambulance User Fees (patient billing) are in place for the purpose of recouping costs. User Fees are set by the MCHD Board of Directors, based on established Medicare rates. Even though current rates are set at 200% of the Medicare rates, the user fees still do not recoup all costs.

 

EMS ambulance billing is determined by the service provided. The following terms are used to describe service types.

  • Basic Life Support (BLS) – Medical evaluation, vital signs, bandaging, splinting, oxygen, etc.
  • Advanced Life Support (ALS) – Medications, IVs, Advanced Airway Procedures, Heart Monitoring, 12 lead EKG’s, Heart Pacing, etc.
  • ALS 1 – ALS procedure
  • ALS 2 – Multiple advanced ALS procedures
  • SCT – Specialty Care Transport – Interfacility transport of a critically injured or ill patient, care required is provided by a paramedic with additional training or other medical providers
  • Loaded Mileage – Distance of transport with the patient on board
  • Assist No Transport – Request for assistance, BLS or ALS services provided

Everyone transported to an Emergency Department (ED) receives at least BLS care. Some patients receive ALS or ALS II level care.

Not all patients we see are transported to an ED. Some patients who are not transported may still receive BLS, ALS or ALS II level of care. An Assist No Transport fee may be charged when a patient is evaluated, vital signs, supplies used and ALS or BLS procedures are performed.

 

2020-2021 Rates

Transported to a medical facility
Service Type Fee Loaded Miles
BLS ER $729.10 + $15.24/mile
ALS ER $865.80 + $15.24/mile
ALS II $1,253.12 + $15.24/mile
SCT $1,480.96 + $15.24/mile
Transported from a medical facility
Service Type Fee Loaded Miles
BLS Non-ER $455.68 + $15.24/mile
ALS Non-ER $546.82 + $15.24/mile
No Transport
Assist No

Transport

$125.00  

 

 

Out – of – Pocket Costs

In some situations insurance companies and Medicare pay some portion of the EMS bill. What remains of the bill after they have paid is the responsibility of the patient. Refer to your insurance company or Medicare for information on how much they will cover.

 

 

HCPCS DESCRIPTION DEFINITION 2018 MCHD FEE Schedule
A0434 Specialty Care Transport: Facility to Facility transport Patient on a vent, IV Pump and or requires medically necessary care more advanced than a Texas Certified Paramedic. $1,069.02
 
A0433 Advanced Life Support 2 Base Rate: Patient requires medically necessary administration of three or more medications and or defined ALS interventions. Patients are critically ill or injured. $904.56
 
A0429 Basic Life Support ER Base Rate: Emergency is defined as an immediate response to a call received thru a 911 call center. Patient required medically necessary but limited services and supplies that a Basic Emergency Medical Technician certified in Texas is allowed to perform. $526.29
 
A0428 Basic Life Support NON-ER Base Rate: No emergency response requested. Usually patient is discharged from a facility and transported home or to another facility. Patient requires limited services and supplies that a Basic Medical  Technician certified in Texas is allowed to perform. $328.94
 
A0427 Advanced Life Support ER Base Rate: Emergency is defined as an immediate response to a call received thru a 911 call center. Patient requires medically necessary supplies and services that a Emergency Medical Technician-Intermediate or EMT Paramedic certified in Texas is allowed to perform. $624.96
 
A0426 Advanced Life Support NON-ER Base Rate: No emergency response requested. Usually patient is discharged from a facility and transported home or to another facility. Patient requires medically necessary supplies and services that an EMT-Intermediate or EMT Paramedic certified in the state of Texas is allowed to perform $394.74
 
A0425 Per Mile:  The number of miles the patient is transported in the ambulance Mileage billed in tenths of a mile, from the point of pickup to the destination. $11.06
 
A0998 Assist – No Transport Defined as an immediate response to a call received thru the 911 call center. Upon arrival patient is assessed, services and supplies may have been provided but the patient refuses to be transport. $125.00