File No. 34902
This rule was published in the June 15, 2011, issue (Vol. 2011, No. 12) of the Utah State Bulletin.
Health, Family Health and Preparedness, Emergency Medical Services
Emergency Medical Services Ambulance Rates and Charges
Notice of Proposed Rule
DAR File No.: 34902
Filed: 06/01/2011 06:20:44 PM
Purpose of the rule or reason for the change:
Although this rule has not been amended since 2006, the Department by order has authorized agencies to adjust rates according to the agency's fiscal data as reviewed by the Department. For the past four years, the Department has issued these orders on July 1 with the exception of one issued on January 1, 2009. Currently, the published ambulance rates in the rule are not the current rates which ambulance agencies charge. Rule R426-16 is revised to reflect the 07/01/2011 revised ambulance rates. Ambulance rates in the future will no longer be issued by an Order by the Department per meetings with the Administrative Rules Review Committee. Ambulance rates will be changed through the rulemaking process.
Summary of the rule or change:
The rule amendment will end confusion as the published ambulance rates do not match the current Ambulance Rates in Rule R426-16. Rates were adjusted annually based on factors set forth in the rule, but the new rates were not published as a rule. In the future, all rate changes will be placed in rule. Ambulance agencies no longer charge for Treat and Release, Emergency Response, and Night surcharges. Rule R426-16 needs to be amended to reflect these changes.
State statutory or constitutional authorization for this rule:
- Section 26-8a-403
Anticipated cost or savings to:
the state budget:
The state budget will not be impacted as this is a user fee.
Local government budgets will not be impacted significantly. The rates listed in the rule are increased significantly. However, the EMS agency billings increase by 6.36% from current rates to offset declining collections, wages increases, and the increased fuel and equipment costs.
The rates listed in the rule are increased significantly. However, Emergency Medical Service agencies budgets will not be impacted. The ambulance transport rate increase is 6.36% from current ambulance rates to offset declining collections, wage increases, and the increased fuel and equipment costs.
persons other than small businesses, businesses, or local governmental entities:
The rates listed in the rule are increased significantly. However, Emergency Medical Service budgets will not be impacted. The ambulance transport rate increase is 6.36% from current ambulance rates to offset declining collections, wage increases, and the increased fuel and equipment costs. This is a user fee, only patients transported by ambulance are affected.
Compliance costs for affected persons:
EMS agencies are allowed to bill the rates listed in the proposed rule and there are no costs to the agency for compliance.
Comments by the department head on the fiscal impact the rule may have on businesses:
Ambulance rates are set by this rule. The increase of 6.36% is justified by current costs documented by providers. The large change in the rates in the rule reflect a policy of changing rates without updating the rule. This policy has been stopped. Impact of the rule will be positive for regulated business.
W. David Patton, PhD, Executive Director
The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:Health
Family Health and Preparedness, Emergency Medical Services
3760 S HIGHLAND DR
SALT LAKE CITY, UT 84106
Direct questions regarding this rule to:
- Allan Liu at the above address, by phone at 801-273-6664, by FAX at 801-273-4165, or by Internet E-mail at firstname.lastname@example.org
Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:
This rule may become effective on:
David Patton, Executive Director
R426. Health, Family Health and Preparedness, Emergency Medical Services.
R426-16. Emergency Medical Services Ambulance Rates and Charges.
R426-16-1. Authority and Purpose.
(1) This rule is established under Title 26, Chapter 8a.
(2) The purpose of this rule is to provide for the establishment of maximum ambulance transportation and rates to be charged by licensed ambulance services in the State of Utah.
R426-16-2. Ambulance Transportation Rates and Charges.
(1) Licensed services operating under R426-15 shall not charge more than the rates described is this rule. In addition, the net income of licensed services, including subsidies of any type, shall not exceed the net income limit set by this rule.
(a) The net income limit shall be the greater of eight percent of gross revenue or 14 percent return on average assets.
(b) Licensed Services may change rates at their discretion after notifying the Department, provided that the rates do not exceed the maximums specified in this rule.
(c) An agency may not charge a transportation fee for patients who are not transported.
(2) The initial regulated rates
established in this rule shall be adjusted annually on July 1,
based on [
an annual review of the most recent 12 month percentage
change in price levels from the following sources: U.S. Bureau of
Labor Statistics Occupational Employment and Wage Data, the
National Consumer Pricing Index (CPI), the State of Utah
Governor's Office of Planning and Budget economic report; the
U.S. Bureau of Labor Statistics seasonally adjusted CPI for Urban
Consumers transportation and medical care categories, and the U.S.
Bureau of Labor Statistics seasonally adjusted CPI for Urban Wage
Earners and Clerical Workers transportation and medical categories.
The adjustment shall be made effective and published by order of
the Department prior to June 1 of each year and become effective
July 1, of each year. All licensed services will collect]
financial data as delineated by the department to be submitted as
detailed under R426-[ 8]-2([ 10]). This data shall then be used as the basis for the annual
(3) Base Rates
Basic] Ambulance - $[ 400.40] per transport.
