Medicare Ambulance Fee Schedule Lookup by State
Medicare does not price ambulance under the Physician Fee Schedule. It uses a separate annual file, the Ambulance Fee Schedule, which covers twelve codes and pays every transport as a base rate plus a per-mile rate. Pick a code, a state and a year below and this tool returns the Medicare-allowed amount in each of that state’s payment localities, computed from the CMS source file for 2023 through 2026. No sign-up, no daily limit.
Base rate and mileage, per locality
Source & method
- Rates: the CMS Ambulance Fee Schedule public use file for each calendar year, 2023 through 2026. Every figure on this page is read from that file, not recalculated from a formula.
- Localities and carriers: the locality number, Medicare Administrative Contractor (MAC) number and geographic index shown on each row come from the same CMS file, so any figure can be checked against the contractor’s own fee schedule.
- Formulas: the derivation shown beside each rate was verified against all 10,536 published rate cells in the four annual files. Every urban and rural amount reproduces to within one cent.
- Live tools to verify: CMS Ambulance Fee Schedule and the public use files.
One base rate, twelve codes
Every ground code shares one base
All seven ground transport codes price off a single national base rate, $284.56 in 2026. What separates basic life support from specialty care transport is a service-level multiplier, from 1.00 up to 3.25.
Geography moves the base, not the miles
The locality index adjusts 70 percent of a ground base rate, so the same code spans roughly 45 percent between the cheapest and most expensive locality. Mileage is national and does not move at all.
Pickup point sets the add-on
A ground transport takes a statutory add-on of 2 percent for an urban pickup, or 3 percent for a rural one. The ZIP code where the patient was collected decides it, never the hospital’s location.
Ground mileage = National per-mile rate × 1.02 urban or 1.03 rural · no geographic index
Air base = National base rate × ( 0.5 + 0.5 × GPCI ) · rural × 1.5 · no percentage add-on
Air mileage = National per-mile rate · rural × 1.5 · no geographic index
2026 Medicare ambulance rates, explained
What is the Medicare Ambulance Fee Schedule?
The Ambulance Fee Schedule is the national price list Medicare uses to pay for ambulance transport. It is a separate schedule from the Physician Fee Schedule and covers twelve HCPCS codes, A0425 through A0436, split between seven ground transport levels, two air transport types, and three mileage codes. The Centers for Medicare & Medicaid Services publishes it as a single public use file each December, effective the following January 1, with one row per code per Medicare payment locality. Every figure on this page is read directly from those files for calendar years 2023 through 2026.
What does Medicare pay for an ambulance in 2026?
The table below lists the 2026 national base rate for all twelve codes and the service-level multiplier applied to it. The last two columns give the real range of allowed amounts across the 109 Medicare payment localities, for an urban pickup. The base rate is identical in every locality; the entire spread comes from the geographic index applied on top of it. Mileage codes show a single figure because they carry no geographic adjustment.
| Code | Service | Level | National base | Lowest locality | Highest locality |
|---|---|---|---|---|---|
| A0428 | BLS, non-emergency | 1.00 | $284.56 | $261.60 | $380.05 |
| A0429 | BLS, emergency | 1.60 | $284.56 | $418.56 | $608.09 |
| A0426 | ALS 1, non-emergency | 1.20 | $284.56 | $313.92 | $456.07 |
| A0427 | ALS 1, emergency | 1.90 | $284.56 | $497.05 | $722.10 |
| A0433 | ALS 2 | 2.75 | $284.56 | $719.41 | $1,045.15 |
| A0434 | Specialty care transport | 3.25 | $284.56 | $850.21 | $1,235.18 |
| A0432 | Paramedic intercept, rural | 1.75 | $284.56 | $457.81 | $665.10 |
| A0425 | Ground mileage, per mile | 1.00 | $9.15 | $9.33 | $9.33 |
| A0430 | Fixed wing air, one way | 1.00 | $3,861.62 | $3,589.37 | $4,715.04 |
| A0435 | Fixed wing mileage, per mile | 1.00 | $10.96 | $10.96 | $10.96 |
| A0431 | Rotary wing air, one way | 1.00 | $4,489.71 | $4,173.19 | $5,481.94 |
| A0436 | Rotary wing mileage, per mile | 1.00 | $29.23 | $29.23 | $29.23 |
Source: CMS CY2026 Ambulance Fee Schedule public use file. Urban point of pickup, before the 2 percent sequestration reduction. Rural pickups price higher.
Why is an ambulance bill always two lines?
Medicare pays a transport as a base rate plus loaded mileage, billed as two separate lines on the same claim, and a rate quoted without its mileage is only part of the answer. A 45-mile emergency ground transport picked up in an urban New Mexico ZIP allows $437.42 for the transport itself (A0429) and $9.33 for each loaded mile (A0425), which is $419.85 of mileage, for $857.27 in total. Loaded mileage means miles with the patient on board. The tool above adds the two lines together once you enter the mileage, because that combined figure is the one a bill review actually compares against.
Why ambulance codes are missing from most Medicare lookups
Ambulance codes are present in the Physician Fee Schedule file but carry fee-schedule status X, a statutory exclusion, and no relative value units. A PFS-based tool reads that row, finds nothing to price, and returns an empty result. The code has not been retired and the tool is not broken: CMS is recording that the service is paid under a different schedule. This matters for bill review, because an empty PFS result is easy to read as confirmation that a benchmark is unavailable. It is not evidence either way. The only source that can confirm an ambulance rate is the Ambulance Fee Schedule itself.
