​Wake County EMS ambulance User Fees (patient billing) are in place for the purpose of recouping costs. User Fees are set by the County Commissioners, based on established Medicare rates. Even though current rates are set at 150% 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 EKGs, heart pacing, etc. 
  • ALS I – ALS procedure
  • ALS II – Multiple ALS procedures
  • Loaded Miles – Distance of transport with 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. BLS No Transport fees may be charged when medical supplies are used. ALS No Transport fees may be charged when ALS procedures are performed. ALS No Transport is a single rate, regardless of whether multiple ALS procedures are performed.

Fee Structure
Per Medicare standards, Wake County EMS does not itemize bills, but instead uses the Medicare flat rate structure.

Transported to ED​ ​ ​​
​Service Type ​Fee ​Loaded
BLS​ ​$535.64 ​+ ​$11.33/mile
​ALS I ​$636.06 ​+ $11.33/mile
​ALS II ​$920.63 ​+ ​$11.33/mile
No Transport​ ​
​Service Type ​Fee
​BLS ​$150
​ALS ​$200
Average 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.

This chart shows average out-of-pocket costs for which a patient is responsible, based on who the primary payor is. These figures average all levels and types of service and do not account for multiple payors. This chart is not intended to predict your bill, but rather to show averages of all patients' costs. Your bill may vary significantly from the averages seen here.
Primary Payor ​Average cost
​Insurance ​$184
​Medicare ​$91
​Self-Pay ​$367
​Medicaid ​$0


EMS Fund
Wake County residents have the option to subscribe to the EMS Fund, which will relieve the patient of EMS bill responsibility. Learn more here.