Northampton County to increase EMS Billing Rate in new budget cycle

Northampton County EMS Director Gregory DeYoung has proposed a significant increase in ambulance service fees, citing rising operational costs and regional rate disparities. The proposal, set to be discussed at the Board of Supervisors meeting on April 22, calls for a 15% hike in service fees and a 10% increase in mileage rates, beginning May 1, 2025.

According to a comprehensive review prepared by DeYoung, the county’s current rates have fallen behind those of surrounding localities. The proposed adjustments would still keep Northampton slightly below regional averages in most service categories. For example, the rate for Basic Life Support (BLS) emergency transport would rise from $490.67 to $564.27, while Advanced Life Support Level 2 (ALS2) would increase from $819.79 to $942.76. Mileage rates would rise from $14.78 to $16.26 per mile.

The proposed increases are expected to generate an additional $12,000 in annual revenue. DeYoung also requested ongoing authority to raise fees by up to 5% annually without board approval.

A side-by-side rate comparison with localities including Accomack, Virginia Beach, and Chesapeake was included, as well as reimbursement benchmarks from Medicare and Medicaid. DeYoung’s analysis revealed that 88.4% of EMS operating costs in Northampton stem from labor, significantly above the national average of 69.4%.

Billing and call volume data show the county completed 2,124 ambulance transports in FY24, with an average net revenue of $448.41 per trip. Despite some fluctuation in recovery rates and payer mix, collection performance has improved, reaching 84.13% in early 2025.

DeYoung also identified 87 repeat patients—defined as individuals with five or more encounters in a 12-month period—who accounted for nearly a quarter of all patient contacts in FY24. Roughly 78% of these frequent users were transported to emergency departments. When questioned, DeYoung said he felt the majority had legitimate medical issues that could be managed better, either by primary care or community resources.

The adjustment will be a part of the new budget process, which is scheduled to be approved in June.