Johnson County Ambulance Director Fiona Johnson presented the department’s proposed fee schedule for fiscal year 2026 to the Board of Supervisors on July 16, describing modest, targeted adjustments after a two-year regional rate survey. Johnson said she historically applied cost-of-living increases to the fee schedule and this year included a 3.4% COLA approved by the board. She also compiled comparative data from other Iowa ambulance services, Medicaid/Medicare rate schedules, and private insurers to determine where the county’s rates sat relative to peers. Several rates were increased by modest amounts: basic life support (BLS) nonemergency rose from $575 to $600; advanced life support (ALS) nonemergency rose from $675 to $700; and BLS emergency increased from $755 to $900 to approach the regional average. Johnson said most county rates remain at or below the median among compared services; where increases were implemented, she said the county will remain below or near the regional median. Director Johnson also described a pilot of an anonymized regional survey that she shares with participants so agencies can compare rates without disclosing peers’ identities. She said ambulance billing partners supplied additional reimbursement data and that Iowa’s Medicaid and Medicare rates are generally lower than neighboring states. The proposed schedule also adds event-standby rates, holiday differentials for event coverage, and a la carte options (for example, a command-vehicle supervisor response) to cover nonstandard event needs; supervisors discussed temperature and operational concerns for field assets and confirmed their expectation that event fees should cover incremental costs. No formal vote was taken; the board indicated it would proceed with the COLA-adjusted pay plan process and directed staff to finalize the schedule for formal action. Ending: The department will finalize the written fee schedule, coordinate any follow-up questions with county billing staff, and return the fee schedule for formal approval if required.
