05/27/2026
We recommend reading this post first to understand our costs!
Understanding Your Ambulance Bill: The Morgan County Ambulance Service understands that receiving an ambulance bill can be stressful, confusing, and frustrating.
For many people, an ambulance bill does not arrive after a normal day. It may arrive after a 911 call, a serious illness, an injury, a car crash, a hospital transfer, or one of the worst days a family may experience. We understand that. We also understand that ambulance bills can look expensive, especially when patients are already receiving bills from hospitals, physicians, specialists, labs, or insurance companies.
This post is about transparency.
We want our community to understand why ambulance services are billed, why the charges may look high, how insurance affects the final balance, and what it actually costs to maintain emergency medical services in Morgan County.
Morgan County Ambulance Service is a county-operated EMS agency under the direction of Morgan County Government. MCAS is also operated as an enterprise fund.
An enterprise fund means the ambulance service is accounted for separately and is expected to support its operations through the revenue generated by the service it provides. In plain language, MCAS is not funded the same way many other county departments are. MCAS is not supported through other revenue streams in the same manner as many general county operations. Ambulance billing is a necessary part of keeping the service staffed, equipped, trained, licensed, insured, and ready to respond.
For 2026, the approved Morgan County Ambulance Service budget is $3,090,629. That number represents the cost of operating a full emergency medical services system for Morgan County. It is not simply the cost of the ambulance ride itself. It is the cost of making sure an ambulance is available before the emergency ever happens. The 2026 MCAS budget includes major operating costs such as salaries, overtime, benefits, workers’ compensation, health insurance, medical supplies, equipment repair, fleet costs, billing services, accounting services, insurance, training, utilities, communications, capital equipment, and other required operating expenses.
Morgan County’s estimated population is 30,306 people, according to the U.S. Census Bureau QuickFacts July 1, 2025 population estimate. If the full 2026 MCAS budget of $3,090,629 were simply divided across the entire county population, the cost of maintaining ambulance service would equal approximately $101.98 per person per year, or about $8.50 per person per month.
That number is not a tax bill, and it is not a charge being sent to every resident. It is simply a way to put the cost of EMS readiness into perspective. For roughly the cost of a meal each month, Morgan County maintains an ambulance service that is expected to be ready every hour of every day for 911 calls, hospital transfers, highway emergencies, critical care needs, public events, and mutual aid requests.
That is the reality of EMS. The system has to exist before the emergency happens.
The cost of running an ambulance service includes staffing ambulances 24 hours a day, 7 days a week, 365 days a year. It includes paramedics, EMTs, supervisors, administrative support, employee wages, health insurance, retirement, workers’ compensation, payroll taxes, and other required employment costs. It includes overtime required to maintain coverage during back-to-back calls, hospital transfers, staffing shortages, high call volume, major incidents, and long-distance transports.
It also includes ambulance fleet costs, vehicle maintenance, repairs, equipment rental, fuel, tires, insurance, and future replacement planning. It includes cardiac monitors, stretchers, radios, airway equipment, oxygen equipment, suction units, pumps, medications, IV supplies, bandages, infection-control supplies, disposable medical supplies, and other patient-care equipment.
It includes training, continuing education, certifications, medical direction, licensing, compliance, quality assurance, clinical oversight, billing services, accounting services, software systems, communication systems, utilities, facility costs, and capital planning for future ambulances, medical equipment, and communication systems.
Even when an ambulance is not actively transporting a patient, the cost of readiness still exists. The crew still has to be on duty. The ambulance still has to be maintained. The equipment still has to be checked. The medications still have to be stocked. The radios still have to work. The service still has to be ready for the next emergency.
That readiness is one of the largest costs of EMS.
The charges listed on this flyer are the approved MCAS service fees. These charges may include the level of service provided, the type of call, patient-loaded mileage, and any additional required resources based on the patient’s condition or the needs of the transport.
Current MCAS fees include:
Basic Life Support: $1,250
BLS 911: $1,450
Advanced Life Support Transfer: $1,800
ALS 1 - 911: $2,000
ALS 2 - 911: $2,500
Critical Care Transport: $3,000
Agency Assist: $450
Patient Evaluation 1: $250
Mileage: $35 per patient-loaded mile
Registered Nurse: $500
Respiratory Therapist: $500
Physician: $750
Bariatric Services: $500
Records Request: $15 per request
Standby rates include:
Non-Profit Standby: $35 per attendant / hour
Community Event with Admission Fees: $35 per attendant / hour
For-Profit / Hazmat Standby: $80 per attendant / hour
It's also important for us to note that we are one of the cheapest agencies within our region of Northeastern Colorado!
One of the most important things to understand is this:
The amount billed is not always the amount paid.
When MCAS submits a bill to insurance, the bill reflects the approved charge for the ambulance service provided. The insurance company then processes the claim under that patient’s individual plan. Insurance may apply an allowable amount, deductible, co-pay, coinsurance, out-of-pocket requirement, or denial depending on the patient’s coverage.
An “allowable” amount is the amount the insurance company recognizes for that service. That amount is often much lower than the amount billed. The patient’s final responsibility depends on their insurance plan, deductible status, co-pay, coinsurance, medical necessity rules, and whether the service is covered.
