EMS Billing
The Emergency Medical Services (EMS) Division's Medical Intensive Care Ambulances are supplied with state-of-the-art equipment and are essentially an emergency room on wheels. An established city ordinance requires EMS services be billed directly to the patient. This ordinance helps to ensure the availability of special services, such as EMS, by making them self-sustaining.
A bill for EMS is typically mailed to the patient's home within one week of the date of service. Payment instructions are included on the bill.
Payments can be made by check or with a major credit card. For billing-related questions, please contact the EMS Billing Department.
Accepted payment methods include:
- Visa
- Mastercard
- American Express
- Discover
Insurance Claims
The EMS billing department can assist with filing insurance claims, including Medicare, Medicaid, and private insurers.
To request the filing of a claim, complete an:
Insurance Request Form(PDF, 11KB)
Mail or fax the form to the SAFD Billing Contact.
The EMS billing department will then submit the claim to the appropriate carrier. Insurance carriers typically take up to 60 days to process a claim.
In cases of partial coverage, the EMS billing department will send an adjusted bill to the patient for any remaining balance.
Medicare or Medicaid
For Medicare or Medicaid claims, coverage for ambulance services follows the government's guidelines:
"Ambulance transportation is a covered service when the patient's condition is such that the use of any other method of transportation would endanger the patient's health. A patient whose condition permits transport in any type of vehicle other than an ambulance would not qualify for coverage. The payment for ambulance transportation depends on the patient's condition at the time of service, regardless of the patient's diagnosis or other reason for transport. Medicare only covers ambulance transports. If the ambulance crew does not transport the patient but only renders aid, this is a non-covered service. The patient will be liable for payment of the service."
For more information, review the Medicare Coverage of Ambulance Services.
Private or Commercial Insurers
For private or commercial insurers, the City of San Antonio is not a contracted provider for any HMO's or PPO's. It is up to the insurance carrier to decide if ambulance services will be covered.
Fees
The fees for EMS services are set by the City Council and can change each year. In general:
- The average charge for transporting a patient by ambulance is a little over $1,500.
- There is also a charge for EMS personnel performing a medical assessment, even if the patient isn’t transported to a facility. This non-transport charge averages a little over $100.
NOTE: This list of fees is subject to change and may vary based on specific circumstances or updates from the City Council.
EMS Services
Effective as of October 1, 2024
Cost per patient:
| Service |
Fee |
| Patient transport requiring basic life support emergency medical services |
$1,500 + $12 per mile |
| Patient transport requiring advanced life support Level I emergency medical services |
$1,500 + $12 per mile |
| Patient transport requiring advanced life support Level II emergency medical services |
$1,500 + $12 per mile |
| Transport fee surcharge for each nonresident patient |
$100 |
| Non-transport emergency medical services call |
$100 |
| Transportation of a deceased person to the morgue |
$70 |
The transport fee surcharge for each nonresident patient applies to any person who:
- does not permanently reside within San Antonio city limits, or
- resides within an adjoining incorporated city which does not have a contract with the City of San Antonio to provide emergency medical services.
EMS Supplies & Medications
Cost for each use:
| Item |
Fee |
| Adenosine |
$50 |
| Air Splint |
$10 |
| Albuterol |
$5 |
| Amiodarone |
$170 |
| Analgesic Medication |
$10 |
| Argyle Salem Sump Tube |
$10 |
| Atropine |
$5 |
| Bag-Valve-Mask |
$10 |
| Bandaging |
$10 |
| Blanket |
$3 |
| CPAP Mask & Valve |
$40 |
| Dextrose |
$5 |
| Diazepam |
$175 |
| Diltiazem (Cardizem) |
$3 |
| Diphenhydramine (Benadryl) |
$3 |
| Dopamine drip |
$15 |
| EKG |
$35 |
| Endotracheal Tubes |
$15 |
| Epinephrine |
$5 |
| ET tube checker |
$15 |
| EZ IO Needle |
$125 |
| Flex Guide ET Tube Intro |
$10 |
| Glucagon |
$100 |
| Hemostatic agents |
$30 |
| Immobilization |
$20 |
| IV supplies |
$10 |
| King Tube |
$40 |
| Laryngoscope Blade |
$5 |
| Levophed |
$10 |
| Lidocaine |
$5 |
| Magnesium sulfate |
$3 |
| Methylprednisolone (Solu-Medrol) |
$5 |
| Mucosal Atomization Device |
$5 |
| Naloxone |
$10 |
| Nitroglycerin drip |
$15 |
| Nitroglycerin spray |
$20 |
| Normal Saline |
$5 |
| Olanzapine (Zyprexa) |
$20 |
| Olanzapine (Zyprexa) (IV/IM) |
$40 |
| Ondansetron (Zofran) |
$3 |
| Oxygen |
$15 |
| Pelvic Binders |
$50 |
| Tourniquet |
$25 |
| Vasopressin |
$5 |
Compliments or Complaints
Customer compliments, complaints, or other inquiries related to the provision of EMS services should be directed to the EMS Administrative Offices at 210-207-7525 between the hours of 8 a.m. and 4:30 p.m.