This bill ensures Medicare reimburses qualified providers for essential on-scene and support ambulance services even when patient transportation does not occur.
Becca Balint
Representative
VT
This bill, the Emergency Medical Services Reimbursement for On-Scene and Support Act, amends Medicare rules to ensure payment for certain ambulance services even when the patient is not transported. Beginning in 2026, Medicare will cover these on-scene or support services provided by qualified suppliers at a rate comparable to standard transport reimbursement.
New Medicare Rule Mandates Pay for On-Scene Ambulance Care Without Hospital Transport Starting 2026
Currently, if an ambulance crew treats you for a severe allergic reaction or stabilizes you after a fall but doesn't actually drive you to the emergency room, they often don't get paid by Medicare. The Emergency Medical Services Reimbursement for On-Scene and Support Act changes that. Starting January 1, 2026, this bill amends Section 1861(s)(7) of the Social Security Act to ensure that qualified ambulance providers are reimbursed for on-scene services even when no transportation occurs. This shift recognizes that the value of emergency medicine lies in the treatment provided by skilled paramedics and EMTs, not just the miles driven by the vehicle.
Treatment Without the Trip
Under this new provision, the payment for on-scene care must be comparable to the reimbursement rate for services that include transport. Imagine a scenario where a diabetic patient experiences a severe hypoglycemic episode. A crew arrives, administers glucose, and stabilizes the patient. If the patient recovers fully and doesn't need a hospital bed, the crew can now be compensated for that life-saving intervention. This removes the financial pressure on ambulance companies to transport every single patient to the ER just to ensure they can cover their payroll and equipment costs. It’s a practical fix for a system that previously only valued the 'ride' rather than the 'care.'
Impact on Local Services and Patients
For people living in rural areas or busy urban centers, this change could mean better availability of emergency resources. When providers are fairly compensated for on-scene work, it supports the financial health of local EMS agencies—many of which operate on razor-thin margins. For a 30-year-old managing a parent’s Medicare billing or a small-town resident relying on a volunteer-led ambulance corps, this means more sustainable local healthcare. The bill is straightforward with low vagueness, providing a clear three-year runway for implementation to ensure that billing systems and Medicare protocols are ready for the January 2026 rollout.