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Town of Boston, NY – Ambulance Fund 3% EMS Operating Revenue: Either the Patient Requiring Transport Pays or Taxpayers Pay It is a common misconception that ambulance transportation is a free and essential public service in which the cost is completely covered by local taxes, like police or fire. The reality is that EMS agencies generally rely on four different revenue sources to cover operation costs. The four sources are: Patient Fees & Local Taxes Grants Donations Insurance Payments When transported to a hospital, the EMS agency can bill the patient for the service. EMS agencies cannot charge the patient more than the rate set by the local government authority. This funding model puts more of the cost of providing EMS on the actual users, instead of all taxpayers in the community. Local taxes are still required to support additional operating costs. Source: Texas EMS Alliance – The Cost of Readiness 80