Contra Costa Fire board approves 5.71% ambulance rate increase, effective May 1

The Contra Costa County Fire Protection District board voted March 11 to adopt ordinance 2025-05, raising emergency ambulance service charges effective May 1, 2025.

Chief Richard told the board the contract formula for annual rate adjustments uses the three-year average medical consumer price index compared with average dollars received from non-public payers, and that the contract sets a minimum increase of 5% and a maximum of 9%. This year's calculation produced a 5.71% increase, which the county EMS agency approved as contract administrator. Chief Richard listed current and proposed fees: the base emergency response rate will rise from $3,029.33 to $3,202.30; the mileage rate from $73.22 to $77.40; the oxygen administration charge from $253.93 to $268.43; and the on-scene treatment-without-transport fee from $649.57 to $686.66.

Chief Richard told the board that the largest cost driver for the ambulance system is contractual payments to the district's subcontractor, American Medical Response (AMR), which account for over 80% of total system costs. He said the district is required by contract to follow the specified rate schedule and that annual increases are a routine, contract-driven process.

Board members asked how the district helps patients who cannot pay. Chief Richard described an existing compassionate care program that allows low-income patients to appeal and potentially have charges forgiven if they meet income requirements. He also noted that public payers such as Medi-Cal and Medicare are capitated and patients covered by those programs generally do not receive a balance bill from the district.

After confirming there were no public comments, the board recorded the motion ("motion by Ken, second by Diane") and approved the ordinance by a 5-0 vote. The ordinance will be effective May 1, 2025.