Key terms in an ambulance fee schedule lookup
- Base rate
- The base rate is the allowance for the transport itself, separate from mileage. All ground levels are priced off one national base rate, $284.56 in 2026.
- Service-level multiplier (RVU)
- The multiplier that separates the ground service levels. Basic life support is 1.00, BLS emergency 1.60, ALS 1 emergency 1.90, ALS 2 2.75, and specialty care transport 3.25.
- Loaded mileage
- Loaded mileage is the distance travelled with the patient on board. It is billed on its own code and paid per statute mile.
- Point of pickup
- The ZIP code where the patient was collected. It decides the urban, rural, or super-rural category, and it is not the hospital’s location.
- GPCI (geographic practice cost index)
- The local cost multiplier for a Medicare locality. On ground transports it adjusts 70 percent of the base rate; on air transports it adjusts half.
- Super-rural
- A pickup ZIP in the lowest population-density quartile of rural areas. It carries an additional bonus on the ground base rate.
- Medicare-allowed amount
- The maximum Medicare recognizes for the service. Medicare pays 80 percent of it; the patient or a secondary payer owes the rest.
How bill reviewers use ambulance rates
Legal nurse consultants, billing experts, and defense attorneys use the Medicare-allowed amount to test whether an ambulance charge is reasonable. Air ambulance is one of the most disputed lines in personal injury work. The workflow is to read the base code and the mileage code off the claim. Price both under the schedule in effect on the date of service, then present the total beside the billed charge. Because the figure traces to a published CMS file, it survives cross-examination. Reviewers often pair it with usual-and-customary data, such as our NJ fee schedule and UCR lookup, or apply a percentage multiplier. For physician and professional codes on the same claim, use the Medicare rate lookup. For the full workflow from a stack of bills to a signed expert report, see the Expert Report Engine.
Medicare ambulance rates, answered
Why do ambulance codes return nothing in a Medicare fee schedule lookup?
Because most lookup tools price the Physician Fee Schedule, and ambulance is not on it. Codes A0425 through A0436 do appear in the PFS file, but as status X, a statutory exclusion, carrying no relative value units. That is CMS recording that the code exists and is paid somewhere else. Somewhere else is the Ambulance Fee Schedule, a separate annual file with its own formula. A blank result in a PFS tool is the expected answer for an ambulance code, so it neither confirms nor contradicts any rate you already have.
How does Medicare calculate an ambulance rate?
Every ground transport starts from one national base rate, $284.56 in 2026. That base is multiplied by a service-level factor CMS calls the RVU. Basic life support is 1.00, BLS emergency 1.60, ALS 1 emergency 1.90, ALS 2 2.75, and specialty care transport 3.25. The result is adjusted geographically, with the locality index applied to 70 percent of the amount and the remaining 30 percent left national, then increased by a statutory add-on of 2 percent for an urban pickup or 3 percent for a rural one. Air transport works differently: the geographic index applies to half the base rate and there is no add-on.
How much does Medicare pay for an ambulance ride in 2026?
For an emergency ground transport (A0429), the 2026 Medicare-allowed base rate runs from $418.56 in the cheapest locality to $608.09 in the most expensive, before mileage. Ground mileage adds $9.33 per loaded mile everywhere in the country. A 45-mile emergency run in New Mexico therefore allows $437.42 base plus $419.85 mileage, $857.27 in total. A rotary-wing air ambulance (A0431) allows between $4,173.19 and $5,481.94 for the transport, plus $29.23 per mile.
Does the ambulance fee schedule vary by state?
Base transport rates do, mileage rates do not. The 109 Medicare payment localities each carry their own geographic index, so an emergency ground transport spans about a 45 percent range between the cheapest and most expensive locality. Mileage is different: ground mileage is a single national figure with only the urban or rural add-on applied, and air mileage carries no geographic adjustment at all. So $9.33 per ground mile in 2026 is the same number in every state.
What is the difference between urban, rural, and super-rural pickup?
Medicare prices an ambulance run by where the patient was picked up, not where the hospital sits, and the ZIP code of that pickup point decides the category. An urban pickup carries a 2 percent add-on on ground services and a rural pickup carries 3 percent. Rural also pays a higher rate for the first 17 loaded miles, and a rural air transport pays 1.5 times the urban amount. Super-rural, meaning a pickup ZIP in the lowest population-density quartile of rural areas, carries a further bonus on the base rate.
Why is an air ambulance so much more expensive than a ground ambulance?
The schedules are built on separate base rates rather than a shared one. Ground transports all price off a $284.56 national base in 2026, while rotary-wing air prices off $4,489.71 and fixed-wing off $3,861.62. Air also applies its geographic index differently, to half the base rate rather than to 70 percent of it, and takes no urban or rural percentage add-on. The gap in the allowed amount is roughly tenfold, which is why air ambulance bills are a common subject of reasonableness review.
Can I look up ambulance rates for a past date of service?
Yes. The Year filter prices any code under the 2023, 2024, 2025, or 2026 schedule. Unlike the Physician Fee Schedule, which split 2024 into two rate periods when Congress changed the conversion factor mid-year, CMS issues one ambulance file each January and it governs that whole calendar year. Pick the year matching the bill's date of service. Pricing a 2024 transport against the 2026 file overstates the benchmark by about 5 percent, which is enough to matter in a report.