What Virginia Beach EMS Compassionate Billing Might Mean for Residents

On Dec. 10, Virginia Beach City Council approved a resolution to move forward with preparations for a compassionate EMS billing program through the 2025-26 fiscal year budget process. Preparations include a public education campaign to ensure residents are accurately informed about the program. 

Virginia Beach EMS (VBEMS) is the only locality in Hampton Roads that does not conduct EMS billing. Municipalities billing for emergency medical services is the norm – not the exception. 

Sustainable Funding 

VBEMS is a combined system of career and volunteer rescue squad members. For decades, this unique system has saved the City millions of dollars. Historically, funding for the volunteer rescue squads has come from fundraising and City contributions. VBEMS operating expenses have been provided through the City of Virginia Beach General Fund.  

Due to rising costs, rescue squads have seen expenses increase by more than 40%, and VBEMS expenses have nearly doubled in the last few years. Traditional funding sources are not enough to sustain operational costs. 

Compassionate Billing Study  

EMS Chief Jason Stroud presented to City Council on Nov. 26 findings and recommendations from a feasibility study of EMS compassionate billing commissioned by the Rescue Council. 

The study determined that billing for EMS services is possible with a goal to reduce or avoid out-of-pocket expenses to patients. The feasibility study found that billing patients’ health insurance could provide more than $14 million in annual funding for EMS and volunteer rescue squads. This estimate was based on third-party payers (insurance) — uninsured and self-pay billing was not considered. 

Compassionate Billing Basics 

• Compassionate billing aims to reduce or avoid out-of-pocket expenses to patients. Health insurance plans provide a benefit for ambulance transportation. Charges are based on the level of care provided — Basic Life Support (BLS) or Advanced Life Support (ALS) level 1 or 2. 
• EMS billing will NOT be a consideration when providing patient care. The exceptional patient care for which the City’s unique system is known will continue to be provided to Virginia Beach. No patient will ever be denied service, and every patient will be offered the same degree of care from EMS providers.  
• Billing laws require a “reasonable and customary” effort to collect fees. City Council can elect not to charge residents copays, deductible or uncovered fees. Council can also elect policy to “write-off” outstanding debt and never pursue collections. 

Next Steps 

Preparations conducted for EMS compassionate billing will not be binding unless approved by City Council when it is voted on it in May 2025. 

• Educating the Public – VBEMS and the City’s Communications Office will collaborate on a public education campaign to inform residents about the program leading up to City Council’s final consideration in May 2025. 
• Administrative – It will take six to nine months to initiate EMS billing, if and when approved. 
  • Establish process to partner with third-party billing company. 
  • Establishment of related policies and infrastructure. 
  • Application process for provider ID number(s) and billing credentials. 
• Budget Process – Staff can include EMS compassionate billing as part of FY2025-26 budget process. This includes authorizing ordinance(s), fee schedule and memorandum of understanding with Rescue Council. 

A Transparent and Inclusive Partnership 

VBEMS and Rescue Council leadership are working together to improve our unique system. Billing for ambulance transports will ensure the system continues to thrive and has sufficient funding to continue delivering exceptional prehospital care. 

Funding from compassionate billing will be used to fund pharmaceuticals, purchase ambulances and equipment, provide medical supplies, fund volunteer recruitment and retention initiatives, and ensure continuation of the Virginia Beach rescue squads. 

• View Study

EMS is an award-winning third-service agency that answers more than 53,000 calls for service annually. Through VB Rescue, EMS uses a combined career-volunteer workforce and was named a 2024 American Heart Association Mission: Lifeline Gold EMS Agency. Learn more about EMS by visiting ems.virginiabeach.gov. You can also contact Virginia Beach EMS at vbems@vbgov.com.