Cost analysis for CPT A0426 — Ambulance service, advanced life support, non-emergency transport, level 1 (als 1)
Average Medicare Payment
$255.66
2023 data
Total Payments (2023)
$53.8M
Services (2023)
213.0K
Price Change (2014–2023)
+23.7%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $206.68 | $68.6M | 333.4K | — |
| 2015 | $210.76 | $72.3M | 345.2K | +2.0% |
| 2016 | $209.59 | $74.2M | 356.0K | -0.6% |
| 2017 | $211.89 | $75.0M | 358.1K | +1.1% |
| 2018 | $214.64 | $74.8M | 352.9K | +1.3% |
| 2019 | $220.19 | $75.6M | 347.1K | +2.6% |
| 2020 | $224.07 | $66.9M | 301.2K | +1.8% |
| 2021 | $226.07 | $59.5M | 265.4K | +0.9% |
| 2022 | $235.32 | $51.4M | 220.6K | +4.1% |
| 2023 | $255.66 | $53.8M | 213.0K | +8.6% |
The most expensive state pays 1.3x more than the cheapest for this procedure. AK averages $309.20 vs KY at $232.46.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $309.20 | $145.6K | 471 | 4 |
| ND | $304.33 | $138.2K | 454 | 14 |
| WY | $299.12 | $76.0K | 254 | 4 |
| MT | $298.45 | $211.3K | 708 | 17 |
| CA | $287.34 | $3.2M | 11.3K | 76 |
| SD | $286.46 | $223.4K | 780 | 11 |
| CO | $281.77 | $650.9K | 2.3K | 32 |
| MN | $279.94 | $956.0K | 3.4K | 25 |
| HI | $277.80 | $170.3K | 613 | 1 |
| WA | $274.98 | $774.3K | 2.8K | 26 |
| CT | $272.63 | $534.6K | 2.0K | 11 |
| MA | $271.31 | $1.6M | 5.9K | 30 |
| NY | $269.67 | $2.3M | 8.4K | 69 |
| MD | $269.30 | $1.4M | 5.2K | 12 |
| OR | $267.60 | $434.9K | 1.6K | 26 |
| NH | $267.55 | $334.7K | 1.3K | 7 |
| NV | $264.45 | $341.7K | 1.3K | 11 |
| UT | $263.51 | $571.8K | 2.2K | 22 |
| ID | $262.37 | $213.3K | 813 | 17 |
| AZ | $262.01 | $1.2M | 4.6K | 24 |
| VT | $260.46 | $254.2K | 976 | 13 |
| NE | $257.98 | $1.5M | 5.6K | 20 |
| ME | $253.34 | $268.8K | 1.1K | 20 |
| WI | $252.40 | $1.4M | 5.4K | 47 |
| TX | $252.33 | $3.6M | 14.3K | 102 |
| VA | $251.22 | $1.5M | 5.9K | 24 |
| IL | $250.52 | $2.4M | 9.6K | 58 |
| PA | $248.17 | $2.2M | 9.0K | 92 |
| KS | $247.32 | $757.1K | 3.1K | 27 |
| IA | $246.31 | $502.0K | 2.0K | 33 |
| FL | $246.17 | $3.7M | 15.0K | 49 |
| MI | $245.21 | $1.9M | 7.6K | 61 |
| NM | $244.52 | $425.0K | 1.7K | 12 |
| MO | $242.89 | $1.3M | 5.4K | 51 |
| AR | $242.04 | $1.5M | 6.3K | 35 |
| OK | $241.70 | $1.4M | 6.0K | 46 |
| NC | $240.88 | $1.6M | 6.7K | 50 |
| IN | $238.44 | $982.6K | 4.1K | 35 |
| OH | $238.32 | $3.7M | 15.5K | 63 |
| AL | $237.37 | $972.7K | 4.1K | 50 |
| SC | $236.54 | $1.0M | 4.4K | 14 |
| TN | $235.90 | $1.5M | 6.5K | 59 |
| GA | $235.67 | $1.0M | 4.4K | 47 |
| MS | $235.12 | $640.0K | 2.7K | 16 |
| WV | $233.44 | $602.0K | 2.6K | 32 |
| LA | $233.04 | $681.9K | 2.9K | 4 |
| KY | $232.46 | $805.9K | 3.5K | 62 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Midwest Medical Transport Company Llc | Ambulance Service Provider | NE | $932.1K | 3.7K | $250.84 |
| Superior Air-Ground Ambulance Service, Inc | Ambulance Service Provider | IL | $575.3K | 2.2K | $259.74 |
| Cems Of Ohio Inc | Ambulance Service Provider | OH | $542.9K | 2.3K | $238.87 |
| Acadian Ambulance Service, Inc. | Ambulance Service Provider | LA | $532.0K | 2.3K | $232.43 |
| Ambitrans Medical Transport , Inc. | Ambulance Service Provider | FL | $506.5K | 2.1K | $245.54 |
| Kettering Transportation Services Llc | Ambulance Service Provider | OH | $501.5K | 2.1K | $239.02 |
| Pasco-Pinellas Hillsborough Community Health System Inc | Ambulance Service Provider | FL | $500.3K | 2.1K | $243.24 |
| Physicians Ambulance Service Inc | Ambulance Service Provider | OH | $479.2K | 2.0K | $238.06 |
| Acadian Ambulance Service Of Texas Llc | Ambulance Service Provider | TX | $478.2K | 1.9K | $247.90 |
| Champion Ems | Ambulance Service Provider | TX | $410.5K | 1.7K | $244.37 |
| Novant Health New Hanover Regional Medical Center Llc | Ambulance Service Provider | NC | $381.7K | 1.6K | $241.15 |
| Lifestar Response Of Maryland, Inc | Ambulance Service Provider | MD | $381.4K | 1.4K | $267.09 |
| Etmc Ems | Ambulance Service Provider | TX | $379.9K | 1.6K | $243.69 |
| Empress Ambulance Service Llc | Ambulance Service Provider | NY | $373.0K | 1.3K | $281.28 |
| Brewster Ambulance Service Inc. | Ambulance Service Provider | MA | $360.0K | 1.3K | $276.48 |
| Medtrust Medical Transport, Llc | Ambulance Service Provider | SC | $341.8K | 1.4K | $238.16 |
| American Medical Response Ambulance Service, Inc. | Ambulance Service Provider | CA | $322.4K | 1.1K | $284.27 |
| American Medical Response Mid-Atlantic, Inc. | Ambulance Service Provider | VA | $317.5K | 1.3K | $252.59 |
| Mobile Medical Response Inc | Ambulance Service Provider | MI | $307.9K | 1.3K | $245.18 |
| Emergency Medical Services Authority | Ambulance Service Provider | OK | $291.9K | 1.3K | $233.14 |
Based on the data, CPT A0426 shows a 1.3x variation in pricing across states — relatively consistent by Medicare standards.
Costs have increased 23.7% since 2014. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.