Wake County EMS ambulance User Fees (patient billing) are in place to recoup costs. User Fees are set by the County Commissioners based on established Medicare rates. Even though current rates are 150% of Medicare rates, 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 EKGs, heart pacing, etc.
• ALS I – ALS procedure
• ALS II – Multiple ALS procedures
• Loaded Miles – Distance of transport with the patient on board
   

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

Not all patients we see are transported to an ED. Some patients who are not transported may still receive BLS, ALS I or ALS II-level care. A BLS No Transport fee may be charged when medical supplies are used. An ALS No Transport fee may be charged when ALS procedures are performed. ALS No Transport is a single rate, regardless of whether multiple ALS procedures are performed.

Wake County EMS does not itemize bills but uses the Medicare flat rate structure. The rates below are effective January 1, 2024.

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.