MCAS does not set a patient’s deductible. MCAS does not decide a patient’s co-pay. MCAS does not decide what an insurance company allows, denies, or applies to patient responsibility. Those decisions are made by the insurance plan.
This is why two patients can receive the same ambulance service and end up with very different financial outcomes. One patient may have already met their deductible. Another may not have. One plan may cover ambulance services differently than another plan. One patient may have commercial insurance, another may have Medicare, and another may have Medicaid.
For commercial insurance, the final balance depends heavily on the individual insurance policy. Some plans have high deductibles. Some require coinsurance. Some apply ambulance services to the deductible first. Some may pay only a contracted or allowable amount. Some may leave a remaining patient responsibility after the claim has been processed.
For Medicare patients, ambulance services are covered only when Medicare coverage requirements are met. Medicare does not simply pay whatever amount is billed. Medicare applies Medicare rules, Medicare-approved amounts, deductible requirements, and coinsurance. Medicare states that after the Part B deductible is met, the patient generally pays 20% of the Medicare-approved amount for covered ambulance services.
For Medicaid patients, ambulance coverage is handled under state and federal Medicaid rules. Medicaid reimbursement is not based on the full billed charge. It is based on Medicaid coverage requirements and Medicaid payment rules. Health First Colorado states that balance billing for covered services is prohibited and that providers must accept Health First Colorado payment as payment in full for covered services.
Medicare and Medicaid are two of MCAS’s largest payer groups. That matters because these programs do not reimburse ambulance services based on the full amount billed. They reimburse based on government-set rules and fee schedules.
In simple terms, when MCAS bills one dollar, MCAS often collects far less than one dollar.
For example, using public Colorado Medicaid reimbursement information:
A BLS 911 charge is $1,450. Colorado Medicaid’s base reimbursement for BLS emergency ambulance service is approximately $330.76. That is about 23 cents for every dollar billed, before mileage or other claim-specific factors.
An ALS 1 - 911 charge is $2,000. Colorado Medicaid’s base reimbursement for ALS 1 emergency ambulance service is approximately $392.77. That is about 20 cents for every dollar billed, before mileage or other claim-specific factors.
An ALS 2 - 911 charge is $2,500. Colorado Medicaid’s base reimbursement for ALS 2 ambulance service is approximately $568.49. That is about 23 cents for every dollar billed, before mileage or other claim-specific factors.
A critical care or specialty-care-level transport charge is $3,000. Colorado Medicaid’s listed specialty care transport base rate is approximately $679.63. That is about 23 cents for every dollar billed, before mileage or other claim-specific factors.
Mileage is billed by MCAS at $35 per patient-loaded mile. Colorado Medicaid ambulance mileage reimbursement is approximately $6.51 per mile, which is about 19 cents for every dollar billed.
Medicare reimbursement is also based on a fee schedule, not the full MCAS charge. The Medicare amount can vary by level of service, loaded mileage, and whether the pickup location qualifies as urban, rural, or super-rural. Because of that, there is not one single Medicare “cents per dollar” number that applies to every ambulance bill. However, the same principle applies: Medicare reimburses based on the Medicare-approved amount, not simply the amount billed by MCAS.
Commercial insurance may reimburse differently. Some commercial plans pay more than Medicare or Medicaid, but that does not mean they pay the full billed amount. Commercial insurance may still apply deductibles, co-pays, coinsurance, out-of-network rules, medical necessity reviews, or other plan limitations. Healthcare.gov explains that patient costs may include deductibles, co-payments, coinsurance, and out-of-pocket maximums, depending on the plan.
This is one of the hardest parts of ambulance billing to explain: the charge is the approved fee for the service, but the amount actually collected depends heavily on the payer.
MCAS still has to maintain the same level of readiness regardless of the payer. The ambulance must respond the same way whether the patient has Medicare, Medicaid, commercial insurance, no insurance, or a high-deductible plan. The crew still responds. The ambulance still rolls. The equipment still has to be available. The cost of the EMS system still exists.
Morgan County remains committed to providing dependable EMS coverage to our citizens, visitors, highways, hospitals, communities, and rural areas. That includes emergency 911 response, interfacility transfers, critical care transports, public safety standbys, mutual aid requests, and daily EMS readiness across a large county.
Whether a person lives in Fort Morgan, Brush, Wiggins, Hillrose, Snyder, Weldona, Log Lane Village, Orchard, or anywhere in rural Morgan County, the expectation is the same: when someone calls 911, help needs to be available.
We know ambulance bills can be difficult to receive. We know the healthcare billing system is complicated. We know deductibles, co-pays, coinsurance, Medicare rules, Medicaid rules, allowable amounts, and insurance explanations can be confusing.
But we also believe our community deserves to understand what it takes to provide ambulance service, why those services are billed, and how those dollars help keep EMS available in Morgan County.
Ambulance billing is not about placing an unnecessary burden on patients.
It is about maintaining a county EMS system that is ready when Morgan County needs it most.
Our goal is not just to send a bill.
Our goal is to make sure that when someone calls 911, an ambulance is ready to respond.
