By Stacy Parker
The Virginian-Pilot
VIRGINIA BEACH, Va. — Ambulance fees generated more than $13 million in revenue last fiscal year and enabled the city’s Department of Emergency Medical Services to purchase new ambulances and hire new staff.
Jason Stroud, EMS chief, provided a look at how the “compassionate billing” program fared in its first year at last week’s City Council meeting.
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“We’ve been able to provide much-needed funding and support for our EMS department, our rescue squads, and more importantly, for the benefit of the community,” Stroud said.
The city implemented the program — which bills patients’ health insurance for ambulance transports and limited on-scene advanced life support treatments that do not result in transport — on July 1, 2025 . Virginia Beach was the only city in Hampton Roads that previously did not bill for ambulance service. The city’s 10 mostly-volunteer rescue squads had relied on city funding, donations and grants, but in recent years, were unable to keep up with the rising cost of equipment. Citywide, the squads respond to more than 53,000 calls per year.
Under the new billing program, Virginia Beach residents are not charged co-pays, deductibles or out-of-pocket expenses for ambulance transports.
Last fiscal year, 86% of patients transported in an ambulance were city residents, and the majority of all patients had insurance coverage, with 54% covered by Medicare, a federal health insurance program primarily for people 65 or older.
EMS provides several levels of life support billed at different rates. Basic care with a transport to the hospital costs $583. Insurance typical pays roughly 75%. Caps limit what can be charged to Medicaid and Medicare patients.
Patients who reside outside of the city are asked to cover the co-pay, and a financial hardship program for repayment is available. The compassionate billing program does not allow for third-party collections; outstanding debt is recorded as a loss. EMS wrote off $2.8 million of unpaid bills from ambulance fees last fiscal year.
A patient’s ability to pay is not a factor in the care received, Stroud said.
EMS billed $18.5 million dollars through June 30 , and has received $13.4 million dollars to date. The department distributed 30%, or $4.2 million, to the volunteer rescue squads.
“That enabled them to purchase much-needed equipment and supplies,” Stroud said.
The funds are helping the department pay for seven additional ambulances. Some of the money from compassionate billing is also supporting recruitment and staffing.
The department’s operating budget was $27 million for each of the last two fiscal years as well as the current fiscal year. Compassionate billing revenue is applied to the department’s cost recovery fund.
Virginia Beach Rescue Foundation, a fundraising arm for the rescue squads, received a recruitment grant. EMS was able to hire 43 additional uniformed staff and multiple support staff, develop a pharmacy program and provide advanced life support training for 39 people.
“We said for a long time it (compassionate billing) would be good,” said Councilman David Hutcheson. “Now we’ve got some extra revenue coming in.”
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