The Wake County EMS System annual budget is funded by a combination of user fees (billing for EMS service) and tax subsidy from the general fund. The purpose of user fees is strictly to recoup costs. The EMS fee structure is established by the Wake County Commissioners and is based on Medicare fee structure.
The EMS System strives to be good stewards of tax dollars with a goal of keeping subsidies around 30% or lower. The graph below shows subsidy percentage trends over the years. Growth cycles and necessary expansion account for variances from year to year.
See an overview on fee structure, how bills are determined and average out of pocket costs for patients.
See the annual budget for Wake County. Once there you can click on Emergency Medical Service in the table of contents on the left to see the EMS budget summary.