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Nelson County raises ambulance transport charges to 170% of Medicare allowable, effective Jan. 1
Summary
The board voted to increase county ambulance transport charges to 170% of the Medicare allowable charge, citing unchanged local rates since 2012 and projected revenue increases to support volunteer and career EMS funding.
The Nelson County Board of Supervisors voted on Jan. 14 to raise ambulance transport charges to 170% of the Medicare allowable rate, effective Jan. 1, 2025. The board adopted resolution R 2025-05 (scenario b) after staff presented revenue and collection projections.
County staff said the county's current transport rates had not changed since March 2012 and showed a significant gap between local charges and 2025 Medicare allowable amounts. The county's billing vendor provided estimated additional annual revenue under three scenarios: roughly $30,000'$99,000 depending on the percentage and net collection rate; the county and board selected the middle option.
Staff reported 1,348 trips and gross charges of about $1.2 million for January'December 2024 with net charges of $912,037 and payments received of $544,425, leaving about $347,000 in accounts receivable. The billing firm retains 5.29% of receipts for services. Staff also noted a recent data-transfer problem with trip records that has negatively affected near-term statistics but said the issue is being resolved and collections should rise as those trips mature into the billing cycle.
Board members discussed collection rates, financial-hardship waivers and protections for volunteers. Under the county's policy, volunteer EMS members and immediate household members receive administrative write-offs of amounts due after insurance. The board also directs that necessary medical transport will not be denied for inability to pay and that a hardship waiver threshold uses 200% of the U.S. HHS federal poverty guidelines.
On a roll call the board approved the resolution setting rates at 170% of the Medicare allowable. Chair Reid noted the increase will help offset budgeted EMS contributions for volunteer and career EMS agencies and that staff should re-evaluate rates periodically.
