Medicare Extends Rural Ambulance Payments and Boosts Rates by Up to 26.7% Until 2028

This bill, officially the Protecting Access to Ground Ambulance Medical Services Act of 2025, is all about keeping emergency medical services financially stable, especially in areas where it’s tough to make ends meet. Essentially, it extends the current Medicare payment rules for ground ambulance services and throws in some significant temporary payment bumps. The key takeaway is that the current payment structure, which was set to expire in October 2025, is now locked in until January 1, 2028.

The Lifeline for Rural EMS

The biggest change targets “super rural” ambulance services—those serving the most remote areas. These services often struggle because they cover huge distances with fewer calls, making them expensive to run. The bill pushes back the expiration date for their special, higher Medicare payments from October 1, 2025, to the start of 2028. But it doesn’t stop there. For services provided during that extended period (October 2025 through January 2028), Medicare is implementing a hefty 26.7 percent payment increase. If you live in a remote area, this is huge: it helps ensure the ambulance service covering your community can afford to keep its lights on and its trucks running, which translates directly into faster response times when you need them most.

A Temporary Boost for All Ambulances

It’s not just the rural folks getting a lift. The bill also extends the current payment rules for standard ground ambulance services until January 1, 2028. On top of that extension, all standard services provided during that window get two specific temporary increases: one of 4.3 percent and another of 3.4 percent. That’s a combined 7.7 percent temporary increase for every standard ground ambulance ride covered by Medicare during that two-year-plus period. For the ambulance company owner, this means better cash flow to cover rising fuel and equipment costs. For the rest of us, it means continued access to reliable service without immediate fears of service cuts.

What This Means for Your Wallet and Your Access

This legislation is a clear win for healthcare access, particularly in underserved regions. By extending and increasing these payments, the bill reduces the financial pressure on ambulance providers, which is crucial for maintaining emergency services. Think of it this way: if your elderly parent in a remote area needs emergency transport, this bill helps guarantee that service is available. The cost, however, falls on the Medicare Trust Fund, which will be paying out significantly more for these services over the next few years due to the extended and increased rates. While this is necessary to stabilize the system, it does mean the program carries a higher financial burden for the next couple of years, essentially kicking the can down the road until the January 2028 deadline when Congress will have to decide on a permanent payment structure.