BLS Transport Fees
When an emergency medical response is reported, the Seattle Fire Department responds.
Seattle Fire’s Medic One units provide advanced life support (ALS) transport for life-threatening injuries. These transports are fully funded by the voter-approved King County EMS Levy.
For non-life-threatening injuries, patients are transported to a local emergency department by a private ambulance company. The City of Seattle currently contracts with AMR for these basic life support (BLS) transports. These transports are billed to the patient’s insurance, Medicare or Medicaid.
On limited occasions, Seattle Fire may need to transport a BLS patient. While area fire departments have been able to charge for their BLS transports, Seattle Fire has not. Starting April 15, 2025, this will change.
What is changing
The Seattle City Council has authorized Seattle Fire to bill for any BLS transport the department provides, starting April 15, 2025.
A third-party billing company will send a bill to the patient’s insurance, Medicare or Medicaid. Patients without insurance can apply for financial assistance to pay their transport bill.
Use this link to visit the third-party billing service website. If you need the information in another language, please contact the Seattle Fire Department at (206) 386-1400.
No patient will be denied access to emergency medical services or transport due to inability to pay.
Questions you may have
What is a BLS transport fee?
A Basic Life Support (BLS) transport fee is a charge for the cost of transporting you to a hospital emergency room. It is billed to your health insurance provider. The City of Seattle contracts with AMR to provide BLS transports. On average, AMR takes approximately 40,000 patients per year in Seattle to the emergency room for a fee. On rare occasions (roughly 200 times per year), the Seattle Fire Department (SFD) will transport a BLS patient in an aid car due to operational circumstances. SFD can recover the costs of those transports by charging this new BLS transport fee.
Why is Seattle Fire Department (SFD) implementing a BLS transport fee?
Seattle is the only major city in King County or Washington state that does not currently bill for BLS transports. Billing for this service allows SFD to be reimbursed by the federal government or insurance to help recover the costs of transport.
How did Seattle develop its BLS transport fee plan?
BLS transport fees have been common in the rest of King County and Washington state for almost 20 years. The transport fee plan is modeled after existing policies used by other King County EMS providers.
How much will it cost me to receive BLS transport?
If circumstances require SFD to provide BLS transport, the fee will be $950 + $15 per mile. Fees will be applied equally to everyone receiving BLS transport services. The fee will go to whatever form of insurance you provide: private insurance, Medicare, Medicaid or any other program. Any copays will be the responsibility of the patient.
However, insurance co-pays will be waived for anyone who lives in the City of Seattle and only their insurance will be billed.
Can I choose transport with an SFD aid car instead of AMR?
No. SFD transports will only be requested by officers on scene when the nature of the incident, operational considerations, or other circumstances dictate it.
Will I still be transported if I don't have proof of insurance?
Yes, all patients will receive transport regardless of insurance status.
What if I can't pay the fee?
If you are a resident of Seattle, you will not be required to pay anything “out of pocket.”
If you are not a resident of Seattle, and you have insurance through Medicare, Medicaid or other federally funded insurance program, you will not be required to pay anything “out of pocket” either as long as you provide authorization for the department to charge the fee to the applicable insurance provider.
If you have some other form of private insurance, or no insurance at all, and you cannot afford to pay your portion of the fee, you will have access to a financial assistance policy that allows patients to pay within their means, including partial payments or even full write-offs.
How much revenue is expected to be raised by this fee?
SFD estimates that this program will generate $300,000 annually.
Do other fire departments do this?
Yes, Bellevue, Bothell, Duvall, Kirkland, Mercer Island, Renton, Shoreline and ten other King County fire agencies have EMS transport programs. Bainbridge, Bellingham, Everett, Marysville, Olympia and Tacoma and many other Washington state fire departments also charge for BLS transport.
When would this fee go into effect?
This is scheduled to begin April 15, 2025.
What will the experience be like for patients? What changes can we expect?
Patients will be asked to sign an electronic form stating they authorize billing to their insurance provider. If they cannot sign during the incident (e.g. incapacitated, under the influence), a third-party billing company will secure the information using a name and address.
No patient will be denied access to emergency medical services or transport due to inability to pay or provide proof of insurance.
Whom do I contact if I get a bill?
All necessary contact information will be included in your bill along with our financial assistance policy.