Ambulance - $[
475.40] per transport.
Ambulance - $[
600.50] per transport.
(i) A basic ambulance licensee may charge a base rate of
$720.65 per transport and an intermediate ambulance licensee may
charge a base rate of $795.70 per transport if:]
(A)] a dispatch agency dispatches a paramedic licensee to
treat the individual;
(B)] the paramedic licensee has initiated advanced life
(C)] on-line medical control directs that a paramedic
remain with the patient during transport; and
(D)] [ the ambulance provider pays $210.95 to the paramedic
licensee. (ii) A]n ambulance service that interfaces with a paramedic rescue
service [ must have] an interlocal or equivalent agreement in place,
dealing with reimbursing the paramedic agency for services provided
up to [ the] maximum of $[ 210.95] per transport.
(4) Mileage Rate[
40] per mile or fraction thereof.
(b) In all cases mileage shall be computed from the point of pickup to the point of delivery.
(c) A fuel fluctuation surcharge of $0.25
per mile may be added when
fuel prices [
are more than $.31]
per gallon [ above the price of record, as established by the
Department, on the immediately prior July 1 of each year]
The Department will notify all agencies when this surcharge
(a) A surcharge of $39.75 may be assessed if the response
requires the use of emergency lights and siren. (b) A surcharge of $39.75 may be assessed for ambulance
service between the hours of 8:00 p.m. and 8:00 a.m.
(c)] If the ambulance is required to travel for ten miles or
more on unpaved roads, a surcharge of $1.50 per mile may be
(6) Special Provisions -
(a) If more than one patient is transported from the same point of origin to the same point of delivery in the same ambulance, the charges to be assessed to each individual will be determined as follows:
(i) Each patient will be assessed the transportation rate.
(ii) The [
emergency surcharge, night surcharge and] mileage
rate will be computed as specified, the sum to be divided equally
between the total number of patients.
(b) A round trip may be billed as two one-way trips.
(c) An ambulance shall provide 15 minutes of time at no charge at both point of pickup and point of delivery, and may charge $22.05 per quarter hour or fraction thereof thereafter. On round trips, 30 minutes at no charge will be allowed from the time the ambulance reaches the point of delivery until starting the return trip. At the expiration of the 30 minutes, the ambulance service may charge $22.05 per quarter hour or fraction thereof thereafter.
Treat and Release Rate - (a) An ambulance licensee may charge a treat and release
fee of $200.00 if:
(i) a dispatch agency dispatches the ambulance to provide
emergency care to an individual;
(ii) the ambulance personnel assesses or treats the
(iii) the individual does not refuse service;
(iv) the ambulance does not transport the
(b) An ambulance licensee may charge for supplies and
assess surcharges as provided R426-16-2(5) and
S]upplies shall be priced fairly and competitively with
similar products in the local area[ .]
(9)] Uncontrollable Cost Escalation -
(a) In the event of a temporary escalation
of costs, an ambulance service may petition the [
for permission to make a temporary
service-specific surcharge. The petition shall specify the amount
of the proposed surcharge, the reason for the surcharge, and
provide sufficient financial data to clearly demonstrate the need
for the proposed surcharge. Since this is intended to only provide
temporary relief, the petition shall also include a recommended
The petition shall be submitted to the Department, which
shall within 30 days, notify the ambulance service of the date and
time of the next EMS Committee meeting and the disposition of the
petition. Prior to the EMS Committee meeting, the Department shall
evaluate the petition for reasonableness and prepare a written
response for consideration by the EMS Committee. The EMS Committee
may reject, modify or adopt the proposed surcharge as a proposed
rule and direct the Department to submit a notice of rule change to
the Division of Administrative Rules in accordance with the
Rulemaking Act. The public comment period shall include a public
The licensed service shall file with the Department
five months] of the end of each licensed service's fiscal
year, an operating report in accordance with the instructions,
guidelines and review criteria as specified
in the EMS Committee's "Department of Health
Uniform Licensed Service Fiscal Reporting Guide"].
The Department shall provide a summary of operating reports
received during the previous state fiscal year to the EMS Committee
in the October quarterly meeting[ , beginning 2001].
(11)] Fiscal audits
(a) Upon receipt of licensed service
fiscal reports, the Department shall review them for compliance to
standards established [
in the "Department of Health Uniform Licensed Service
Fiscal Reporting Guide." The Department, or its
representative, may audit licensed services to verify the
information given in the report].
(b) Where the Department determines that the audited service is not in compliance with this rule, the Department shall proceed in accordance with Section 26-8a-504.
R426-16-3. Penalty for Violation of Rule.
Any person who violates any provision of this rule may be
assessed a penalty as provided in Section 26-23-6.]
KEY: emergency medical services
Date of Enactment or Last Substantive Amendment: [
March 15, 2010]
Notice of Continuation: July 28, 2009
Authorizing, and Implemented or Interpreted Law: 26-8a
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For questions regarding the content or application of this rule, please contact Allan Liu at the above address, by phone at 801-273-6664, by FAX at 801-273-4165, or by Internet E-mail at email@example.com.