Medicare Reimbursement
2025 CMS Ambulance Fee Schedule — Urban base rates averaged across payment localities
National ALS1 Emergency Average
$535.05
Highest ALS1 Emergency State
DC $613.33
Lowest ALS1 Emergency State
MS $484.65
Rate Spread
$128.68 difference
State Rates
Rank | State | ALS1 Urban | ALS1 Rural | ALS1 Super-Rural | BLS Urban | SCT Urban |
|---|---|---|---|---|---|---|
| 1 | District of Columbia | $613.33 | $619.34 | $759.31 | $322.80 | $1049.11 |
| 2 | California | $609.40 | $615.38 | $754.45 | $320.73 | $1042.39 |
| 3 | Hawaii | $597.05 | $602.91 | $739.17 | $314.24 | $1021.28 |
| 4 | New Jersey | $593.27 | $599.09 | $734.48 | $312.25 | $1014.81 |
| 5 | Washington | $589.87 | $595.64 | $730.26 | $310.45 | $1008.98 |
| 6 | Massachusetts | $589.49 | $595.26 | $729.80 | $310.25 | $1008.33 |
| 7 | New York | $587.29 | $593.05 | $727.07 | $309.10 | $1004.57 |
| 8 | Connecticut | $575.10 | $580.74 | $711.99 | $302.69 | $983.73 |
| 9 | Alaska | $571.32 | $576.92 | $707.30 | $300.69 | $977.26 |
| 10 | Colorado | $560.72 | $566.22 | $694.19 | $295.12 | $959.13 |
| 11 | Maryland | $558.45 | $563.92 | $691.37 | $293.93 | $955.24 |
| 12 | Oregon | $557.50 | $562.97 | $690.20 | $293.42 | $953.63 |
| 13 | Rhode Island | $555.42 | $560.87 | $687.63 | $292.33 | $950.07 |
| 14 | New Hampshire | $553.53 | $558.96 | $685.28 | $291.33 | $946.83 |
| 15 | Minnesota | $550.12 | $555.52 | $681.07 | $289.54 | $941.00 |
| 16 | Montana | $540.66 | $545.96 | $669.35 | $284.56 | $924.82 |
| 17 | Wyoming | $540.66 | $545.96 | $669.35 | $284.56 | $924.82 |
| 18 | South Dakota | $540.66 | $545.96 | $669.35 | $284.56 | $924.82 |
| 19 | Nevada | $540.66 | $545.96 | $669.35 | $284.56 | $924.82 |
| 20 | North Dakota | $540.66 | $545.96 | $669.35 | $284.56 | $924.82 |
| 21 | Vermont | $538.01 | $543.29 | $666.07 | $283.17 | $920.29 |
| 22 | Delaware | $537.64 | $542.91 | $665.61 | $282.97 | $919.64 |
| 23 | Pennsylvania | $536.88 | $542.14 | $664.67 | $282.57 | $918.35 |
| 24 | Texas | $536.31 | $541.57 | $663.96 | $282.27 | $917.37 |
| 25 | Florida | $536.25 | $541.50 | $663.88 | $282.24 | $917.27 |
| 26 | Virginia | $534.61 | $539.85 | $661.86 | $281.37 | $914.46 |
| 27 | Illinois | $531.30 | $536.50 | $657.75 | $279.63 | $908.79 |
| 28 | Arizona | $531.20 | $536.41 | $657.64 | $279.58 | $908.63 |
| 29 | Maine | $526.47 | $531.63 | $651.78 | $277.09 | $900.55 |
| 30 | Wisconsin | $524.39 | $529.53 | $649.20 | $275.99 | $896.98 |
| 31 | Michigan | $521.17 | $526.28 | $645.22 | $274.30 | $891.48 |
| 32 | Georgia | $517.95 | $523.04 | $641.24 | $272.61 | $885.98 |
| 33 | Utah | $515.31 | $520.36 | $637.96 | $271.21 | $881.44 |
| 34 | North Carolina | $512.66 | $517.68 | $634.68 | $269.82 | $876.91 |
| 35 | Indiana | $511.14 | $516.15 | $632.80 | $269.02 | $874.32 |
| 36 | Missouri | $510.26 | $515.26 | $631.71 | $268.56 | $872.81 |
| 37 | Nebraska | $509.25 | $514.24 | $630.46 | $268.03 | $871.09 |
| 38 | Iowa | $507.74 | $512.71 | $628.58 | $267.23 | $868.50 |
| 39 | South Carolina | $507.74 | $512.71 | $628.58 | $267.23 | $868.50 |
| 40 | Ohio | $506.98 | $511.95 | $627.65 | $266.83 | $867.20 |
| 41 | Idaho | $505.84 | $510.80 | $626.24 | $266.23 | $865.26 |
| 42 | New Mexico | $505.84 | $510.80 | $626.24 | $266.23 | $865.26 |
| 43 | Louisiana | $505.84 | $510.81 | $626.25 | $266.24 | $865.26 |
| 44 | Kansas | $505.09 | $510.04 | $625.31 | $265.84 | $863.97 |
| 45 | Tennessee | $501.30 | $506.22 | $620.63 | $263.84 | $857.49 |
| 46 | Oklahoma | $499.41 | $504.31 | $618.28 | $262.85 | $854.26 |
| 47 | Kentucky | $494.11 | $498.96 | $611.72 | $260.06 | $845.19 |
| 48 | Alabama | $491.08 | $495.90 | $607.97 | $258.47 | $840.01 |
| 49 | West Virginia | $488.44 | $493.22 | $604.69 | $257.07 | $835.48 |
| 50 | Arkansas | $487.68 | $492.46 | $603.76 | $256.67 | $834.19 |
| 51 | Mississippi | $484.65 | $489.40 | $600.00 | $255.08 | $829.01 |
Top 15 States by ALS1 Emergency
Rate Code Breakdown
A0427 ALS1 Emergency
Advanced Life Support response to 911 call
A0428 BLS Emergency
Basic Life Support response to 911 call
A0429 ALS2
ALS requiring at least 3 medications or IV
A0434 SCT
Specialty Care Transport by qualified personnel
Rates shown are urban averages across payment localities.
Rural rates are typically 1% higher. Super-rural rates include a 22.6% bonus for lowest-quartile rural areas.
Source: CMS 2025 Ambulance Fee Schedule Public Use File