EMS Billing Policies & Fees

The 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. EMS Fees The fees for EMS services are set by the City Council and can change each year, but in general the average charge for transporting a patient by ambulance is a little over $500. There is also a charge whenever EMS personnel are called out to do a medical assessment, even if the patient isn’t transported to a facility. This non-transport charge averages a little over $80. For more information, a detailed listing of EMS fees is provided on this page.	SAFD Billing Contact Information City of San Antonio EMS P.O. Box 158 San Antonio, TX 78291 Phone: (210) 227-7252 Fax: (210) 224-6945
The Billing Process A bill for EMS services is usually mailed to the home of the patient within one week from the date of service. Payment can be made by check or with a major credit card - VISA, Mastercard, American Express, or Discover. Payment instructions are listed on the bill. 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-English / Insurance Request Form-Spanish and mail or fax it 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. 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.” Review “Medicare Coverage of Ambulance Services” (PDF) for more information. For private or commercial insurers, the City of San Antonio is not a contracted provider for any HMO’s or PPO’s. It’s up to the insurance carrier to decide if ambulance services will be covered. For Billing Questions All questions related to billing should be directed to the EMS billing department 210.227.7252 between the hours of 8:00 AM and 5:00 PM Central Standard Time (CST). For 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 8:00 AM and 4:30 PM CST. Or use our online form to register a compliment or complaint.
Detailed Listing of EMS Fees Fees for EMS Services Fees for EMS Supplies or Medications Effective as of Oct 1, 2009 Cost per patient: Patient transport requiring Basic Life Support emergency medical services - $475.00 + $9.00 per mile. Patient transport requiring Advanced Life Support Level I emergency medical services - $510.00 + $9.00 per mile. Patient transport requiring Advanced Life Support Level II emergency medical services - $690.00 + $9.00 per mile. The transport fee + a $15 First Responder fee if applicable. The transport fee + a $100 surcharge for each nonresident patient. A nonresident is any person who does not permanently reside within San Antonio city limits, or who resides within an adjoining incorporated city which does not have a contract with the City of San Antonio to provide emergency medical services. Non-transport emergency medical services call - $80.00 Cost per each use: Albuterol - $5.00 Dextrose - $5.00 Epinephrine - $5.00 Atropine - $5.00 Naloxine - $5.00 Normal saline – $5.00 Bandaging - $10.00 Intravenous line - $10.00 Oxygen and related supplies - $10.00 Electrocardiogram monitor and related supplies - $35.00 Amiodarone - $170.00 Spinal immobilization (blocks, straps, cervical collar, and backboard) - $20.00 Bag valve unit mask - $10.00 Yellow blanket - $3.00 Air splint - $10.00 Laryngoscope blade - $5.00 EZ-Intraosseus (IO) needle - $100.00 Glucagon - $80.00
Note: Fees are subject to change without notice based on City Council actions.