Ground Ambulance Rides and Potential for Surprise Billing

Congress last year enacted the “No Surprises Act,” which prohibits most surprise out-of-network bills when a patient receives out-of-network services during an emergency visit or at an in-network hospital without advance notice starting in 2022. However, the protections do not apply to ground ambulance services, and the law instead requires a federal advisory committee to study the issue and recommend options to protect patients from surprise bills.

This analysis finds that half of emergency ground ambulance rides result in an out-of-network charge for people with private health insurance, potentially leaving patients at risk of getting a surprise bill. Overall ambulances transport about 3 million privately insured patients to emergency rooms each year. Local fire and rescue departments and other government agencies account for nearly two thirds of those rides.