Carmel committee reviews ambulance capital fund rates, billing and collection practices

CARMEL, Ind. — The Finance, Utilities and Rules Committee of the Carmel Common Council on March 11 reviewed proposed changes tied to ordinance D-27-67-25 and spent the bulk of the meeting analyzing the ambulance capital fund’s fee schedule, billing and collection practices.

The discussion centered on how the city sets ambulance charges, who pays (resident vs. nonresident), how much the city is able to collect after Medicare and Medicaid reimbursements and write-offs, and whether the ambulance fund should continue to pay for capital equipment and lease debt. Joel Thacker, fire chief of the Carmel Fire Department, presented comparisons of Carmel’s 2025 rates with 2024 rates from neighboring departments and described operational and billing practices.

Why it matters: The ambulance capital fund is a self-funded revenue source tied to ambulance billing that Carmel uses for EMS supplies, equipment and some capital outlays. Committee members said they want to preserve access to emergency care for Carmel residents while making sure the fund is managed sustainably and that fees and collection practices reflect current billing realities (Medicare/Medicaid limits, third‑party collections and hospital interactions).

Thacker told the committee Carmel’s billed resident rate for a BLS 9-1-1 transport in 2025 is $656 and the nonresident rate is $856; he said those figures put Carmel “very low, compared to other rates around.” He said Carmel logged about 6,000 medical calls in 2024, of which roughly 5,000 were transports. Based on the department’s cost model, he said an average cost per…