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Muscatine council approves ambulance fee increase tied to market rates; chief says revenue will support staffing
Summary
The council approved a proposed ambulance fee schedule increase after staff recommended aligning charges with market rates; the fire chief said the change was intended to cover staffing and bring rates closer to statewide averages, with estimated additional revenue of roughly $75,000 from the billing company's conservative estimate.
The Muscatine City Council on Sept. 4 approved an update to the city’s ambulance fee schedule that raises rates after staff said the city’s charges had not been adjusted since about 2020.
Fire Chief Harmon told the council the city historically tied ambulance fees to a Blue Cross Blue Shield reimbursement rate that has not changed since 2020. “They made it a business decision that has not changed since 2020,” Harmon said. He said staff and the billing company reviewed market data and proposed a fee schedule at the lower end of that vendor’s recommended range.
Harmon said the ambulance operation is an enterprise fund and that additional revenues would be used to provide and staff emergency medical services. When asked about the revenue impact, Harmon said a conservative estimate from the billing company was about $75,000 in additional receipts. He also cautioned that the increase would not affect Medicaid or Medicare payments and that, by law, the city cannot balance-bill those payors: “By law, what we get from Medicaid and Medicare is what we get, and we cannot balance bill.”
Council member Osborne asked whether the change would create a windfall; staff responded that some years show only modest surpluses and that added revenue is likely to be used for staffing and related service costs. Harmon emphasized the need to monitor market rates annually rather than remain tied to a single payer.
Why this matters Ambulance fees fund an enterprise operation that covers staff and equipment costs. Adjusting the fee schedule affects billing practices, projected revenues for the service, and how the department plans for staffing and capital needs.
What’s next Staff will implement the revised fee schedule and continue to review rates annually. The council will receive budget updates through normal reporting channels.
Sources: Muscatine City Council meeting transcript, Sept. 4, 2025; Fire Chief Harmon remarks recorded at the meeting.
