The No Surprises Act (NSA), which went into effect in 2022, provides protection against surprise billing in a wide range of settings — but not for ground ambulances. Since consumers cannot choose an ambulance service when they dial 911, patients have little ability to avoid out-of-network charges. In the fall of 2023, the Advisory Committee on Ground Ambulance and Patient Billing (GAPB), a federal advisory committee created under the NSA, approved recommendations to federal policymakers on how best to protect consumers from surprise billing for emergency ground ambulance services, including interfacility transports.
Currently, 18 states have some sort of ground ambulance protections for those enrolled in fully insured plans. This interactive map summarizes state laws that offer protections from ground ambulance balance billing, including reimbursement rate guidance, public and private provider coverage, and nonemergency transport coverage.
To contact state regulators for more information regarding ground ambulance protections, please click here for agency websites. For more details on the GAPB recommendations for federal ground ambulance balance billing protections, please refer to the Centers for Medicaid and Medicare Services’ advisory committee’s webpage.