Ambulance bills after a crash

The balance-billing protection

Since 2024, California limits what an out-of-network ground ambulance can bill a patient who has state-regulated health coverage. For health plan contracts and health insurance policies issued, amended or renewed on or after January 1, 2024, you owe the out-of-network ambulance no more than the in-network cost-sharing amount, meaning the copay, coinsurance or deductible you would have paid an in-network ambulance (Health & Safety Code § 1371.56 for health plans; Insurance Code § 10126.66 for health insurers).

The same statutes limit collection. The ambulance provider may send only the in-network cost-sharing amount to collections. It may not report you to a credit bureau or sue you for at least 12 months after the first bill, and it may not use wage garnishment or a lien on your primary residence to collect it.

If you have no insurance

A ground ambulance provider may not require an uninsured or self-pay patient to pay more than the Medi-Cal or Medicare fee-for-service amount, whichever is greater, and the same collection limits apply (Health & Safety Code § 1797.233).

Riverside County's published ambulance rates

The Riverside County EMS Agency publishes the rates approved for ambulance providers in the county. Rate sheet for fiscal year July 1, 2026 to June 30, 2027, published by the Riverside County EMS Agency. The sheet notes that rates are subject to change without notice. [source]

Mileage is charged per mile on top of the base rate, and the sheet lists other charges (such as oxygen and night calls) that we do not reproduce here because their columns could not be read reliably. The full sheet is on the EMS Agency's website.

What to do with a surprise ambulance bill

1. Don't pay the full bill right away. Check whether your plan has processed the claim and what your in-network cost-sharing amount is; your plan must tell you and the provider that amount when it pays.
2. Ask the ambulance company for an itemized bill, and compare the base rate and mileage with the county's published rates.
3. If the provider bills you more than your cost-sharing amount, write to it citing the statute above and keep a copy.
4. If your coverage is a health insurance policy, the California Department of Insurance can help: Consumer help line for insurance information and questions: 1-800-927-4357. [source]. HMO and most other health plans are regulated by the Department of Managed Health Care.
5. Keep every ambulance bill and payment record. If someone else caused the crash, the reasonable cost of the ambulance is part of your medical damages, and your health plan or Medi-Cal may later seek repayment from a settlement (see medical liens).

These protections apply to state-regulated coverage. Many large employers' self-funded plans are regulated under federal law instead; your plan documents or member services line will say which applies.

Every fact on this page links to the official source it came from. We checked each one in September 2026. Agencies change fees and procedures, so confirm with the agency before you go. How we research.