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flag North Dakota ambulance services lost $500 per patient in 2025 due to low reimbursements and high costs, leading to millions in unpaid bills.

flag North Dakota ambulance providers lost an average of $500 per patient transport in 2025, with revenue of $1,100 falling short of $1,600 in expenses, driven by high personnel costs and rising ambulance prices. flag Medicare reimbursements, which cover about 60% of calls in some areas, are far below private insurance rates, and providers aren’t paid for 17% of calls that don’t require transport. flag Nearly 2,300 billed transports resulted in $2.7 million in unpaid claims, with total unpaid bills estimated at $5.8 million statewide. flag Providers rely on tax subsidies, grants, and contracted services to stay operational, and the Legislature’s interim Emergency Response Services Committee plans to review the findings and may propose legislation in 2027.

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